Prevention for Those Who Can Pay

2 J. L. & BIOSCIENCES 365 (2015)

U Iowa Legal Studies Research Paper No. 2017-36

32 Pages Posted: 6 Nov 2017 Last revised: 10 Nov 2017

See all articles by Anya Prince

Anya Prince

University of Iowa College of Law

Date Written: February 2, 2015


Clinical use of genetic testing to predict adult onset conditions allows individuals to minimize or circumvent disease when preventive medical interventions are available. Recent policy recommendations and changes expand patient access to information about asymptomatic genetic conditions and create mechanisms for expanded insurance coverage for genetic tests. The American College of Medical Genetics and Genomics (ACMG) recommends that laboratories provide incidental findings of medically actionable genetic variants after whole genome sequencing. The Patient Protection and Affordable Care Act (ACA) established mechanisms to mandate coverage for genetic tests, such as BRCA. The ACA and ACMG, however, do not address insurance coverage for preventive interventions. These policies equate access to testing as access to prevention, without exploring the accessibility and affordability of interventions. In reality, insurance coverage for preventive interventions in asymptomatic adults is variable given the US health insurance system’s focus on treatment. Health disparities will be exacerbated if only privileged segments of society can access preventive interventions, such as prophylactic surgeries, screenings, or medication. To ensure equitable access to interventions, federal or state legislatures should mandate insurance coverage for both predictive genetic testing and recommended follow-up interventions included in a list established by an expert panel or regulatory body.

Suggested Citation

Prince, Anya, Prevention for Those Who Can Pay (February 2, 2015). 2 J. L. & BIOSCIENCES 365 (2015), U Iowa Legal Studies Research Paper No. 2017-36, Available at SSRN:

Anya Prince (Contact Author)

University of Iowa College of Law ( email )

Melrose and Byington
Iowa City, IA 52242
United States

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