Rep. Obernolte introduces legislation to remove barriers for organ donors

WASHINGTON, D.C. – U.S. Congressman Jay Obernolte (R-CA) has introduced bipartisan legislation with Congresswoman Suzan DelBene (D-WA) to substantially increase the number of living organ donors that are 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. 

“When deciding whether or not to perform the selfless act of donating an organ, the financial burdens of donation stops too many potential donors who are motivated and medically suitable,” said Rep. Obernolte. “Donating an organ often involves travel expenses or 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.” 

“This bipartisan legislation is a critical step in removing unnecessary roadblocks that discourage organ donation. Living donors make extraordinary sacrifices to give the gift of life to people in need but the current health care system doesn’t provide them with the support they need. The HOLD Act would address these financial and logistical challenges, opening the door for more life-saving donations. By increasing organ donations, we can improve health outcomes, reduce waiting times, and lower long-term health care costs for Medicare and the entire system,” said Congresswoman Suzan DelBene (WA-01). 

Background: 

Burdensome income restrictions currently limit who can be reimbursed for becoming a living organ donor. Under existing regulations, a donor is only eligible for reimbursement if the combined income of the donor and the recipient is less than 350% of the federal poverty level, approximately $63,870 annually for a household of two in 2024. This restrictive policy forces 91% of living donors to shoulder the financial burden of their donation. 

The Help Organ Donors Act (HOLD Act) would make these income-based eligibility restrictions apply only to the donor, not the organ recipient, ensuring that living donors can access reimbursement regardless of the recipient's financial status. This legislation will support the more than 37 million Americans living with chronic kidney diseases, including the more than 800,000 individuals with kidney failure. 

Patients with kidney failure often depend on dialysis—a time-consuming and physically demanding treatment—while waiting for a life-saving kidney transplant. Unfortunately, the need for organs far exceeds the supply, with over 89,000 people currently on the national waiting list for a kidney transplant. 

The economic implications are equally significant. Medicare spends approximately $160 billion annually—over 20% of its total budget—on patients with kidney diseases. Dialysis and related care for kidney failure alone account for nearly $55 billion each year. By contrast, kidney transplantation and post-transplant care are far less costly, representing a more effective and sustainable investment in patient care. Expanding access to living donor reimbursement would not only save lives but also reduce the financial burden on Medicare. 

The HOLD Act passed the House of Representatives unanimously during the 118th Congress and represents a critical step forward in addressing these disparities, improving outcomes for patients, and encouraging more individuals to become living donors.  

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