SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Genetic Information Nondiscrimination Act of 2007’’. 
(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows:
Sec. 1. Short title; table of contents. 
Sec. 2. Findings. 
TITLE I—GENETIC NONDISCRIMINATION IN HEALTH INSURANCE 
Sec. 101. Amendments to Employee Retirement Income Security Act of 1974. 
Sec. 102. Amendments to the Public Health Service Act. 
Sec. 103. Amendments to the Internal Revenue Code of 1986. 
Sec. 104. Amendments to title XVIII of the Social Security Act relating to 
medigap. 
Sec. 105. Privacy and confidentiality. 
Sec. 106. Assuring coordination. 
TITLE II—PROHIBITING EMPLOYMENT DISCRIMINATION ON THE 
BASIS OF GENETIC INFORMATION 
Sec. 201. Definitions. 
Sec. 202. Employer practices. 
Sec. 203. Employment agency practices. 
Sec. 204. Labor organization practices. 
Sec. 205. Training programs. 
Sec. 206. Confidentiality of genetic information. 
Sec. 207. Remedies and enforcement. 
Sec. 208. Disparate impact. 
Sec. 209. Construction. 
Sec. 210. Medical information that is not genetic information. 
Sec. 211. Regulations. 
Sec. 212. Authorization of appropriations. 
Sec. 213. Effective date. 
TITLE III—MISCELLANEOUS PROVISIONS 
Sec. 301. Guarantee agency collection retention. 
Sec. 302. Severability.
SEC. 2. FINDINGS. 
Congress makes the following findings: 
(1) Deciphering the sequence of the human ge-
nome and other advances in genetics open major 
new opportunities for medical progress. New knowl-
edge about the genetic basis of illness will allow for 
earlier detection of illnesses, often before symptoms 
have begun. Genetic testing can allow individuals to 
take steps to reduce the likelihood that they will con-
tract a particular disorder. New knowledge about ge-
netics may allow for the development of better thera-
pies that are more effective against disease or have 
fewer side effects than current treatments. These 
advances give rise to the potential misuse of genetic 
information to discriminate in health insurance and 
employment. 
(2) The early science of genetics became the 
basis of State laws that provided for the sterilization 
of persons having presumed genetic ‘‘defects’’ such 
as mental retardation, mental disease, epilepsy, 
blindness, and hearing loss, among other conditions. 
The first sterilization law was enacted in the State 
of Indiana in 1907. By 1981, a majority of States 
adopted sterilization laws to ‘‘correct’’ apparent ge-
netic traits or tendencies. Many of these State laws 
have since been repealed, and many have been modi-
fied to include essential constitutional requirements 
of due process and equal protection. However, the 
current explosion in the science of genetics, and the 
history of sterilization laws by the States based on
early genetic science, compels Congressional action 
in this area. 
(3) Although genes are facially neutral markers, 
many genetic conditions and disorders are associated 
with particular racial and ethnic groups and gender. 
Because some genetic traits are most prevalent in 
particular groups, members of a particular group 
may be stigmatized or discriminated against as a re-
sult of that genetic information. This form of dis-
crimination was evident in the 1970s, which saw the 
advent of programs to screen and identify carriers of 
sickle cell anemia, a disease which afflicts African-
Americans. Once again, State legislatures began to 
enact discriminatory laws in the area, and in the 
early 1970s began mandating genetic screening of 
all African Americans for sickle cell anemia, leading 
to discrimination and unnecessary fear. To alleviate 
some of this stigma, Congress in 1972 passed the 
National Sickle Cell Anemia Control Act, which 
withholds Federal funding from States unless sickle 
cell testing is voluntary. 
(4) Congress has been informed of examples of 
genetic discrimination in the workplace. These in-
clude the use of pre-employment genetic screening at 
Lawrence Berkeley Laboratory, which led to a court
decision in favor of the employees in that case Nor-
man-Bloodsaw v. Lawrence Berkeley Laboratory 
(135 F.3d 1260, 1269 (9th Cir. 1998)). Congress 
clearly has a compelling public interest in relieving 
the fear of discrimination and in prohibiting its ac-
tual practice in employment and health insurance. 
(5) Federal law addressing genetic discrimina-
tion in health insurance and employment is incom-
plete in both the scope and depth of its protections. 
Moreover, while many States have enacted some type 
of genetic non-discrimination law, these laws vary 
widely with respect to their approach, application, 
and level of protection. Congress has collected sub-
stantial evidence that the American public and the 
medical community find the existing patchwork of 
State and Federal laws to be confusing and inad-
equate to protect them from discrimination. There-
fore Federal legislation establishing a national and 
uniform basic standard is necessary to fully protect 
the public from discrimination and allay their con-
cerns about the potential for discrimination, thereby 
allowing individuals to take advantage of genetic 
testing, technologies, research, and new therapies.
TITLE 
I—GENETIC 
NON-
DISCRIMINATION IN HEALTH 
INSURANCE 
SEC. 101. AMENDMENTS TO EMPLOYEE RETIREMENT IN-
COME SECURITY ACT OF 1974. 
(a) NO
DISCRIMINATION
IN
GROUP
PREMIUMS 
BASED ON GENETIC INFORMATION.—Section 702(b) of 
the Employee Retirement Income Security Act of 1974 
(29 U.S.C. 1182(b)) is amended—
(1) in paragraph (2)(A), by inserting before the 
semicolon the following: ‘‘except as provided in para-
graph (3)’’; and 
(2) by adding at the end the following: 
‘‘(3) NO
GROUP-BASED
DISCRIMINATION
ON 
BASIS OF GENETIC INFORMATION.—For purposes of 
this section, a group health plan, and a health insur-
ance issuer offering group health insurance coverage 
in connection with a group health plan, may not ad-
just premium or contribution amounts for the group 
covered under such plan on the basis of genetic in-
formation.’’. 
