Lesley Beth Harris

January 28, 1999

Disease and Discrimination

Analytical Review of 2 web sites

Both of the web sites I am reviewing contain information on HIV-infected or AIDS patients and the struggle to obtain adequate health insurance. Health insurance companies are reluctant to provide insurance for people carrying the disease, claiming that the length of the illness and the high cost of care would force them to go bankrupt while at the same time the patients are unable to gain access to the necessary treatment due to the overwhelming costs of medical bills. The Americans with Disabilities Act (ADA) passed in July, 1990 guarantees that people with HIV or AIDS should be granted insurance and medical care just as any other person would, however, the issue remains highly disputed.

1. Insurance in the Age of AIDS

http://www.nolo.com/ChunkCTIM/InsAIDS.HTML

by Peri H. Paknoo

This web site is maintained by a self-help law center that covers a variety of legal issues for personal research, information, and legal aid (it even has a link to a bunch of lawyer jokes). The link to this article begins by explaining that the recent passage of the ADA applies to persons with either HIV or AIDS, therefore to deny them health insurance is "unlawful discrimination." The issue, unfortunately, is complicated by the claim by insurance companies that to take on any person with either HIV or AIDS would eventually force them in to bankruptcy. In addition the question of privacy and confidentiality is also disputed when people seek medical insurance. The site then gives two examples of people who had difficulty obtaining insurance based on their HIV or AIDS status. The first story is about a married couple, the Levins. Mr. Levins was HIV negative, however, his wife tested positive. After 4 years of testing negative Mr. Levins was continually denied health insurance, whether he practiced safe sex or not. The case was taken to federal court and although it is still pending, it "sets a strong argument for prohibiting discrimination against people who are in relationships with HIV-positive individuals, but who are virus-free themselves."

The second example in the article is about a man, Mr. Deramus, who attempted to switch insurance companies in 1988. In order to join the new company, Jackson National Life Insurance Company (JNL), Mr. Deramus took a series of medical tests through which JNL learned of his HIV-positive status. Mr. Deramus was denied coverage but never told why and did not learn of his condition for another 18 months. He died in 1991 and his wife sued JNL for their failure to inform Mr. Deramus of his condition. Although she lost the suit, Mrs. Deramus plans to appeal.

Although this web site lacks a comprehensive history of the legal developments affecting health insurance and HIV/AIDS patients, it does provide some general history on the subject. In addition, the two examples of Mr. Levins and Mr. Deramus are fascinating and raise a number of related concerns, for example, should health insurance companies always inform potential clients of the results of their medical tests? The intended audience for the Nolo Press is clearly general public and anyone doing AIDS/legal research. Correspondingly the site is very easy to access and incredibly user friendly-- the main article begins the site and related web sites are listed at the bottom of the page. The biggest problem with the site is that there is no date anywhere on the article, the home page of Nolo Press or the listing for the site. This link was established sometime after 1991 (the last date referenced in the article) but I was unable to locate more information pertaining to either law suit. I would recommend this site as a reference for someone researching the question of insurance and HIV/AIDS patients.

2. HIV Insurance Caps Violate Americans With Disabilities Act

http://www.lambdalegal.org/cgi-bin/pages/documents/record?record=313

December 3, 1998

maintained by Lambda Legal Defense and Education Fund: http://www.lambdalegal.org/

Lambda Legal Defense and Education Fund is an organization that defends the civil rights of lesbians, gay men, and people with HIV/AIDS. The home page contains links to recent news and developments, state-by-state information, and general events and issues. This particular link recounts the results of recent federal lawsuit, Doe v. Mutual of Omaha. Mutual, a health insurance company had placed a lifetime ceiling on Doe’s insurance policy at $100,000 and another client, Smith, at $25,000. Normally, however, Mutual will provide up to one million dollars for other medical conditions, despite the fact that the cost of treating HIV/AIDS was "similar or less than the cost of treating other medical conditions." Doe and Smith had both considered going without certain "state-of the-art therapies" to save their lives due to the insurance cap. Mutual lost the law suit and now agrees to lift the caps but is still expected to appeal the general issue of whether or not the ADA prohibits a certain level of discrimination in determining health insurance.

Much like the first web site, the Lambda Legal Defense and Education Fund site provides information on issues of health insurance and persons with HIV/AIDS. The link is interesting and very recent- it is constantly updated. Through the course of all the relevant links the site lacks very little, if any information. The stories are intended to educate the general public and the entire system is incredibly user-friendly. I would recommend this site to anyone interested in learning more about the legal issues surrounding HIV/AIDS.