The expressed fear at the public forums is that health insurance companies have been using, and will continue to use to an even greater extent, predictive genetic testing to deny insurance or restrict benefits. While there is a lack of conclusive evidence that discrimination based on predictive genetic testing has decreased access to of health insurance, the perception that such a problem exists has resulted in state and proposed national legislation addressing this issue. Currently, health insurers in Michigan do not require genetic testing to obtain or renew health insurance policies. To date, this effort has not been successful. Insurance issues include not just whether individuals can obtain and retain insurance policies, but whether it is appropriate for third-party payers to make decisions about coverage and premium rates based on genetic information.
Insurance companies are concerned about adverse selection.
Health care providers are concerned about the coverage of necessary medical tests and treatments in general. Some of these purchase health insurance from one of a small group of commercial insurers that place individual applicants into a group that is experience rated. Within the group, age and other factors modify each individual's premium. Individual applicants are subject to actuarial rating and potentially higher premiums than applicants for group plans. For individuals unable or unwilling to purchase health insurance from a commercial carrier, Michigan law provides that Blue Cross Blue Shield of Michigan is the insurer of last resort and is required to make insurance available to all who apply.