Representatives Matsui and Wilson have introduced legislation that, if passed, could allow pilot programs involving compensation of organ donors.

  Congresswoman Doris Matsui (D-CA) and Congressman Joe Wilson (R-SC)  have introduced legislation that, if passed, could allow pilot programs involving compensation of organ donors.

Here's the press release:

WASHINGTON, D.C. – Today, Congresswoman Doris Matsui (D-CA) and Congressman Joe Wilson (R-SC) introduced the Organ Donation Clarification Act, a bipartisan bill to reduce barriers to organ donation and increase the supply of organs for transplantation.

Every day, 17 Americans die waiting for a lifesaving organ transplant. As of this month, over 114,000 Americans are on the national waitlist. In 2022, although over 42,000 patients received a transplant, over 68,000 additional patients were added to the national waitlist.

With over 95,000 patients in need of a kidney transplant, the average wait time is between three to five years. Those delays cause tens of thousands of Americans to go through lifesaving yet burdensome and disruptive dialysis treatments in the hope that they live long enough for a kidney to become available.  However, thousands of Americans every year will become too sick to receive a transplant and die waiting for one. Not only can thousands of lives be saved, but getting everyone the lifesaving transplant they need can also save billions of dollars a year in dialysis costs.

“Every day that our country suffers from an organ donation shortage means more preventable loss of life,” said Congresswoman Matsui. “By removing disincentives and barriers for prospective donors, we can reach more patients and save lives. The Organ Donation Clarification Act is a bipartisan solution that will help us bridge the gap in organ donations and give hope to patients and families waiting for a lifesaving transplant.”

“I am grateful to introduce this bipartisan bill with Congresswoman Matsui to address the severe organ donation shortage in our country,” said Congressman Wilson. “An average of 17 people in the U.S. succumb to their illnesses every day because they could not survive the wait for a viable organ. In certain parts of the country, the waitlist can be over five years for a kidney. Current law lacks clarity and prevents potential organ donations. This legislation addresses those issues by removing the hurdles for potential donors and allowing new, innovative ways to increase organ donation. This would not only save taxpayer dollars but, most importantly, it would save lives.”

“We appreciate Congresswoman Matsui’s leadership on this bill, which improves the chances that a living donor can make the choice to save a life,” said Dr. David Lubarsky, CEO of UC Davis Health. “UC Davis Health is enormously proud of our Transplant Center, which is one of the largest in the country and has saved more than 5,000 lives in its 38 years of operation.”  

Organ transplantation is governed by the National Organ Transplant Act (NOTA) of 1984. This law prohibits buying or selling organs for “valuable consideration.” Confusion about what constitutes valuable consideration has hampered donation by scaring people away from reimbursing living organ donors for things like medical expenses and lost wages. Both are legal under NOTA, but the law's lack of clarity and its criminal penalties have created uncertainty and prevented reimbursements in many cases.

Moreover, current law does not allow for any entity to test the efficacy of providing benefits to encourage donation. The bill would allow for government run pilot programs to test the provision of non-cash benefits in order to increase organ donation, subject to ethical review, and mandates a report so the broader transplant community can understand best practices for encouraging additional organ donation. These benefits could include funeral benefits for deceased donors and health insurance, tuition assistance, or other proposals to increase the number of living donors. A 2019 American Economic Review survey indicates that between 65 and 80 percent of Americans would support such a program to encourage additional donation.

Finally, when determining eligibility for reimbursements for donation expenses such as travel and medical costs, current law requires the government to take into account the income of the recipient, rather than solely focusing on the income of the donor. This often disqualifies potential donors by creating additional financial burden.  

The Organ Donation Clarification Act would:

• Clarify that certain reimbursements are not valuable consideration but are reimbursements for expenses a donor incurs;
• Allow government-run pilot programs to test the effect of providing non-cash benefits to promote organ donation;
• Clarify that the National Living Donor Assistance Center (NLDAC) can’t consider the organ recipient’s income when determining whether to reimburse a donor’s expenses.

This bipartisan legislation is endorsed by the Americans for Tax Reform, American Transplant Foundation, Foundation for Kidney Transplant Research, National Kidney Donation Organization, Transplant First Academy, Chris Klug Foundation, Flood Sisters Kidney Foundation, American Liver Foundation, National Kidney Donation Organization, Kidney Transplant Collaborative and Wait List Zero.

Text of the legislation can be viewed here.

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HT: Frank McCormick