(b) LIMITATIONS ON GENETIC TESTING; PROHIBI-
TION ON COLLECTION OF GENETIC INFORMATION; APPLI-
CATION TO ALL PLANS.—Section 702 of the Employee
Retirement Income Security Act of 1974 (29 U.S.C. 1182) 
is amended by adding at the end the following: 
‘‘(c) GENETIC TESTING.—
‘‘(1) LIMITATION ON REQUESTING OR REQUIR-
ING GENETIC TESTING.—A group health plan, and a 
health insurance issuer offering health insurance 
coverage in connection with a group health plan, 
shall not request or require an individual or a family 
member of such individual to undergo a genetic test. 
‘‘(2) RULE OF CONSTRUCTION.—Paragraph (1) 
shall not be construed to limit the authority of a 
health care professional who is providing health care 
services to an individual to request that such indi-
vidual undergo a genetic test. 
‘‘(3) RULE OF CONSTRUCTION REGARDING PAY-
MENT.—
‘‘(A) IN GENERAL.—Nothing in paragraph 
(1) shall be construed to preclude a group 
health plan, or a health insurance issuer offer-
ing health insurance coverage in connection 
with a group health plan, from obtaining and 
using the results of a genetic test in making a 
determination regarding payment (as such term 
is defined for the purposes of applying the regu-
lations promulgated by the Secretary of Health
and Human Services under part C of title XI 
of the Social Security Act and section 264 of 
the Health Insurance Portability and Account-
ability Act of 1996, as may be revised from 
time to time) consistent with subsection (a). 
‘‘(B) LIMITATION.—For purposes of sub-
paragraph (A), a group health plan, or a health 
insurance issuer offering health insurance cov-
erage in connection with a group health plan, 
may request only the minimum amount of in-
formation necessary to accomplish the intended 
purpose. 
‘‘(4) RESEARCH EXCEPTION.—Notwithstanding 
paragraph (1), a group health plan, or a health in-
surance issuer offering health insurance coverage in 
connection with a group health plan, may request, 
but not require, that a participant or beneficiary un-
dergo a genetic test if each of the following condi-
tions is met: 
‘‘(A) The request is made, in writing, pur-
suant to research that complies with part 46 of 
title 45, Code of Federal Regulations, or equiv-
alent Federal regulations, and any applicable 
State or local law or regulations for the protec-
tion of human subjects in research.
‘‘(B) The plan or issuer clearly indicates to 
each participant or beneficiary, or in the case of 
a minor child, to the legal guardian of such 
beneficiary, to whom the request is made that—
‘‘(i) compliance with the request is 
voluntary; and 
‘‘(ii) non-compliance will have no ef-
fect on enrollment status or premium or 
contribution amounts. 
‘‘(C) No genetic information collected or 
acquired under this paragraph shall be used for 
underwriting purposes. 
‘‘(D) The plan or issuer notifies the Sec-
retary in writing that the plan or issuer is con-
ducting activities pursuant to the exception pro-
vided for under this paragraph, including a de-
scription of the activities conducted. 
‘‘(E) The plan or issuer complies with such 
other conditions as the Secretary may by regu-
lation require for activities conducted under this 
paragraph. 
‘‘(d) PROHIBITION ON COLLECTION OF GENETIC IN-
FORMATION.—
‘‘(1) IN GENERAL.—A group health plan, and a 
health insurance issuer offering health insurance
coverage in connection with a group health plan, 
shall not request, require, or purchase genetic infor-
mation for underwriting purposes (as defined in sec-
tion 733). 
‘‘(2) PROHIBITION
ON
COLLECTION
OF
GE-
NETIC
INFORMATION
PRIOR
TO
ENROLLMENT.—A 
group health plan, and a health insurance issuer of-
fering health insurance coverage in connection with 
a group health plan, shall not request, require, or 
purchase genetic information with respect to any in-
dividual prior to such individual’s enrollment under 
the plan or coverage in connection with such enroll-
ment. 
‘‘(3) INCIDENTAL
COLLECTION.—If a group 
health plan, or a health insurance issuer offering 
health insurance coverage in connection with a group 
health plan, obtains genetic information incidental to 
the requesting, requiring, or purchasing of other in-
formation concerning any individual, such request, 
requirement, or purchase shall not be considered a 
violation of paragraph (2) if such request, require-
ment, or purchase is not in violation of paragraph 
(1). 
‘‘(e) APPLICATION TO ALL PLANS.—The provisions 
of subsections (a)(1)(F), (b)(3), (c), and (d), and sub-
section (b)(1) and section 701 with respect to genetic in-
formation, shall apply to group health plans and health 
insurance issuers without regard to section 732(a).’’. 
(c) APPLICATION TO GENETIC INFORMATION OF A 
FETUS OR EMBRYO.—Such section is further amended by 
adding at the end the following: 
‘‘(f) GENETIC INFORMATION OF A FETUS OR EM-
BRYO.—Any reference in this part to genetic information 
concerning an individual or family member of an indi-
vidual shall—
‘‘(1) with respect to such an individual or fam-
ily member of an individual who is a pregnant 
woman, include genetic information of any fetus car-
ried by such pregnant woman; and 
‘‘(2) with respect to an individual or family 
member utilizing an assisted reproductive tech-
nology, include genetic information of any embryo le-
gally held by the individual or family member.’’. 
(d) DEFINITIONS.—Section 733(d) of the Employee 
Retirement Income Security Act of 1974 (29 U.S.C. 
1191b(d)) is amended by adding at the end the following: 
‘‘(5) FAMILY
MEMBER.—The term ‘family 
member’ means, with respect to an individual—
‘‘(A) a dependent (as such term is used for 
purposes of section 701(f)(2)) of such indi-
vidual, and 
‘‘(B) any other individual who is a first-de-
gree, second-degree, third-degree, or fourth-de-
gree relative of such individual or of an indi-
vidual described in subparagraph (A). 
‘‘(6) GENETIC INFORMATION.—
‘‘(A) IN GENERAL.—The term ‘genetic in-
formation’ means, with respect to any indi-
vidual, information about—
‘‘(i) such individual’s genetic tests, 
‘‘(ii) the genetic tests of family mem-
bers of such individual, and 
‘‘(iii) subject to subparagraph (D), 
the manifestation of a disease or disorder 
in family members of such individual. 
