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Fort Worth Star-Telegram

Janet Cunningham has a strong family history of ovarian and breast cancer, and her sister has already tested positive for the genetic marker that puts her at heightened risk for the disease.

Now Cunningham wants to know whether she, too, has the marker. But if she tests positive, does that mean she and her three daughters could not get health insurance?

Not anymore.

A federal law, the Genetic Information Nondiscrimination Act of 2008, or GINA, goes into effect Dec. 7, prohibiting insurance companies from using family medical histories or genetic testing to deny medical insurance or set rates.

The federal law will expand on a Texas law that prohibits use of genetic test results in determining large group medical insurance coverage and in hiring. The federal law further prohibits the use of family medical histories and expands protection to those who have individual insurance and smaller group plans.

For Cunningham, 48, of Fort Worth, that means her mother's death from ovarian cancer and her sister's fight with ovarian, breast and now uterine cancer cannot be used against her or her children.

"I want to know now - I've got three girls," Cunningham said recently, as she had blood drawn at the JPS Health Center for Women in Fort Worth. JPS provides the testing with support from the Susan B. Komen for the Cure Foundation, Moncrief Cancer Resources and the University of Texas Southwestern Medical Center at Dallas.

"I knew right away I would do it."

Another provision in the federal law, which prohibits employers from using genetic information or family medical history in hiring, went into effect Saturday. The new law does not apply to life, disability or long-term care insurance plans.

Thompson & Knight Attorney Russell Gully in the Fort Worth Star-Telegram

Business impact

For some local businesses, the new provision for health insurance will mean a shift in how they set up their group medical plans.

Some North Texas companies now use health risk assessment forms, including family histories, in determining whether employees are eligible for group insurance, particularly top-tier plans. Those companies are now working to revise their programs to exclude that information, said Dallas attorney Russell Gully, who works with employers and group health plans.

That doesn't mean someone who already has the illness won't face problems - the law does not prohibit use of the individual's own medical history. But it does mean that a grandfather's heart disease or aunt's cancer will not be used against a person in obtaining insurance or in hiring.

"If someone has a disease or disorder, they can take that into account," Gully said. "For individuals that may have hereditary issues, this will make it easier for them to get health insurance."

Some companies are now rewriting their health assessments to remove questions about family history; others are simply notifying workers that the responses are voluntary.

"It would be best if the assessment didn't have anything to do with family," Gully said.

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