Justices decline to hear AIDS patients' insurance case

Supreme Court rebuffs challenge to coverage

January 11, 2000|By Lyle Denniston | Lyle Denniston,SUN NATIONAL STAFF

WASHINGTON -- The Supreme Court rebuffed yesterday a move by AIDS patients and people infected with HIV to use federal law to gain equal health insurance benefits.

Without explanation, the justices refused to consider an appeal by two Chicago men who have tested positive for the human immunodeficiency virus and claim that their insurance company violated the Americans with Disabilities Act by discriminating against them.

Their medical insurer, Mutual of Omaha, sets a lifetime ceiling on benefits for policy holders who have acquired immune deficiency syndrome or AIDS-related diseases, but the company sets higher ceilings for treatment of other illnesses.

The 7th U.S. Circuit Court of Appeals in Chicago ruled in June that the federal law protecting the disabled is not aimed at regulating the products that an insurance company offers to the public.

If a company chooses to sell insurance with lifetime limits on some forms of coverage but not others, federal law will not intrude, the appeals court said.

Moreover, it said, government controls on insurance are left to the states, not to Congress.

"We are disappointed that the court will not provide much-needed guidance to the lower courts on this life-and-death issue," said Heather C. Sawyer, a staff lawyer in Chicago for the Lambda Legal Defense Fund, a gay-rights advocacy group.

She said that the court order "did not give a green light to this practice" but meant only that the court was not ready to rule on the issue.

Mutual of Omaha said in a statement, "This is an important decision. The decision means the ADA does not require every business to modify every product to accommodate every disability."

It added that limits on benefits within insurance policies are common in the industry and are usually used to "limit exposure to unknown or unpredictable risk."

Two types of ceilings on coverage were set in the policies that the Chicago men challenged. One set a lifetime maximum of $100,000 on benefits for treating those with AIDS or AIDS-related medical conditions. The other set a lifetime ceiling of $25,000.

A federal judge said that because the insurance company does not impose the same limits for other diseases, the ceilings amounted to discrimination that violated the ADA. The appeals court overturned that result.

Returning from a four-week recess, the justices refused yesterday to grant new appeals, instead turning aside scores of new cases.

In three related orders, the court refused to give any encouragements to a widening effort by labor union health plans to sue the tobacco industry to recoup the cost of providing treatment of smoking-related illnesses.

Union funds in New York, Oregon and Pennsylvania had tried unsuccessfully in lower courts to sue the tobacco makers under federal antitrust and anti-racketeering laws. Without comment, the Supreme Court turned aside their pleas to revive their lawsuits.

The justices also declined a challenge to a nationwide network of databases that collect genetic code -- or DNA -- samples from people convicted of crimes. The information is kept on record to aid in solving crimes.

In a test case in Massachusetts, that state's supreme court upheld a 1997 state law requiring people who have been convicted to file DNA samples for investigative purposes. The Supreme Court declined to disturb that outcome.

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