Press Releases

Today, Representatives Suzan DelBene (WA-01) and Jay Obernolte (CA-23) introduced bipartisan legislation to increase the number of living organ donors eligible for federal assistance through the National Living Donor Assistance Center. The Honor Our Living Donors (HOLD) Act will allow more donors to qualify for wage, travel, and caregiver reimbursement when donating organs.  

Burdensome income restrictions limit who can be reimbursed for being a living donor. Currently, a donor can only be reimbursed if the income of the recipient and donor combined is less than 350% of the HHS poverty level, roughly $51,000 a year. As a result, 91% of donors finance their own donations. The HOLD Act would no longer limit donor eligibility based on the income of the intended recipient. 

This bill would benefit over 37 million Americans living with kidney diseases, including more than 800,000 with kidney failure. People with kidney failure are likely on dialysis and patiently waiting for a kidney donation. Medicare spends approximately $150 billion annually, which is over 18 percent of the total spending, on people with kidney diseases. Managing kidney failure through dialysis and related care accounts for roughly $50 billion in Medicare spending each year. The cost of transplantation and post-transplant care is substantially less.

"The HOLD Act is an important step toward eliminating unnecessary barriers to organ donation," said DelBene. "We must support heroic living donors who give the incredible gift of life to those in need. This legislation would encourage more life-saving donations, improve health outcomes, and ultimately reduce costs to Medicare and our health care system.” 

“When deciding whether or not to perform the selfless act of donating an organ, the financial burden of donation stops far too many potential donors who are motivated and medically suitable,” said Obernolte. “Donating an organ often involves taking time off work for invasive medical procedures. The HOLD Act will ensure more individuals can recoup this personal cost and help give the gift of life to others.”  

“The Honor Our Living Donors (HOLD) Act will provide low income living organ donors with a cost neutral organ donation by removing recipient income from the National Living Donor Assistance Center (NLDAC) application and focusing solely on the critical factor, donor income,” said Waitlist Zero. “NLDAC, a federal living donor reimbursement system, currently requires that for donors to qualify for funding both donor and recipient income be below $51,000 for an individual. Many low-income Americans, especially rural Americans, cannot bear the cost of being a living organ donor due to the travel expenses to the transplant center as well as the lost wages incurred while they recover from the surgery. Reps. Obernolte and DelBene’s HOLD Act, will reduce the kidney and liver donor waitlist by increasing the number of living organ donations, the gold standard for patients with chronic kidney and liver disease.” 

“The Honor Our Living Donors Act will simplify access to financial support for living donors through the National Living Donor Assistance Center by using donors’ own income to determine their eligibility to receive support for donation-related costs”, said the American Society of Nephrology. “Currently, donors’ eligibility to receive support is determined using the organ recipient’s income. This policy change is an important step towards supporting living donors who need financial help as they provide the gift of life.” 

“Under the NLDAC program's current requirements, living donors sometimes must ask their prospective recipients for assistance with donation related expenses, such as hotel charges, airfare, or lost wages,” said Kevin Longino. National Kidney Association CEO and transplant recipient. “The potential tension and discomfort of basing NLDAC eligibility on the recipient’s income is burdensome and counterproductive. NKF appreciates Rep. Obernolte and Rep. DelBene’s leadership to expand and improve the NLDAC program and base eligibility for reimbursement solely on the donor’s financial status.”