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Comment & Response
December 11, 2018

Potential Harms of HIPAA

Author Affiliations
  • 1Department of Neurology, Thomas Jefferson University, Philadelphia, Pennsylvania
JAMA. 2018;320(22):2379. doi:10.1001/jama.2018.17179

To the Editor Dr Berwick and Ms Gaines1 discussed potential harms of HIPAA, which has increased burdens for practitioners, staff, patients, and the US health care system.

The law has been around for so long that practitioners and patients tend to forget that one of the main motivating factors for it, and for the Privacy Rule in particular, was the insurance companies’ practice of increasing rates or denial of coverage based on preexisting conditions. This practice was outlawed by the Affordable Care Act (ACA), and there is little reason to expect this to change, as coverage for preexisting conditions has always been one of the most popular aspects of the ACA, and even health insurers support continuation.2 Thus, it is worth questioning whether the HIPAA Privacy Rule is worth maintaining at all, given that one of the major drivers of its creation has been eliminated by subsequent legislation. Berwick and Gaines implied that the rule should be reweighted in the direction of patient care, but this would only add further regulatory burden and stress. A better rebalancing might involve scaling its provisions back or an outright repeal, now that the consequences to patients do not include inability to obtain health insurance from disclosure of preexisting conditions.