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Table 3. Comparison of Federal Legislation Addressing Genetic Coverage, Limitations, and Protections

Law Coverage Limitations Protect All Americans 
Adapted from Leib et al.[31]
Civil Rights Act of 1964 Employment onlyDoes not apply to health insuranceYes
Applies in instances of discrimination based on genetic information if associated with race or ethnic groupsStrong association with a racial or ethnic group for hereditary cancers is rare
Americans with Disabilities Act of 1990 Disabilities associated with manifesting genetic informationDoes not apply to health insuranceYes
Health Insurance Portability and Accountability Act of 1996 Group health insurance plansDoes not stop insurers from requiring genetic testsYes
Genetic information is not defined
Forbids excluding an individual in a group health plan due to genetic informationGenetic information can be used for plan underwriting
Forbids premium increases for different group plan membersDisclosure of genetic information is not restricted
Preexisting conditions can not include predictive genetic informationDoes not apply to individual health plans, unless covered by the portability provision
Executive Order 13145 of 2000 Forbids Federal employee workplace genetic discriminationDoes not apply to health insuranceNo; excludes members of the United States military and anyone who is NOT a federal employee
Only applies to Federal employees
Genetic Information Nondiscrimination Act of 2008 (GINA) (Enacted in 2009) Forbids genetic discrimination in the workplace and in health insuranceCivil suit is restricted to only those who have had all administrative remedies exhaustedNo; excludes members of the United States military, veterans obtaining health care through the Veteran’s Administration, and the Indian Health Service
Genetic information broadly defined
Specific to group and individual insurance plans
Forbids use of genetic information in underwriting
Forbids requiring genetic testing by employers and insurersDoes not cover life, disability, and long-term care insurance


  1. Leib JR, Hoodfar E, Haidle JL, et al.: The new genetic privacy law: how GINA will affect patients seeking counseling and testing for inherited cancer risk. Community Oncology 5 (6): 351-4, 2008.