Bill Summary
The "Expanding Support for Living Donors Act of 2026" aims to enhance the Living Organ Donation Reimbursement Program under the Public Health Service Act. Key provisions of the legislation include:
1. **Eligibility Expansion**: It allows individuals with a household income up to 700% of the poverty line to qualify for reimbursement of expenses related to organ donation, thereby eliminating income-based restrictions for low-income donors.
2. **Reimbursement Amounts**: The bill sets a maximum reimbursement amount of $10,000 for fiscal year 2027, with adjustments for inflation in subsequent years. It also permits the Secretary of Health and Human Services to lower this cap if grant funding is insufficient, with prior notice to Congress.
3. **Annual Reporting**: The Secretary of Health and Human Services is required to submit an annual report to Congress detailing the program's effectiveness, including information on reimbursement adequacy, the number of donors reimbursed, and the financial implications for Medicare.
4. **GAO Study**: Within one year of the bill's enactment, the Government Accountability Office (GAO) will conduct a study on how Medicare could potentially cover costs that are currently reimbursed through the Living Organ Donation Reimbursement Program.
Overall, this legislation seeks to improve support for living organ donors, reduce financial barriers, and ensure the program's sustainability and effectiveness.
Possible Impacts
The "Expanding Support for Living Donors Act of 2026" can have several significant effects on individuals and the healthcare system. Here are three examples:
1. **Increased Access to Organ Donation**: By expanding reimbursement eligibility to individuals with household incomes up to 700% of the poverty line, the legislation makes it financially easier for a broader range of people to become living organ donors. This can lead to an increase in the number of living donors, which is crucial for addressing the shortage of available organs for transplantation. More donations can improve patient outcomes and potentially save lives.
2. **Financial Relief for Donors**: The act establishes a reimbursement program that covers qualifying expenses related to organ donation, up to a maximum of $10,000 (with adjustments for inflation in subsequent years). This financial support can alleviate the economic burden on donors, who may otherwise face costs such as travel, lost wages, and medical expenses. By minimizing financial disincentives, the act encourages more individuals to consider organ donation.
3. **Accountability and Program Evaluation**: The requirement for the Secretary to submit an annual report on the program's effectiveness and funding adequacy ensures that the impact of the reimbursement initiative is regularly assessed. This transparency helps identify challenges, track demographic and financial data, and assess the program's overall success. Continuous evaluation can lead to improvements in the program, ensuring that it meets the needs of donors and recipients alike, and provides insights into potential policy adjustments that could further enhance the living organ donation landscape.
[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7868 Introduced in House (IH)]
<DOC>
119th CONGRESS
2d Session
H. R. 7868
To amend the Public Health Service Act with respect to the Living Organ
Donation Reimbursement Program.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 9, 2026
Ms. DelBene (for herself, Mrs. Miller of West Virginia, and Ms.
Schrier) introduced the following bill; which was referred to the
Committee on Energy and Commerce, and in addition to the Committee on
Ways and Means, for a period to be subsequently determined by the
Speaker, in each case for consideration of such provisions as fall
within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To amend the Public Health Service Act with respect to the Living Organ
Donation Reimbursement Program.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Expanding Support for Living Donors
Act of 2026''.
SEC. 2. EXPANDING SUPPORT FOR LIVING DONORS.
Section 377 of the Public Health Service Act (42 U.S.C. 274f) is
amended--
(1) by redesignating subsections (f) through (h) as
subsections (h) through (j), respectively;
(2) by inserting after subsection (e) the following:
``(f) Eligibility of Donating Individuals Based on Household
Income.--
``(1) In general.--In providing reimbursement to donating
individuals using funds from grant awards under this section,
the recipient of the grant award shall not limit the
eligibility of a donating individual for such reimbursement
based on the individual's income if the individual's household
income is at or below 700 percent of the poverty line.
``(2) Definition.--In this subsection, the term `poverty
line' means the applicable poverty line as set forth in the
most recent poverty guidelines of the Department of Health and
Human Services published under the authority of section 673(2)
of the Community Services Block Grant Act.
``(g) Reimbursement Amount.--
``(1) In general.--The amount of reimbursement of
qualifying expenses provided by a recipient of a grant award
under this section to each such donating individual shall be
the lesser of--
``(A) the total amount of the donating individual's
qualifying expenses; and
``(B) the maximum permissible amount described in
paragraph (2).
``(2) Maximum permissible amount.--
``(A) Rule.--Subject to subparagraph (B), the
maximum permissible amount described in this section
is--
``(i) for fiscal year 2027, $10,000; and
``(ii) for subsequent fiscal years, the
maximum permissible amount allowed under this
subsection for the preceding fiscal year
adjusted by the total percentage change
(rounded to the nearest hundredth) that
occurred in the Consumer Price Index for all
urban consumers (all items; United States city
average) for the preceding fiscal year.
