Genetic testing can help parents learn what inheritable traits they may pass on to potential children.
There are tests that can detect if parents may pass on serious health conditions such as cystic fibrosis and many others. There are also genetic tests that can help in oncology, neurology and more to help identify treatments and potential future health states for patients.
What genetic testing should the Oregon Health Plan cover?
It’s a demanding question — a mix of medicine, equity, ethics, statistics and cost. It’s all the more challenging with the reduction in federal support for Medicaid in Oregon.
Oregon’s Health Evidence Review Commission makes decisions about what should be included in the Oregon Health Plan. A state committee made up of medical experts met Wednesday to make recommendations to the commission.
Genetics and the statistics on risk are not simple even for medical professionals. Ensuring people on the Oregon Health Plan receive appropriate counseling about the results of any genetic testing can be just as important as the testing itself. Will they get the counseling they need? Do general practitioners have the tools they need to be able to explain results to patients?
Then there’s the frequency with which a genetic trait is present in the population. What should be the threshold when testing is appropriate: 1 in 100, 1 in 200, something else?
There are equity considerations. Are Oregon Health Plan members getting the same kind of access to genetic testing and counseling as people on commercial insurance? There’s been concern that people from marginalized backgrounds don’t get access to genetic testing as often as other people. Genetic testing results can also have implications for family members and lead to additional testing and expense.
Oregon’s Health Evidence Review Commission has to make difficult choices of what makes its list of services it wants for people on the Oregon Health Plan. In the past, it has ordered the funding by priority. The Legislature then doesn’t have to pick and choose what to fund. Legislators would pick a funding line. Things above it would get funded. Things below it would not. The Oregon Health Authority told us the process may work differently in the future. Regardless, the reduction in federal funding to Medicaid could be what shapes the final choice.
Editorials reflect the views of The Bulletin’s editorial board, Editor Jody Lawrence-Turner, Editor Tim Trainor and Editorial Page Editor Richard Coe.