‘‘(B) INCLUSION OF GENETIC SERVICES.—
Such term includes, with respect to any indi-
vidual, any request for, or receipt of, genetic 
services (including genetic services received pur-
suant to participation in clinical research) by 
such individual or any family member of such 
individual.
‘‘(C) EXCLUSIONS.—The term ‘genetic in-
formation’ shall not include information about 
the sex or age of any individual. 
‘‘(D) APPLICATION TO FAMILY MEMBERS 
COVERED UNDER SAME PLAN.—Information de-
scribed in clause (iii) of subparagraph (A) shall 
not be treated as genetic information to the ex-
tent that such information is taken into account 
only with respect to the individual in which 
such disease or disorder is manifested and not 
as genetic information with respect to any other 
individual. 
‘‘(7) GENETIC TEST.—
‘‘(A) IN
GENERAL.—The term ‘genetic 
test’ means an analysis of human DNA, RNA, 
chromosomes, proteins, or metabolites, that de-
tects genotypes, mutations, or chromosomal 
changes. 
‘‘(B) EXCEPTIONS.—The term ‘genetic 
test’ does not mean—
‘‘(i) an analysis of proteins or metabo-
lites that does not detect genotypes, 
mutations, or chromosomal changes; or 
‘‘(ii) an analysis of proteins or me-
tabolites that is directly related to a mani-
fested disease, disorder, or pathological 
condition that could reasonably be detected 
by a health care professional with appro-
priate training and expertise in the field of 
medicine involved. 
‘‘(8) GENETIC
SERVICES.—The term ‘genetic 
services’ means—
‘‘(A) a genetic test; 
‘‘(B) genetic counseling (including obtain-
ing, interpreting, or assessing genetic informa-
tion); or 
‘‘(C) genetic education. 
‘‘(9) UNDERWRITING
PURPOSES.—The term 
‘underwriting purposes’ means, with respect to any 
group health plan, or health insurance coverage of-
fered in connection with a group health plan—
‘‘(A) rules for, or determination of, eligi-
bility (including enrollment and continued eligi-
bility) for benefits under the plan or coverage; 
‘‘(B) the computation of premium or con-
tribution amounts under the plan or coverage; 
‘‘(C) the application of any pre-existing 
condition exclusion under the plan or coverage; 
and
‘‘(D) other activities related to the cre-
ation, renewal, or replacement of a contract of 
health insurance or health benefits.’’. 
(e) ERISA ENFORCEMENT.—Section 502 of the Em-
ployee Retirement Income Security Act of 1974 (29 
U.S.C. 1132) is amended—
(1) in subsection (a)(6), by striking ‘‘(7), or 
(8)’’ and inserting ‘‘(7), (8), or (9)’’; and 
(2) in subsection (c), by redesignating para-
graph (9) as paragraph (10), and by inserting after 
paragraph (8) the following new paragraph: 
‘‘(9) SECRETARIAL ENFORCEMENT AUTHORITY 
RELATING TO USE OF GENETIC INFORMATION.—
‘‘(A) GENERAL RULE.—The Secretary may 
impose a penalty against any plan sponsor of a 
group health plan, or any health insurance 
issuer offering health insurance coverage in 
connection with the plan, for any failure by 
such sponsor or issuer to meet the requirements 
of subsection (a)(1)(F), (b)(3), (c), or (d) of 
section 702 or section 701 or 702(b)(1) with re-
spect to genetic information, in connection with 
the plan. 
‘‘(B) AMOUNT.—
‘‘(i) IN
GENERAL.—The amount of 
the penalty imposed by subparagraph (A) 
shall be $100 for each day in the non-
compliance period with respect to each par-
ticipant or beneficiary to whom such fail-
ure relates. 
‘‘(ii) NONCOMPLIANCE PERIOD.—For 
purposes of this paragraph, the term ‘non-
compliance period’ means, with respect to 
any failure, the period—
‘‘(I) beginning on the date such 
failure first occurs; and 
‘‘(II) ending on the date the fail-
ure is corrected. 
‘‘(C) MINIMUM PENALTIES WHERE FAIL-
URE DISCOVERED.—Notwithstanding clauses (i) 
and (ii) of subparagraph (D): 
‘‘(i) IN GENERAL.—In the case of 1 or 
more failures with respect to a participant 
or beneficiary—
‘‘(I) which are not corrected be-
fore the date on which the plan re-
ceives a notice from the Secretary of 
such violation; and
‘‘(II) which occurred or continued 
during the period involved; 
the amount of penalty imposed by subpara-
graph (A) by reason of such failures with 
respect to such participant or beneficiary 
shall not be less than $2,500. 
‘‘(ii) 
HIGHER
MINIMUM
PENALTY 
WHERE VIOLATIONS ARE MORE THAN DE 
MINIMIS.—To the extent violations for 
which any person is liable under this para-
graph for any year are more than de mini-
mis, clause (i) shall be applied by sub-
stituting ‘$15,000’ for ‘$2,500’ with re-
spect to such person. 
‘‘(D) LIMITATIONS.—
‘‘(i) PENALTY NOT TO APPLY WHERE 
FAILURE
NOT
DISCOVERED
EXERCISING 
REASONABLE
DILIGENCE.—No 
penalty 
shall be imposed by subparagraph (A) on 
any failure during any period for which it 
is established to the satisfaction of the 
Secretary that the person otherwise liable 
for such penalty did not know, and exer-
cising reasonable diligence would not have 
known, that such failure existed.
SEC. 102. AMENDMENTS TO THE PUBLIC HEALTH SERVICE 
ACT. 
(a) AMENDMENTS RELATING TO THE GROUP MAR-
KET.—
(1) NO DISCRIMINATION IN GROUP PREMIUMS 
BASED
ON
GENETIC
INFORMATION.—Section 
2702(b) of the Public Health Service Act (42 U.S.C. 
