Health Policy Project Presentation and Paper: The Genetic Information Nondiscrimination Act of 2008 1. Prepare a research paper that describes the purpose for the legislation assigned to your group and any regulations/rules promulgated as result of the regulations. 2. Discuss the origin of the assigned legislation. 3. Identify the legislative process (committee/subcommittee) that determined the outcome of the legislation and any agency that determined the regulations/rules of the law promulgated due to the legislation. (i.e. support, interest groups, executive influence, lobbyists, etc.) 4. Outline the results of the legislation or regulation, its application in the health care industry TODAY, and its relevance to the state of Georgia communities.

1. The Genetic Information
Nondiscrimination Act of 2008
Thao T. Nguyen, Danielle N. Wade, Raven J. Morgan,
Naisha C. Renous, Deford L. Smith

2. Purpose of GINA
• The purpose of the Genetic Information Nondiscrimination Act of 2008 is
to provide protection from genetic discrimination in health insurance and
employment (GINA, 2015). This act makes it illegal for the health insurance
providers to require genetic information to make decisions on eligibility or
coverage for patients. This part of the law was implemented in May of 2009.
Title II of the Act makes it illegal for employers to use a person's genetic
information when making decisions about hiring, promotion, and several
other terms of employment. This part of the law went into effect on
November 21, 2009 (GINA, 2015).

3. GINA Origins
• Original bill was proposed in 1995
• Was modified and retried to pass multiple
times from 1995-2007
• Finally passed in 2008
• Sen. Olympia J. Snow
• Rep. Louise McIntosh Slaughter
• Signed by George W. Bush On May 21 2008

4. Legislative Process

5. Identify the legislative process (committee/subcommittee) that
determined the outcome of the legislation
Genetic Information Nondiscrimination Act of 2008
Pub. L. No.110-233 would be the 233rd law adopted during the 110th Congress (2007 - 2008)
Statutes at Large: 122 Stat. 881
Chamber Standing Committees Subcommittee
1. House of Representatives
Measure Number: (H.R. 493)
House Education and Labor
House Energy and Commerce Subcommittee on Health
House Ways and Means
2. Senate
Measure Number: (S.358)
Committee on Health, Education,
Labor, and Pensions

6. Agency that determined the regulations/rules of the law
promulgated due to the legislation
• Title I: Genetic Nondiscrimination in Health Insurance
Agencies: The Departments of Labor (DOL), Health and Human Services (HHS), and the
Treasury have responsibility for issuing regulations for Title I of GINA.
HHS: Centers for Medicare & Medicaid Services (CMS) and the Office for Civil Rights
DOL: Department of the Treasury (the Internal Revenue Service)
• Title II: Prohibiting employment discrimination on the basis of genetic information
Agency: The Equal Employment Opportunity Commission (EEOC) administers Title II of
GINA. The U.S. Equal Employment Opportunity Commission is responsible for administering
and enforcing civil rights laws against workplace discrimination.
• Title III: Miscellaneous Provisions

7. Date House of Representatives Measure Number: (H.R. 493)
Introduction January 16,
2007
By Rep. Louise M. Slaughter
Step 1: Referral to
Committee
Bills are referred to standing committees in the House
January 16,
2007
Referred to Committee on Education and Labor, Committee on Energy and Commerce,
& Ways and Means
February, 02,
2007
Referred to Committee on House Energy and Commerce Subcommittee on Health
Step 2: Committee Action March 29,
2007
The bill reaches and is placed on the Union Calendar, Calendar No. 46.
The Union Calendar is the list of bills available for consideration to the Committee of the
Whole. Bills are referred to the Union Calendar if they directly or indirectly deal with
money.
January 18,
2007
A bill can be referred to a subcommittee [Subcommittee on Health] or considered by the
committee as a whole
Step 3: Subcommittee
Review
The Legislative Process at the Federal Level

8. Step 4: Mark Up Febuary 14,
2007
After hearings are completed, the subcommittee on Health will meet to mark- up the bill. Marking
up the bill means to make changes and amendments prior to recommending the bill to the full
committees.
February 12,
2007
House Education and Labor
March 23, 2007 House Energy and Commerce
March 21, 2007 House Ways and Means
Step 5: Committee Action to
Report a Bill
March 21, 2007: House committee/subcommittee actions: Ordered to be Reported (Amended) by
Voice Vote
Febuary 14,
2007
Committee on Education and Labor ordered to be Reported (Amended) by Voice Vote
Step 6: Publication of a Written
Report
March 5, 2007 March 5, 2007 at 3:47p.m.: Reported (Amended) by the Committee on Education and Labor. H.
Rept. 110-28, Part I
March 26, 2007 March 26, 2007: Reported (Amended) by the House Ways and Means. H. Rept. 110-28, Part II.
April 19, 2007 (Amended) by the House Energy and Commerce. H. Rept. 110-28, Part III.
April 19, 2007 Reported by the House Energy and Commerce. H. Rept. 110-28, Part IV
March 13, 2007 Reported by the House Energy and Commerce Subcommittee on Health

