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Insurers, Consumers, and Testing: The AIDS Experience

Published online by Cambridge University Press:  28 April 2021

Peter Hiam
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Extract

At the end of 1987, the insurance industry could breathe a sigh of relief. By a combination of good luck, astute planning, and nerve, life and health insurers had managed to impose HIV-testing requirements on insurance applicants while making few concessions to the gay community or insurance regulators. To a greater degree than almost anyone had thought possible, the insurers had deflected most of the expected health costs from the AIDS epidemic onto the nation’s taxpayers, and had taken steps to deny life or health insurance to anyone they considered to be at risk of AIDS.

The use of blood tests to determine if an individual is infected with the human immunodeficiency virus (HIV) that causes AIDS has been a matter of considerable controversy. Yet to date only a handful of states have restricted the use of HIV testing by companies offering life or health insurance.

Type
AIDS: Insurance
Information
Law, Medicine and Healthcare , Volume 15 , Issue 4 , Winter 1987 , pp. 212 - 222
Copyright
Copyright © American Society of Law, Medicine and Ethics 1987

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References

Calif. Health & Safety Code, c. 1.11, $199.21 (1988) (prohibiting use of HIV blood test that identifies person tested for determination of insurability); 7 D.C. Code Anno. $35-221-229(1987) (insurer may not deny insurance because of positive HIV test or because individual declines to take test; before August 1991, insurers may not require individuals to take test or consider tests for rate-making purposes); 29 Fla. Stats. Anno. $381,606 (1986) (prohibiting result of serologic test conducted under Health Department declaration of public health threat to determine if a person may be insured for disability, health, or life insurance); 9 C.Mass.R. $36.01-36.15 (1987) (prohibiting HIV tests for accident and health insurance and group life insurance; permits HIV testing on the basis of objective criteria for individual life and non-cancelable disability insurance under certain conditions) (regulations under preliminary injunction; Life Ins. Ass'n of Mass. v. Singer, CA No. 87-5321, Supr. Ct., Suffolk Cry, Massachusetts Lawyers Weekly, 16 (Oct. 12, 1987): 105-6); 11 N.Y.C.R.R. $52.27 (1987) (prohibiting HIV tests for determination of insurability for health insurance). See also Office of Technology Assessment, AIDS and Health Insurance—An OTA Survey (Washington, D.C.: U.S. Government Printing Office, 1988).Google Scholar
Centers for Disease Control, “Pneumocystis Pneumonia—Los Angeles,” Morbidity and Mortality Weekly Report, 30 (1981): 250–52.Google Scholar
Nancy, Mueller, “The Epidemiology of the Human Immunodeficiency Virus Infection,” Law, Medicine & Health Care, 14 (Dec. 1986): 250–58.Google Scholar
Sarndagharan, M.G. et al., “Antibodies Reactive with Human T-Lymphotropic Retrovirus (HTLV-III) in the Serum of Patients with AIDS,” Science, 124 (1984): 506–8. A new FDA rule requires the testing of all human blood and blood products; 53 Fed. Reg. 111 (1-1-88).Google Scholar
Friedland, G.H., Klein, R.S., “Transmission of the Human Immunodeficiency Virus,” New England Journal of Medicine, 317 (1987): 1125–35.CrossRefGoogle Scholar
Id.Google Scholar
Robert-Guroff, M., Brown, M., and Gallo, R.C., “HTLV-III-Neutralizing Antibodies in Patients with AIDS and AIDS-Related Complex,” Nature, 316 (1985): 72–74.Google Scholar
Institute of Medicine, Confronting AIDS (Washington, D.C.: National Academy of Sciences, 1986), 59–60.Google Scholar
American Council of Life Insurance, 1986 Life Insurance Fact Book (Washington, D.C., 1986), 6.Google Scholar
The McCarran—Fergeson Act exempts the state-regulated business of insurance, such as risk-spreading and actuarial activities, from federal antitrust scrutiny. See, e.g., Group Life Insurance v. Royal Drug, 440 U.S. 205, reh. den. 441 U.S. 917 (1979).Google Scholar
“Fortieth Annual Report on American Industry,” Forbes Magazine, 141 (Jan. 11, 1988): 151, 155.Google Scholar
Exhibit S of document submitted by Lincoln National Life Insurance Company to the Massachusetts Division of Insurance regarding public hearing held Aug. 4, 1987, respecting proposed 221 CMR36.00.Google Scholar
See Barry, Michael, Cleary, Paul and Fineberg, Harvey, “Screening for HIV Infection: Risks, Benefits, and the Burden of Proof,” Law, Medicine & Health Care, 14 (Dec. 1986): 259–67.Google Scholar
