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110th Congress                                             Rept. 110-28
                        HOUSE OF REPRESENTATIVES
 1st Session                                                     Part 4

======================================================================



 
          GENETIC INFORMATION NONDISCRIMINATION ACT OF 2007

                                _______
                                

                 April 19, 2007.--Ordered to be printed

                                _______
                                

Mr. Dingell, from the Committee on Energy and Commerce, submitted the
                              following

                          SUPPLEMENTAL REPORT

                        [To accompany H.R. 493]

    This supplemental report shows the cost estimate of the 
Congressional Budget Office with respect to the bill (H.R. 
493), as reported, which was not included in part 3 of the 
report submitted by the Committee on Energy and Commerce on 
March 29, 2007 (H. Rept. 110-28, pt. 3).

                                CONTENTS

                                                                   Page
Committee Cost Estimate..........................................     1
Congressional Budget Office Estimate.............................     1
Federal Mandates Statement.......................................     3

                        COMMITTEE COST ESTIMATE

    The Committee on Energy and Commerce adopts as its own the 
cost estimate prepared by the Director of the Congressional 
Budget Office pursuant to section 402 of the Congressional 
Budget Act of 1974.

                  CONGRESSIONAL BUDGET OFFICE ESTIMATE

    Regarding clause 3(c)(3) of rule XIII of the Rules of the 
House of Representatives, the following is the cost estimate 
provided by the Congressional Budget Office pursuant to section 
402 of the Congressional Budget Act of 1974:

                                     U.S. Congress,
                               Congressional Budget Office,
                                    Washington, DC, April 16, 2007.
Hon. John D. Dingell,
Chairman, Committee on Energy and Commerce,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for H.R. 493, the Genetic 
Information Nondiscrimination Act of 2007.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Shinobu 
Suzuki.
            Sincerely,
                                                   Peter R. Orszag.
    Enclosure.

H.R. 493--Genetic Information Nondiscrimination Act of 2007

    H.R. 493 would amend the Employee Retirement Income 
Security Act of 1974 (ERISA), the Public Health Service Act, 
and Title XVIII of the Social Security Act to prohibit the use 
of genetic information (including results of genetic tests and 
family history of disease) by employers in employment decisions 
and by health insurers and health plans in making enrollment 
determinations and setting insurance premiums.
    CBO estimates that enacting the bill would increase the 
number of individuals who obtain health insurance by about 600 
people per year, nearly all of whom would obtain insurance in 
the individual market. The bill would affect federal revenues 
because the premiums paid by some of those newly insured 
individuals would be tax-deductible.
    CBO estimates that enacting H.R. 493 would reduce revenues 
by less than $500,000 in each year from 2008 through 2017, by 
$1 million over the 2008-2012 period, and by $2 million over 
the 2008-2017 period. (These estimates include reductions in 
off-budget receipts from Social Security payroll taxes of less 
than $500,000 over the 2008-2012 period, and slightly less than 
$1 million over the 2008-2017 period.) The bill's requirements 
would apply to Medicare supplemental insurance, which could 
affect direct spending for Medicare. However, we estimate that 
the bill would have no significant effect on direct spending.
    The bill would require the Secretaries of Health and Human 
Services (HHS), Labor, and the Treasury to issue regulations to 
carry out the provisions of this bill, and would require the 
Secretaries of HHS and Labor to enforce those provisions. In 
addition, six years after enactment, the bill would establish a 
commission to review the science of genetics and to make 
recommendations to the Congress on the need to establish a 
disparate impact standard for genetic discrimination. The bill 
would authorize the appropriation of such sums as necessary to 
establish the commission and to carry out the other provisions 
of the bill. Assuming the availability of appropriated funds, 
CBO estimates that implementing H.R. 493 would incur 
discretionary costs of less than $500,000 in 2008 and $2 
million over the 2008-2017 period.
    H.R. 493 would preempt some state laws that establish 
confidentiality standards for genetic information, and would 
restrict how state and local governments use such information 
in employment practices and in the provision of health care to 
employees. The preemption and the limitations on state and 
local actions would be intergovernmental mandates as defined in 
the Unfunded Mandates Reform Act (UMRA), but there is little 
indication that state, local, or tribal governments currently 
engage in or are likely to engage in the activities that would 
be prohibited by the bill. Consequently, CBO estimates that the 
costs of the mandates would not be significant and would not 
exceed the threshold established in UMRA ($66 million in 2007, 
adjusted annually for inflation).
    The bill contains private-sector mandates on health 
insurers, health plans, employers, labor unions, and other 
organizations. CBO estimates that the direct cost of those 
requirements would not exceed the annual threshold specified in 
UMRA ($131 million in 2007, adjusted annually for inflation) in 
any of the first five years that the mandates would be 
effective.
    CBO has prepared two previous estimates for H.R. 493. On 
March 2, 2007, CBO transmitted an estimate for H.R. 493 as 
ordered reported by the House Committee on Education and Labor 
on February 14, 2007. On March 23, 2007, CBO transmitted an 
estimate for H.R. 493 as ordered reported by the House 
Committee on Ways and Means on March 21, 2007. The Ways and 
Means version differs from the other two versions in that it 
would make conforming modifications to the Internal Revenue 
Code. CBO and the Joint Committee on Taxation estimate that 
those conforming modifications would have no incremental 
budgetary effect. The Energy and Commerce version differs from 
the other two versions in that it makes conforming 
modifications to privacy and confidentiality provisions of the 
Public Health Services Act and the Social Security Act. CBO 
estimates that those modifications would have no incremental 
budgetary effect. Thus, CBO's estimates for the three versions 
of the legislation are identical.
    The CBO staff contacts for this estimate are Shinobu Suzuki 
(for federal costs), Leo Lex (for the state and local impact), 
and Stuart Hagen (for the private-sector impact). This estimate 
was approved by Peter H. Fontaine, Deputy Assistant Director 
for Budget Analysis.

                       FEDERAL MANDATES STATEMENT

    The Committee adopts as its own the estimate of Federal 
mandates prepared by the Director of the Congressional Budget 
Office pursuant to section 423 of the Unfunded Mandates Reform 
Act.