300gg–1(b)) is amended—
(A) in paragraph (2)(A), by inserting be-
fore the semicolon the following: ‘‘except as pro-
vided in paragraph (3)’’; and 
(B) by adding at the end the following: 
‘‘(3) NO
GROUP-BASED
DISCRIMINATION
ON 
BASIS OF GENETIC INFORMATION.—For purposes of 
this section, a group health plan, and health insur-
ance issuer offering group health insurance coverage 
in connection with a group health plan, may not ad-
just premium or contribution amounts for the group 
covered under such plan on the basis of genetic in-
formation.’’. 
(2) LIMITATIONS ON GENETIC TESTING; PROHI-
BITION ON COLLECTION OF GENETIC INFORMATION; 
APPLICATION TO ALL PLANS.—Section 2702 of the 
Public Health Service Act (42 U.S.C. 300gg–1) is 
amended by adding at the end the following: 
‘‘(c) GENETIC TESTING.—
‘‘(1) LIMITATION ON REQUESTING OR REQUIR-
ING GENETIC TESTING.—A group health plan, and a 
health insurance issuer offering health insurance 
coverage in connection with a group health plan, 
shall not request or require an individual or a family 
member of such individual to undergo a genetic test. 
‘‘(2) RULE OF CONSTRUCTION.—Paragraph (1) 
shall not be construed to limit the authority of a 
health care professional who is providing health care 
services to an individual to request that such indi-
vidual undergo a genetic test. 
‘‘(3) RULE OF CONSTRUCTION REGARDING PAY-
MENT.—
‘‘(A) IN GENERAL.—Nothing in paragraph 
(1) shall be construed to preclude a group 
health plan, or a health insurance issuer offer-
ing health insurance coverage in connection 
with a group health plan, from obtaining and 
using the results of a genetic test in making a 
determination regarding payment (as such term 
is defined for the purposes of applying the regu-
lations promulgated by the Secretary under 
part C of title XI of the Social Security Act and 
section 264 of the Health Insurance Portability 
and Accountability Act of 1996, as may be re-
vised from time to time) consistent with sub-
section (a). 
‘‘(B) LIMITATION.—For purposes of sub-
paragraph (A), a group health plan, or a health 
insurance issuer offering health insurance cov-
erage in connection with a group health plan, 
may request only the minimum amount of in-
formation necessary to accomplish the intended 
purpose. 
‘‘(4) RESEARCH EXCEPTION.—Notwithstanding 
paragraph (1), a group health plan, or a health in-
surance issuer offering health insurance coverage in 
connection with a group health plan, may request, 
but not require, that a participant or beneficiary un-
dergo a genetic test if each of the following condi-
tions is met: 
‘‘(A) The request is made pursuant to re-
search that complies with part 46 of title 45, 
Code of Federal Regulations, or equivalent Fed-
eral regulations, and any applicable State or 
local law or regulations for the protection of 
human subjects in research. 
‘‘(B) The plan or issuer clearly indicates to 
each participant or beneficiary, or in the case of
a minor child, to the legal guardian of such 
beneficiary, to whom the request is made that—
‘‘(i) compliance with the request is 
voluntary; and 
‘‘(ii) non-compliance will have no ef-
fect on enrollment status or premium or 
contribution amounts. 
‘‘(C) No genetic information collected or 
acquired under this paragraph shall be used for 
underwriting purposes. 
‘‘(D) The plan or issuer notifies the Sec-
retary in writing that the plan or issuer is con-
ducting activities pursuant to the exception pro-
vided for under this paragraph, including a de-
scription of the activities conducted. 
‘‘(E) The plan or issuer complies with such 
other conditions as the Secretary may by regu-
lation require for activities conducted under this 
paragraph. 
‘‘(d) PROHIBITION ON COLLECTION OF GENETIC IN-
FORMATION.—
‘‘(1) IN GENERAL.—A group health plan, and a 
health insurance issuer offering health insurance 
coverage in connection with a group health plan, 
shall not request, require, or purchase genetic infor-
mation for underwriting purposes (as defined in sec-
tion 2791). 
‘‘(2) PROHIBITION
ON
COLLECTION
OF
GE-
NETIC
INFORMATION
PRIOR
TO
ENROLLMENT.—A 
group health plan, and a health insurance issuer of-
fering health insurance coverage in connection with 
a group health plan, shall not request, require, or 
purchase genetic information with respect to any in-
dividual prior to such individual’s enrollment under 
the plan or coverage in connection with such enroll-
ment. 
‘‘(3) INCIDENTAL
COLLECTION.—If a group 
health plan, or a health insurance issuer offering 
health insurance coverage in connection with a group 
health plan, obtains genetic information incidental to 
the requesting, requiring, or purchasing of other in-
formation concerning any individual, such request, 
requirement, or purchase shall not be considered a 
violation of paragraph (2) if such request, require-
ment, or purchase is not in violation of paragraph 
(1). 
‘‘(e) APPLICATION TO ALL PLANS.—The provisions 
of subsections (a)(1)(F), (b)(3), (c) , and (d) and sub-
section (b)(1) and section 2701 with respect to genetic in-
formation, shall apply to group health plans and health 
insurance issuers without regard to section 2721(a).’’. 
(3) APPLICATION TO GENETIC INFORMATION OF 
A
FETUS
OR
EMBRYO.—Such section is further 
amended by adding at the end the following: 
‘‘(f) GENETIC INFORMATION OF A FETUS OR EM-
BRYO.—Any reference in this part to genetic information 
concerning an individual or family member of an indi-
vidual shall—
‘‘(1) with respect to such an individual or fam-
ily member of an individual who is a pregnant 
woman, include genetic information of any fetus car-
ried by such pregnant woman; and 
‘‘(2) with respect to an individual or family 
member utilizing an assisted reproductive tech-
nology, include genetic information of any embryo le-
gally held by the individual or family member.’’. 
(4) DEFINITIONS.—Section 2791(d) of the Pub-
lic Health Service Act (42 U.S.C. 300gg–91(d)) is 
amended by adding at the end the following: 
‘‘(15) FAMILY
MEMBER.—The term ‘family 
member’ means, with respect to any individual—
‘‘(A) a dependent (as such term is used for 
purposes of section 2701(f)(2)) of such indi-
vidual; and
‘‘(B) any other individual who is a first-de-
gree, second-degree, third-degree, or fourth-de-
gree relative of such individual or of an indi-
vidual described in subparagraph (A). 
