Work

Underwriting Discrimination: Risk and the Rhetoric of Bureaucratic Homophobia

Year: 2026
Type: article
Abstract: Insurance companies have long utilized the noxiously bureaucratic language of “pre-existing conditions” clauses to protect their profits by disenfranchising people with medical problems. Prior to the passage of the Affordable Care Act, corporate executives defended such practices by utilizing rhetorics that naturalized capitalist constructions of risk. However, a person need not live with an actual health condition to fall victim to malicious underwriting strategies. A person’s assumed identity, occupation, zip code, or even coworkers provided actuarial justification for excluding people from care. This essay examines how the insurance industry rhetorically isolated those they situated at high risk of HIV infection in the 1980s and 1990s by invoking the incommensurability of capitalist practices: discrimination might be undesirable but, they rationalized, companies had a right to pursue profits. Queer communities were enlivened as inherently cataclysmic to the economic well-being of the industry, even as medical interventions that might save lives were positioned out of reach. I argue that bureaucratic constructions of risk engendered a “moralistic drift” built on an ableist foundation of contagion. Paradoxically, these policies subverted the ways individuals were expected to minimize the impact of risks by insinuating they had no agency over their health to start.
Language: English
Subfield: Philosophy
Open Access status: hybrid
OpenAlex ID: W7166561375
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Cites: 6
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