AIDS Tests for Insurance Debated : Industry Officials Cite Statistics; Gays Demand Guidelines

ORLANDO, Fla. —  Insurance industry representatives and gay rights advocates clashed Tuesday in a debate before state insurance commissioners from around the nation on whether life and health insurers should be allowed to test individual applicants for the presence of AIDS antibodies.

Industry spokesmen, citing federal health authorities, said carriers of the antibodies have a 20% to 30% chance of developing AIDS within five years and are at least 26 times more likely to die within seven years, if they are in their 30s, than those without the antibodies.

Insisting that the solvency of the insurance industry is threatened by the spreading AIDS epidemic, they said that unless the companies are allowed to test and screen out such applicants, life and health insurance premiums for all individual buyers are going to skyrocket.

National Rules Urged

The gay rights advocates argued that no antibodies testing should be used by insurance companies before strict anti-discrimination and privacy rules are adopted nationwide and until provision has been made for those with the antibodies to be able to buy insurance through a national risk pool--a special program for high-risk applicants.

On Thursday, commissioners are scheduled to meet privately and could vote on whether to recommend that states adopt a uniform policy on antibody testing. However, some sources here indicated that they expect no decision on the issue.

California is one of only two states that has a law explicitly prohibiting insurers from using the AIDS antibodies tests, although a few other states have limited their use by administrative fiat. Presence of the antibodies does not mean that a person will get AIDS, but signals that the individual has been exposed to the virus, which is assumed still to be present.

May Seek Repeal

Life and health insurers have said in recent weeks that they are considering whether to press the Legislature to repeal the law in California, and they have drafted repeal legislation.

Tuesday’s debate involved four people--two on each side--who had been participants in an advisory committee established a year ago by the National Assn. of Insurance Commissioners to study the questions involving AIDS and the insurance industry.

The debate attracted hundreds of the 1,300 participants in this week’s insurance meetings here. In addition to most state insurance commissioners, many state insurance department staff members, numerous industry representatives and a few consumer advocates are here.

Speaking for the Health Insurance Assn. of America and the American Council of Life Insurance, respectively, Karen Clifford and Russel P. Iuculano insisted that insurers have always treated victims of disease differently than healthy individuals when they come to buy insurance on an individual basis, either charging them higher premiums or refusing to sell them policies.

High Percentage

Iuculano said that of every 1,000 healthy 34-year-old males, for example, only 7 1/2 can be expected to die within seven years. For smokers, it is 15 out of 1,000, for diabetics 30 and for quadriplegics 56, but for the carrier of AIDS antibodies it is 200 to 300. AIDS, he said, is striking hardest among younger people--the very people who haven’t paid much in premiums. Of all people claiming payments for AIDS, 44% have held their policies less than two years, he said.

The arguments of the industry representatives were sharply questioned, however, by Delaware Insurance Commissioner David N. Levinson, who in an exchange with Clifford got her acknowledgment that the industry is not presently seeking antibodies tests for participants in group insurance policies.

Most in Group Policies

When Clifford said that 90% of all health insurance purchasers are involved in group policies, Levinson responded that the proposed testing of the remaining 10% would not result in a very substantial reduction of cost for the insurers.

“Either your solvency arguments don’t hold water, or they do,” he remarked. “If they do, then individual testing won’t save you. You may all go down the tubes.”

Clifford responded that the group policies tend to involve so many people that costs even out. But under questioning from Levinson, she said that no estimates were available as to how much group premiums will have to increase as a result of group policies covering many future AIDS victims.

The gay rights advocates were Jeffrey Levi of the National Gay and Lesbian Task Force and Benjamin Schatz of the National Gay Rights Advocates.

“Why are we concerned about testing?” Levi asked.

“Protections against discrimination and rules of confidentiality are not in place yet,” he said. “A showing of the presence of antibodies may conceivably result in someone losing a job or custody of their children.

“Two, if the test is a condition of access to insurance, it is no longer voluntary.

“Three, if people are going to be refused insurance on this basis, then it will be states and taxpayers who eventually pick up their health costs.”