I don't get it, if you're medically unfit for a job, why would you want the job?

For instance, if your job is to be on your feet all day and you can barely stand, then that job is not for you. I have never met employers that are so flush in opportunities of candidates that they just randomly choose to exclude certain people.

And if it's insurance, there's a group rate. The difference only variable is what the employee chooses out of your selected plans (why make a plan available if you don't want people to pick that one?) and family size. It's illegal to discriminate of family size and that does add up to 10k extra on the employer side. But there are downsides to hiring young single people, so things may balance out.

Usually there's one or two job responsibilities among many, that you can do, but not the way everyone else does them. The ADA requires employers to make reasonable accommodations, and some employers don't want to.

So less, the job requires you to stand all day, and more, once a week or so they ask you make a binder of materials, and the hole puncher they want you to use dislocates your hands (true story). Or, it's a desk job, but you can't get from your desk to the bathroom in your wheelchair unless they widen the aisles between desks (hypothetical).

Very large employers don't have a group rate. The insurance company administers the plan on behalf of the company according to pre-agreed rules, then the company covers all costs according to the employee health situation.

Read your policy!

I believe existing laws carve out exceptions for medical fitness for certain positions for this very reason. If I may, stepping back for a second: the reason privacy laws exist, is to protect people from bad behavior from employers, health insurance, etc.

If we circumvent those privacy laws, through user licenses, or new technology - we are removing the protections of normal citizens. Therefore, the bad behavior which we already decided as a society to ban can now be perpetrated again, with perhaps a fresh new word for it to dodge said old laws.

If I understand your comment, you are essentially wondering why those old laws existed in the first place. I would suggest racism or other systemic issues, and differences in insurance premiums, are more than enough to justify the existence of privacy laws. Take a normal office job as an example over a manual labor intensive job. No reason at all that health conditions should impact that. The idea of not being hired because I have a young child, or a health condition, that would raise the group rate from the insurer passing the cost to my employer (which would be in their best interest to do) is a terrible thought. And it happened before, and we banned that practice (or did our best to do so).

All this to say, I believe HIPAA helps people, and if ChatGPT is being used to partially or fully facilitate medical decision making, they should be bound under strict laws preventing the release of that data regardless of their existing user agreements.

> And if it's insurance, there's a group rate.

Insurers derive rates for each employer from each employer's costs where laws allow this. And many employers self fund medical insurance.