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Abstract: In November 1985, District of Columbia Councilmember John Ray introduced a bill that would have imposed a five-year moratorium on all kinds of applicant AIDS-testing in the district by health, life, and disability insurers. Ray wrote the bill after learning that insurers were testing for antibodies to the AIDS virus in order to predict who would come down with the fatal disease. He believed insurers had panicked and were using a test whose accuracy and predictive value hadn't yet been properly established. If the council passed Ray's bill, the district would become the only jurisdiction in the United States to outlaw all kinds of AIDS-testing by insurers. This case outlines the facts known about the AIDS epidemic in 1986 and describes some of the science behind the screening tests for the HIV-antibody. In detailing Ray's bill and the arguments for and against its passage, the case examines the balance between insurers' desire to retain control of their risk-assessment procedures and some applicants' desire to limit that control.
Learning Objective: Students are asked to weigh the roles of health and life insurance in American society and the logic of their pricing systems against the possible social, medical, and financial costs borne by those applicants denied insurance on the basis of a positive HIV-antibody test.