Proposed Bulletin, National Association of Insurance Commissioners Advisory Committee on AIDS, 1986.Google Scholar
Statement submitted by Karen Clifford of Health Insurance Association of America to Health Insurance (B) Committee of the National Association of Insurance Commissioners (Dec 19, 1986): 2.Google Scholar
Wis. Stat. Ann. 631.90, as amended by A.487, eff. Nov. 23, 1985.Google Scholar
Written statement of B'nai B'rith Members Program filed with New York Insurance Department regarding public hearing held June 25, 1987, respecting proposed 11NYCRR52.Google Scholar
Wash. Admin. Code ch. 284-90-010.Google Scholar
Presti, Steven Lo, “Who Should Bear the Cost of AIDS?”, Professional Agent, June 1986: 57.Google Scholar
Testimony of Nationwide Insurance Company before New York Insurance Department at public hearing held June 25, 1987, regarding proposed 11NYCRR52.Google Scholar
Statements submitted by Karen Clifford and Russell Iuculano of Health Insurance Association of America and American Council of Life Insurance, respectively, to Health Insurance (B) Committee of the National Association of Insurance Commissioners (Dec. 19, 1986): 5.Google Scholar
See, for example, Me. Rev. Stat. Ann. 24A, $2450; Mass. G.L. c.175, $108C; N.Y. Ins. Law $3225.Google Scholar
Letter from Peter Hiam, Massachusetts Commissioner of Insurance, to Dukakis, Michael S., Governor of Massachusetts, July 8, 1987.Google Scholar
AIDS Survey, American Council of Life Insurance/Health Insurance Association of America, Aug. 16, 1986.Google Scholar
Letter from Peter Hiam, Massachusetts Commissioner of Insurance, to Schweicker, Richard S., President, American Council of Life Insurance, April 2, 1987.Google Scholar
Best's Insurance Management Reports, A.M. Best Company Release 33, Nov. 16, 1987.Google Scholar
AIDS Survey, American Council of Life Insurance/Health Insurance Association of America, June 1987.Google Scholar
Morgan, W.M., Curran, J.W., “Acquired Immunodeficiency Syndrome: Current and Future Trends,” Public Health Reports, 101 (1986): 459–65.Google Scholar
AIDS Survey, Institute of Home Office Underwriters, Underwriting Procedures and Committee, Question 2.Google Scholar
AIDS Survey, American Council of Life Insurers/Health Insurance Association of America, Aug. 16, 1986: 4.Google Scholar
“Industry Survey Shows Impact of AIDS Claims,” Journal of Commerce, Oct. 7, 1986.Google Scholar
Lo, Presti, supra note 19.Google Scholar
Gostin, Larry, Curran, William, and Clark, Mary, “The Case Against Compulsory Case Finding in Controlling AIDS—Testing, Screening, and Reporting,” American Journal of Law & Medicine, 12 (1987): 7–53; Bayer, Ron, Levine, Carol, and Susan, Wolf, “HIV Antibody Screening: An Ethical Framework for Evaluating Proposed Programs,” Journal of the American Medical Association, 256 (1986): 1768-74.CrossRefGoogle Scholar
“Suicides Raise Questions on AIDS Testing,” Boston Globe, Feb. 14, 1987, at 17.Google Scholar
Cleary, Paul, Barry, Michael, and Mayer, Kenneth, “Compulsory Premarital Screening for the Human Immunodeficiency Virus,” Journal of the American Medical Association, 258 (1987): 1757–62.Google Scholar
New York Times, June 1, 1987, sec A1.Google Scholar
Meyer, Klemens, Pauker, Stephen, “Screening for HIV; Can We Afford the False Positive Rate?”, New England Journal of Medicine, July 23, 1987: 238.Google Scholar
Exhibit, F, Agent Communication, filed by New York Life Insurance Company with the New York Insurance Department regarding public hearing held June 25, 1987, respecting proposed 11NYCRR52.Google Scholar
Insurer Position: “For Cause” Testing, Life Insurance Association of Massachusetts, March 11, 1987.Google Scholar
Curran, William, Gostin, Larry, and Clark, Mary, Acquired Immunodeficiency Syndrome: Legal and Regulatory Policy (Washington, D.C.: U.S. Dept. of Health and Human Services, contract no. 282-86-0032, 1986).Google Scholar
Lo Presti, supra note 19, at 56.Google Scholar
Testimony of John Carter, President, Equitable Life Assurance Society of the United States, before the New York Insurance Department at the public hearing held June 25, 1987, respecting proposed 11NYCRR52.Google Scholar
Written notes by Neil Day, President of Medical Information Bureau, Inc., filed with Massachusetts Division of Insurance, March 10, 1987.Google Scholar
Exhibit C of Written Statement by Harry A. Woodman, filed with the New York Insurance Department regarding proposed 11NYCRR52.Google Scholar