‘‘(16) GENETIC INFORMATION.—
‘‘(A) IN GENERAL.—The term ‘genetic in-
formation’ means, with respect to any indi-
vidual, information about—
‘‘(i) such individual’s genetic tests, 
‘‘(ii) the genetic tests of family mem-
bers of such individual, and 
‘‘(iii) subject to subparagraph (D), 
the manifestation of a disease or disorder 
in family members of such individual. 
‘‘(B) INCLUSION OF GENETIC SERVICES.—
Such term includes, with respect to any indi-
vidual, any request for, or receipt of, genetic 
services (including genetic services received pur-
suant to participation in clinical research) by 
such individual or any family member of such 
individual. 
‘‘(C) EXCLUSIONS.—The term ‘genetic in-
formation’ shall not include information about 
the sex or age of any individual.
‘‘(D) APPLICATION TO FAMILY MEMBERS 
COVERED UNDER SAME PLAN.—Information de-
scribed in clause (iii) of subparagraph (A) shall 
not be treated as genetic information to the ex-
tent that such information is taken into account 
only with respect to the individual in which 
such disease or disorder is manifested and not 
as genetic information with respect to any other 
individual. 
‘‘(17) GENETIC TEST.—
‘‘(A) IN
GENERAL.—The term ‘genetic 
test’ means an analysis of human DNA, RNA, 
chromosomes, proteins, or metabolites, that de-
tects genotypes, mutations, or chromosomal 
changes. 
‘‘(B) EXCEPTIONS.—The term ‘genetic 
test’ does not mean—
‘‘(i) an analysis of proteins or metabo-
lites that does not detect genotypes, 
mutations, or chromosomal changes; or 
‘‘(ii) an analysis of proteins or me-
tabolites that is directly related to a mani-
fested disease, disorder, or pathological 
condition that could reasonably be detected 
by a health care professional with appro-
priate training and expertise in the field of 
medicine involved. 
‘‘(18) GENETIC SERVICES.—The term ‘genetic 
services’ means—
‘‘(A) a genetic test; 
‘‘(B) genetic counseling (including obtain-
ing, interpreting, or assessing genetic informa-
tion); or 
‘‘(C) genetic education. 
‘‘(19) UNDERWRITING
PURPOSES.—The term 
‘underwriting purposes’ means, with respect to any 
group health plan, or health insurance coverage of-
fered in connection with a group health plan—
‘‘(A) rules for, or determination of, eligi-
bility (including enrollment and continued eligi-
bility) for benefits under the plan or coverage; 
‘‘(B) the computation of premium or con-
tribution amounts under the plan or coverage; 
‘‘(C) the application of any pre-existing 
condition exclusion under the plan or coverage; 
and 
‘‘(D) other activities related to the cre-
ation, renewal, or replacement of a contract of 
health insurance or health benefits.’’.
(5) REMEDIES
AND
ENFORCEMENT.—Section 
2722(b) of the Public Health Service Act (42 U.S.C. 
300gg–22(b)) is amended by adding at the end the 
following: 
‘‘(3) ENFORCEMENT AUTHORITY RELATING TO 
GENETIC DISCRIMINATION.—
‘‘(A) GENERAL RULE.—In the cases de-
scribed in paragraph (1), notwithstanding the 
provisions of paragraph (2)(C), the succeeding 
subparagraphs of this paragraph shall apply 
with respect to an action under this subsection 
by the Secretary with respect to any failure of 
a health insurance issuer in connection with a 
group health plan, to meet the requirements of 
subsection (a)(1)(F), (b)(3), (c), or (d) of sec-
tion 2702 or section 2701 or 2702(b)(1) with 
respect to genetic information in connection 
with the plan. 
‘‘(B) AMOUNT.—
‘‘(i) IN
GENERAL.—The amount of 
the penalty imposed under this paragraph 
shall be $100 for each day in the non-
compliance period with respect to each par-
ticipant or beneficiary to whom such fail-
ure relates.
‘‘(ii) NONCOMPLIANCE PERIOD.—For 
purposes of this paragraph, the term ‘non-
compliance period’ means, with respect to 
any failure, the period—
‘‘(I) beginning on the date such 
failure first occurs; and 
‘‘(II) ending on the date the fail-
ure is corrected. 
‘‘(C) MINIMUM PENALTIES WHERE FAIL-
URE DISCOVERED.—Notwithstanding clauses (i) 
and (ii) of subparagraph (D): 
‘‘(i) IN GENERAL.—In the case of 1 or 
more failures with respect to an indi-
vidual—
‘‘(I) which are not corrected be-
fore the date on which the plan re-
ceives a notice from the Secretary of 
such violation; and 
‘‘(II) which occurred or continued 
during the period involved; 
the amount of penalty imposed by subpara-
graph (A) by reason of such failures with 
respect to such individual shall not be less 
than $2,500.
‘‘(ii) 
HIGHER
MINIMUM
PENALTY 
WHERE VIOLATIONS ARE MORE THAN DE 
MINIMIS.—To the extent violations for 
which any person is liable under this para-
graph for any year are more than de mini-
mis, clause (i) shall be applied by sub-
stituting ‘$15,000’ for ‘$2,500’ with re-
spect to such person. 
‘‘(D) LIMITATIONS.—
‘‘(i) PENALTY NOT TO APPLY WHERE 
FAILURE
NOT
DISCOVERED
EXERCISING 
REASONABLE
DILIGENCE.—No 
penalty 
shall be imposed by subparagraph (A) on 
any failure during any period for which it 
is established to the satisfaction of the 
Secretary that the person otherwise liable 
for such penalty did not know, and exer-
cising reasonable diligence would not have 
known, that such failure existed. 
‘‘(ii) PENALTY
NOT
TO
APPLY
TO 
FAILURES
CORRECTED
WITHIN
CERTAIN 
PERIODS.—No penalty shall be imposed by 
subparagraph (A) on any failure if—
‘‘(I) such failure was due to rea-
sonable cause and not to willful ne-
glect; and 
‘‘(II) such failure is corrected 
during the 30-day period beginning on 
the first date the person otherwise lia-
ble for such penalty knew, or exer-
cising reasonable diligence would have 
known, that such failure existed. 