9. Step 7: Scheduling Floor
Action
After the bill is reported back to the House of Representatives where it originated, it is
placed in chronological order on the calendar. In the House different legislature
calendars include the union, the house, the private, the corrections, and the calendar of
motions to discharge committees.
Step 8: Debate 13 yrs (1995-
2008)
When the bill reaches the floor of the House, there are rules or procedures governing
the debate on legislation. These rules determine the conditions and amount of time
allocated for general debate.
Step 9: Voting April 25, 2007 The bill is passed/agreed to in House by members voting: On motion to suspend the
rules and agree to the resolution Agreed to by voice vote of 420-3, Yea-Nay Vote.
Number: 261.
Vote Result: Bill Passed
Step 10: Referral to
Other Chamber
May 1, 2008 The bill is introduced in and passed by the House. The bill is referred to the other
chamber, Senate. The bill is Passed/agreed to in Senate: Received in the Senate,
considered, and agreed to without amendment by Unanimous Consent.
Step 11: Conference
Committee Action
Agreements are reached and a conference report is prepared descibbing the
committee members’ reccomendatiopns for changes. Bothe the House and Senate
approve of the conference report.
Step 12: Final Actions May 21, 2008 The bill has been approved by both the House and Senate. The bill is sent to President
Bush, approved, and signed. H.R. 493, the Genetic Information Nondiscrimination
Act is now a law.
Step 13: Overriding a
Veto
Not necessary for this bill due to GINA being passed.

10. The Legislative Process at the Federal Level
Date Senate Measure Number:(S. 358)
Introduction January 22, 2007 By Sen. Olympia J. Snowe
Step 1: Referral to Committee Bills are referred to standing committees in the
Senate
January 22, 2007 Read twice and referred to the Committee on Health,
Education, Labor, and Pensions
Step 2: Committee Action March 29, 2007 Placed on Senate Legislative Calendar under General
Orders. Calendar No. 97.
Step 3: Subcommittee Review
Step 4: Mark Up
Step 5: Committee Action to Report a Bill
Step 6: Publication of a Written Report April 10, 2007: By Senator Kennedy from Committee
on Health, Education, Labor, and Pensions filed
written report. Report No. 110-48 PDF file

11. Step 7: Scheduling Floor Action After the bill is reported back to the Senate and placed on the legislative
calendar.
Step 8: Debate When the bill reaches the floor of the Senate, there are rules or procedures
governing the debate on legislation. These rules determine the conditions
and amount of time allocated for general debate.
Step 9: Voting April 24, 2008,
02:13 PM
Passed/agreed to in Senate: Passed Senate with an amendment by Yea-Nay
Vote. 95 - 0. Record Vote Number: 113.
Vote Result: Bill Passed
Step 10: Referral to Other
Chamber
May 5, 2008 Resolving differences — House actions: On motion that the House agree to
the Senate amendment Agreed to by the Yeas and Nays: 414 - 1 (Roll no.
234).
Step 11: Conference Committee
Action
Step 12: Final Actions May 21, 2008 President Bush Signs H.R. 493, the Genetic Information Nondiscrimination
Act of 2008
Step 13: Overriding a Veto

12. Regulation Results
Prohibits:
• Discrimination from insurance companies and employers
• Health insurers from using a person’s genetic information to determine if they are
eligible for any insurance or to determine premiums
• Genetic discrimination in the workplace
• Employers from using an individual’s genetic information to make employment
decisions
Employers are required to keep patient genetic information in separate confidential
files.

13. RESULTS!
• Still Relatively New
• Insurance Fears
• Fewer people getting tested
• Some Cases
• EEOC v Fabricut Inc.
• EEOC v Nestle
• Need new privacy implementation
• Issues with EMR/EHR ethical issues
• Might need to amend
• Still hard to implement
• EVERY ONE IS AFFECTED !!!

14. Q & A