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Medicine and Social JusticeEssays on the Distribution of Health Care$
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Rosamond Rhodes, Margaret Battin, and Anita Silvers

Print publication date: 2012

Print ISBN-13: 9780199744206

Published to Oxford Scholarship Online: May 2015

DOI: 10.1093/acprof:osobl/9780199744206.001.0001

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Are Pre-existing Condition Exclusion Clauses Just?

Are Pre-existing Condition Exclusion Clauses Just?

Lessons from Causal and Ethical Considerations Regarding Genetic Testing

Chapter:
(p.387) 32 Are Pre-existing Condition Exclusion Clauses Just?
Source:
Medicine and Social Justice
Author(s):

Robert T. Pennock

Publisher:
Oxford University Press
DOI:10.1093/acprof:osobl/9780199744206.003.0033

This chapter examines the health care reform issue with significant public support: the prohibition on denying coverage for preexisting conditions, especially those identified by genetic testing. The Genetic Information Nondiscrimination Act of 2008 (GINA) is designed to prohibit the improper use of genetic information in health insurance and employment. GINA prohibits group health plans and health insurers from denying coverage to a healthy individual, or from charging that person a higher premium based solely on a genetic predisposition to developing a disease in the future. The broader health care reform of the Patient Protection and Affordable Care Act requires the private health insurance market to provide coverage for individuals with preexisting conditions. The chapter considers the CaSE model as a framework for representing causation and then applies it to the case of genetic diseases. It concludes by asking whether preexisting conditions—genetic or otherwise—should be grounds for denying someone health insurance.

Keywords:   health care reform, preexisting conditions, genetic testing, Genetic Information Nondiscrimination Act, health insurance, genetic diseases, health care, Patient Protection and Affordable Care Act, causation, CaSE model

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