‘‘(iii) OVERALL LIMITATION FOR UN-
INTENTIONAL FAILURES.—In the case of 
failures which are due to reasonable cause 
and not to willful neglect, the penalty im-
posed by subparagraph (A) for failures 
shall not exceed the amount equal to the 
lesser of—
‘‘(I) 10 percent of the aggregate 
amount paid or incurred by the em-
ployer (or predecessor employer) dur-
ing the preceding taxable year for 
group health plans; or 
‘‘(II) $500,000. 
‘‘(E) WAIVER BY SECRETARY.—In the case 
of a failure which is due to reasonable cause 
and not to willful neglect, the Secretary may
waive part or all of the penalty imposed by sub-
paragraph (A) to the extent that the payment 
of such penalty would be excessive relative to 
the failure involved.’’. 
(b) AMENDMENT RELATING
TO
THE INDIVIDUAL 
MARKET.—
(1) IN GENERAL.—The first subpart 3 of part 
B of title XXVII of the Public Health Service Act 
(42 U.S.C. 300gg–51 et seq.) (relating to other re-
quirements) is amended—
(A) by redesignating such subpart as sub-
part 2; and 
(B) by adding at the end the following: 
‘‘SEC. 2753. PROHIBITION OF HEALTH DISCRIMINATION ON 
THE BASIS OF GENETIC INFORMATION. 
‘‘(a) PROHIBITION ON GENETIC INFORMATION AS A 
CONDITION OF ELIGIBILITY.—A health insurance issuer 
offering health insurance coverage in the individual mar-
ket may not establish rules for the eligibility (including 
continued eligibility) of any individual to enroll in indi-
vidual health insurance coverage based on genetic infor-
mation. 
‘‘(b) PROHIBITION ON GENETIC INFORMATION IN 
SETTING PREMIUM RATES.—A health insurance issuer of-
fering health insurance coverage in the individual market
shall not adjust premium or contribution amounts for an 
individual on the basis of genetic information concerning 
the individual or a family member of the individual. 
‘‘(c) PROHIBITION ON GENETIC INFORMATION AS 
PREEXISTING CONDITION.—A health insurance issuer of-
fering health insurance coverage in the individual market 
may not, on the basis of genetic information, impose any 
preexisting condition exclusion (as defined in section 
2701(b)(1)(A)) with respect to such coverage. 
‘‘(d) GENETIC TESTING.—
‘‘(1) LIMITATION ON REQUESTING OR REQUIR-
ING GENETIC TESTING.—A health insurance issuer 
offering health insurance coverage in the individual 
market shall not request or require an individual or 
a family member of such individual to undergo a ge-
netic test. 
‘‘(2) RULE OF CONSTRUCTION.—Paragraph (1) 
shall not be construed to limit the authority of a 
health care professional who is providing health care 
services to an individual to request that such indi-
vidual undergo a genetic test. 
‘‘(3) RULE OF CONSTRUCTION REGARDING PAY-
MENT.—
‘‘(A) IN GENERAL.—Nothing in paragraph 
(1) shall be construed to preclude a health in-
surance issuer offering health insurance cov-
erage in the individual market from obtaining 
and using the results of a genetic test in mak-
ing a determination regarding payment (as such 
term is defined for the purposes of applying the 
regulations promulgated by the Secretary under 
part C of title XI of the Social Security Act and 
section 264 of the Health Insurance Portability 
and Accountability Act of 1996, as may be re-
vised from time to time) consistent with sub-
section (a) and (c). 
‘‘(B) LIMITATION.—For purposes of sub-
paragraph (A), a health insurance issuer offer-
ing health insurance coverage in the individual 
market may request only the minimum amount 
of information necessary to accomplish the in-
tended purpose. 
‘‘(4) RESEARCH EXCEPTION.—Notwithstanding 
paragraph (1), a health insurance issuer offering 
health insurance coverage in the individual market 
may request, but not require, that an individual or 
a family member of such individual undergo a ge-
netic test if each of the following conditions is met: 
‘‘(A) The request is made pursuant to re-
search that complies with part 46 of title 45,
Code of Federal Regulations, or equivalent Fed-
eral regulations, and any applicable State or 
local law or regulations for the protection of 
human subjects in research. 
‘‘(B) The issuer clearly indicates to each 
individual, or in the case of a minor child, to 
the legal guardian of such child, to whom the 
request is made that—
‘‘(i) compliance with the request is 
voluntary; and 
‘‘(ii) non-compliance will have no ef-
fect on enrollment status or premium or 
contribution amounts. 
‘‘(C) No genetic information collected or 
acquired under this paragraph shall be used for 
underwriting purposes. 
‘‘(D) The issuer notifies the Secretary in 
writing that the issuer is conducting activities 
pursuant to the exception provided for under 
this paragraph, including a description of the 
activities conducted. 
‘‘(E) The issuer complies with such other 
conditions as the Secretary may by regulation 
require for activities conducted under this para-
graph.
‘‘(e) PROHIBITION ON COLLECTION OF GENETIC IN-
FORMATION.—
‘‘(1) IN GENERAL.—A health insurance issuer 
offering health insurance coverage in the individual 
market shall not request, require, or purchase ge-
netic information for underwriting purposes (as de-
fined in section 2791). 
‘‘(2) PROHIBITION
ON
COLLECTION
OF
GE-
NETIC
INFORMATION
PRIOR
TO
ENROLLMENT.—A 
health insurance issuer offering health insurance 
coverage in the individual market shall not request, 
require, or purchase genetic information with respect 
to any individual prior to such individual’s enroll-
ment under the plan in connection with such enroll-
ment. 
‘‘(3) INCIDENTAL COLLECTION.—If a health in-
surance issuer offering health insurance coverage in 
the individual market obtains genetic information in-
cidental to the requesting, requiring, or purchasing 
of other information concerning any individual, such 
request, requirement, or purchase shall not be con-
sidered a violation of paragraph (2) if such request, 
requirement, or purchase is not in violation of para-
graph (1).