``(B) Exception for recipients based on
insufficient funds.--The Secretary may, with respect to
reimbursement provided by a recipient of a grant award
under this section to donating individuals, lower the
maximum permissible amount under subparagraph (A) for a
fiscal year if the Secretary--
``(i) determines that such recipient has
insufficient funds to provide the full amount
that would otherwise apply under paragraph (1)
to all donating individuals; and
``(ii) at least 30 days before making such
determination effective, provides to the
Congress written notice of such determination,
including a justification.
``(C) Special rules.--If the Secretary, with
respect to reimbursement provided by a recipient of a
grant award under this section to donating individuals,
makes a determination under subparagraph (B) to lower
the maximum permissible amount under subparagraph (A)
for a fiscal year--
``(i) such determination shall not affect
the amount of reimbursement for any approved
donating individual prior to the effective date
of such determination; and
``(ii) the maximum permissible amount under
subparagraph (A)(ii) for any subsequent year
shall be calculated without regard to such
lowered amount.'';
(3) in subsection (i), as so redesignated, by striking ``is
authorized to be appropriated $5,000,000 for each of the fiscal
years 2005 through 2009'' and inserting ``are authorized to be
appropriated such sums as may be necessary for fiscal years
2028 through 2037''; and
(4) by amending subsection (j), as so redesignated, to read
as follows:
``(j) Annual Report.--Not later than December 31 of each year,
beginning in fiscal year 2027, the Secretary shall--
``(1) prepare, submit to the Congress, and make public a
report on--
``(A) whether grants under this section provided
adequate funding during the preceding fiscal year to
reimburse all donating individuals participating in the
grant program under this section for all qualifying
expenses; and
``(B) the impacts, ongoing activities, challenges,
and future needs of the program under this section; and
``(2) include in each such report, for the fiscal year
covered by the report--
``(A) the estimated number of all donating
individuals participating in the grant program under
this section who did not receive reimbursement for all
qualifying expenses;
``(B) the total amount of funding that is estimated
to be necessary to fully reimburse all donating
individuals participating in the grant program under
this section for all qualifying expenses;
``(C) an overview of the program under this
section;
``(D) current and trended historical information
about the program under this section, including--
``(i) the total number of donating
individuals applying for reimbursement;
``(ii) the average and median reimbursement
amount provided to donating individuals;
``(iii) demographic information regarding--
``(I) donating individuals applying
for reimbursement; and
``(II) donating individuals
approved for reimbursement;
``(iv) the types of expenses for which
reimbursement was requested (including requests
for reimbursement of non-qualifying expenses);
``(v) the amount of funding provided to
donating individuals with respect to each such
type of expenses;
``(vi) the amount of funding provided to
donating individuals with respect to each organ
category; and
``(vii) the total amount expended to carry
out this section, disaggregated by--
``(I) the amount expended by the
Secretary and the recipients of grants
under this section on administrative
expenses; and
``(II) the amount provided to
donating individuals as reimbursement;
``(E) the impacts of the program under this
section, including--
``(i) the number of completed donations for
which reimbursement was provided;
``(ii) the proportion of living donor
transplants in the United States in which the
donor received reimbursement through the
program under this section; and
``(iii) an estimate of the savings to the
Medicare program under title XVIII of the
Social Security Act resulting from the program
under this section, both--
``(I) for the fiscal year covered
by the report; and
``(II) cumulatively since the
program's creation;
``(F) the types of donations made by donating
individuals receiving reimbursement, disaggregated
according to--
``(i) the type of organ donated; and
``(ii) whether the donations were directed,
non-directed, or a paired exchange;
``(G) a description of any efforts to expand or
improve the program under this section;
``(H) a description of the efforts of the Secretary
and recipients of grants under this section to increase
awareness of the program under this section;
``(I) a description of challenges experienced by
the program under this section, including--
``(i) the number and percentage of donating
individuals applying for reimbursement whose
qualifying expenses approached or exceeded the
maximum amount allowed under subsection (g);
and
``(ii) an estimate of the total funding
needed to fully reimburse, without regard to
the maximum amount allowed under subsection (g)
or donor income eligibility caps, all donating
individuals in the United States for all
qualifying expenses;
``(J) areas of concern regarding, and identified
barriers to, the elimination of financial disincentives
to living organ donation; and
``(K) such other matters as the Secretary
determines appropriate.''.
SEC. 3. GAO STUDY.
Not later than 1 year after the date of enactment of this Act, the
Comptroller General of the United States shall--
(1) conduct a study on how the Medicare program under title
XVIII of the Social Security Act (42 U.S.C. 1395 et seq.)
could, under existing statutory authorities, pay costs that
would otherwise be paid through the Living Organ Donation
Reimbursement Program under section 377 of the Public Health
Service Act (42 U.S.C. 274f); and
(2) submit to the Congress a report on the results of such
study, including recommendations for any changes needed to
achieve such purpose.
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