‘‘(f) GENETIC INFORMATION OF A FETUS OR EM-
BRYO.—Any reference in this part to genetic information 
concerning an individual or family member of an indi-
vidual shall—
‘‘(1) with respect to such an individual or fam-
ily member of an individual who is a pregnant 
woman, include genetic information of any fetus car-
ried by such pregnant woman; and 
‘‘(2) with respect to an individual or family 
member utilizing an assisted reproductive tech-
nology, include genetic information of any embryo le-
gally held by the individual or family member.’’. 
(2) REMEDIES
AND
ENFORCEMENT.—Section 
2761(b) of the Public Health Service Act (42 U.S.C. 
300gg–61(b)) is amended to read as follows: 
‘‘(b) SECRETARIAL ENFORCEMENT AUTHORITY.—
The Secretary shall have the same authority in relation 
to enforcement of the provisions of this part with respect 
to issuers of health insurance coverage in the individual 
market in a State as the Secretary has under section 
2722(b)(2), and section 2722(b)(3) with respect to viola-
tions of genetic nondiscrimination provisions, in relation 
to the enforcement of the provisions of part A with respect 
to issuers of health insurance coverage in the small group 
market in the State.’’.
(c) ELIMINATION
OF OPTION
OF NON-FEDERAL 
GOVERNMENTAL PLANS TO BE EXCEPTED FROM RE-
QUIREMENTS CONCERNING GENETIC INFORMATION.—
Section 2721(b)(2) of the Public Health Service Act (42 
U.S.C. 300gg–21(b)(2)) is amended—
(1) in subparagraph (A), by striking ‘‘If the 
plan sponsor’’ and inserting ‘‘Except as provided in 
subparagraph (D), if the plan sponsor’’; and 
(2) by adding at the end the following: 
‘‘(D) ELECTION NOT APPLICABLE TO RE-
QUIREMENTS CONCERNING GENETIC INFORMA-
TION.—The election described in subparagraph 
(A) shall not be available with respect to the 
provisions of subsections (a)(1)(F), (b)(3), (c), 
and (d) of section 2702 and the provisions of 
sections 2701 and 2702(b) to the extent that 
such provisions apply to genetic information.’’. 
(d) REGULATIONS AND EFFECTIVE DATE.—
(1) REGULATIONS.—Not later than 1 year after 
the date of enactment of this Act, the Secretary of 
Health and Human Services shall issue final regula-
tions to carry out the amendments made by this sec-
tion. 
(2) EFFECTIVE DATE.—The amendments made 
by this section shall apply—
(A) with respect to group health plans, and 
health insurance coverage offered in connection 
with group health plans, for plan years begin-
ning after the date that is 18 months after the 
date of enactment of this Act; and 
(B) with respect to health insurance cov-
erage offered, sold, issued, renewed, in effect, or 
operated in the individual market after the date 
that is 18 months after the date of enactment 
of this Act. 
SEC. 103. AMENDMENTS TO THE INTERNAL REVENUE CODE 
OF 1986. 
(a) NO
DISCRIMINATION
IN
GROUP
PREMIUMS 
BASED ON GENETIC INFORMATION.—Subsection (b) of 
section 9802 of the Internal Revenue Code of 1986 is 
amended—
(1) in paragraph (2)(A), by inserting before the 
semicolon the following: ‘‘except as provided in para-
graph (3)’’; and 
(2) by adding at the end the following: 
‘‘(3) NO
GROUP-BASED
DISCRIMINATION
ON 
BASIS OF GENETIC INFORMATION.—For purposes of 
this section, a group health plan may not adjust pre-
mium or contribution amounts for the group covered
under such plan on the basis of genetic informa-
tion.’’. 
(b) LIMITATIONS ON GENETIC TESTING; PROHIBI-
TION ON COLLECTION OF GENETIC INFORMATION; APPLI-
CATION TO ALL PLANS.—Section 9802 of such Code is 
amended by redesignating subsection (c) as subsection (f) 
and by inserting after subsection (b) the following new 
subsections: 
‘‘(c) GENETIC TESTING.—
‘‘(1) LIMITATION ON REQUESTING OR REQUIR-
ING GENETIC TESTING.—A group health plan may 
not request or require an individual or a family 
member of such individual to undergo a genetic test. 
‘‘(2) RULE OF CONSTRUCTION.—Paragraph (1) 
shall not be construed to limit the authority of a 
health care professional who is providing health care 
services to an individual to request that such indi-
vidual undergo a genetic test. 
‘‘(3) RULE OF CONSTRUCTION REGARDING PAY-
MENT.—
‘‘(A) IN GENERAL.—Nothing in paragraph 
(1) shall be construed to preclude a group 
health plan from obtaining and using the re-
sults of a genetic test in making a determina-
tion regarding payment (as such term is defined
for the purposes of applying the regulations 
promulgated by the Secretary of Health and 
Human Services under part C of title XI of the 
Social Security Act and section 264 of the 
Health Insurance Portability and Accountability 
Act of 1996, as may be revised from time to 
time) consistent with subsection (a). 
‘‘(B) LIMITATION.—For purposes of sub-
paragraph (A), a group health plan may re-
quest only the minimum amount of information 
necessary to accomplish the intended purpose. 
‘‘(4) RESEARCH EXCEPTION.—Notwithstanding 
paragraph (1), a group health plan may request, but 
not require, that a participant or beneficiary under-
go a genetic test if each of the following conditions 
is met: 
‘‘(A) The request is made pursuant to re-
search that complies with part 46 of title 45, 
Code of Federal Regulations, or equivalent Fed-
eral regulations, and any applicable State or 
local law or regulations for the protection of 
human subjects in research. 
‘‘(B) The plan clearly indicates to each 
participant or beneficiary, or in the case of a
minor child, to the legal guardian of such bene-
ficiary, to whom the request is made that—
‘‘(i) compliance with the request is 
voluntary; and 
‘‘(ii) non-compliance will have no ef-
fect on enrollment status or premium or 
contribution amounts. 
‘‘(C) No genetic information collected or 
acquired under this paragraph shall be used for 
underwriting purposes. 
‘‘(D) The plan notifies the Secretary in 
writing that the plan is conducting activities 
pursuant to the exception provided for under 
this paragraph, including a description of the 
activities conducted. 
‘‘(E) The plan complies with such other 
conditions as the Secretary may by regulation 
require for activities conducted under this para-
graph. 
‘‘(d) PROHIBITION ON COLLECTION OF GENETIC IN-
FORMATION.—
‘‘(1) IN GENERAL.—A group health plan shall 
not request, require, or purchase genetic information 
for underwriting purposes (as defined in section 
9832).
‘‘(i) such individual’s genetic tests, 
‘‘(ii) the genetic tests of family mem-
bers of such individual, and 
‘‘(iii) subject to subparagraph (D), 
the manifestation of a disease or disorder 
in family members of such individual. 
‘‘(B) INCLUSION OF GENETIC SERVICES.—
Such term includes, with respect to any indi-
vidual, any request for, or receipt of, genetic 
services (including genetic services received pur-
suant to participation in clinical research) by 
such individual or any family member of such 
individual. 
‘‘(C) EXCLUSIONS.—The term ‘genetic in-
formation’ shall not include information about 
the sex or age of any individual. 
‘‘(D) APPLICATION TO FAMILY MEMBERS 
COVERED UNDER SAME PLAN.—Information de-
scribed in clause (iii) of subparagraph (A) shall 
not be treated as genetic information to the ex-
tent that such information is taken into account 
only with respect to the individual in which 
such disease or disorder is manifested and not 
as genetic information with respect to any other 
individual.
‘‘(8) GENETIC TEST.—
‘‘(A) IN
GENERAL.—The term ‘genetic 
test’ means an analysis of human DNA, RNA, 
chromosomes, proteins, or metabolites, that de-
tects genotypes, mutations, or chromosomal 
changes. 
‘‘(B) EXCEPTIONS.—The term ‘genetic 
test’ does not mean—
‘‘(i) an analysis of proteins or metabo-
lites that does not detect genotypes, 
mutations, or chromosomal changes, or 
‘‘(ii) an analysis of proteins or me-
tabolites that is directly related to a mani-
fested disease, disorder, or pathological 
condition that could reasonably be detected 
by a health care professional with appro-
priate training and expertise in the field of 
medicine involved. 
‘‘(9) GENETIC
SERVICES.—The term ‘genetic 
services’ means—
‘‘(A) a genetic test; 
‘‘(B) genetic counseling (including obtain-
ing, interpreting, or assessing genetic informa-
tion); or 
‘‘(C) genetic education.
‘‘(10) UNDERWRITING
PURPOSES.—The term 
‘underwriting purposes’ means, with respect to any 
group health plan ,or health insurance coverage of-
fered in connection with a group health plan—
‘‘(A) rules for, or determination of, eligi-
bility (including enrollment and continued eligi-
bility) for benefits under the plan or coverage; 
‘‘(B) the computation of premium or con-
tribution amounts under the plan or coverage; 
‘‘(C) the application of any pre-existing 
condition exclusion under the plan or coverage; 
and 
‘‘(D) other activities related to the cre-
ation, renewal, or replacement of a contract of 
health insurance or health benefits.’’. 
(e) ENFORCEMENT.—
(1) IN
GENERAL.—Subchapter C of chapter 
100 of the Internal Revenue Code of 1986 (relating 
to general provisions) is amended by adding at the 
end the following new section: 
‘‘SEC. 9834. ENFORCEMENT. 
‘‘For the imposition of tax on any failure of a group 
health plan to meet the requirements of this chapter, see 
section 4980D.’’.
(2) CONFORMING AMENDMENT.—The table of 
sections for subchapter C of chapter 100 of such 
Code is amended by adding at the end the following 
new item:
‘‘Sec. 9834. Enforcement.’’.
(f) REGULATIONS AND EFFECTIVE DATE.—
(1) REGULATIONS.—The Secretary of the 
Treasury shall issue final regulations or other guid-
ance not later than 1 year after the date of the en-
actment of this Act to carry out the amendments 
made by this section. 
(2) EFFECTIVE DATE.—The amendments made 
by this section shall apply with respect to group 
health plans for plan years beginning after the date 
that is 18 months after the date of the enactment 
of this Act. 
SEC. 104. AMENDMENTS TO TITLE XVIII OF THE SOCIAL SE-
CURITY ACT RELATING TO MEDIGAP. 
(a) NONDISCRIMINATION.—Section 1882(s)(2) of the 
Social Security Act (42 U.S.C. 1395ss(s)(2)) is amended 
by adding at the end the following: 
‘‘(E) An issuer of a medicare supplemental 
policy shall not deny or condition the issuance 
or effectiveness of the policy (including the im-
position of any exclusion of benefits under the 
policy based on a pre-existing condition) and
shall not discriminate in the pricing of the pol-
icy (including the adjustment of premium rates) 
of an individual on the basis of the genetic in-
formation with respect to such individual.’’. 
(b) LIMITATIONS ON GENETIC TESTING AND GE-
NETIC INFORMATION.—
(1) IN GENERAL.—Section 1882 of the Social 
Security Act (42 U.S.C. 1395ss) is amended by add-
ing at the end the following: 
‘‘(x) LIMITATIONS ON GENETIC TESTING AND IN-
FORMATION.—
‘‘(1) GENETIC TESTING.—
‘‘(A) LIMITATION ON REQUESTING OR RE-
QUIRING
GENETIC
TESTING.—An issuer of a 
medicare supplemental policy shall not request 
or require an individual or a family member of 
such individual to undergo a genetic test. 
‘‘(B) RULE OF CONSTRUCTION.—Subpara-
graph (A) shall not be construed to limit the 
authority of a health care professional who is 
providing health care services to an individual 
to request that such individual undergo a ge-
netic test. 
‘‘(C) RULE OF CONSTRUCTION REGARDING 
PAYMENT.—