Representatives Jay Obernolte (CA-23) and Suzan DelBene (WA-01) celebrated the passage of the Honor Our Living Donors (HOLD) Act through the House Committee on Energy and Commerce with unanimous bipartisan support. The HOLD Act aims to enable more living donors to qualify for wage, travel, and caregiver reimbursement when donating organs.
“One of the most powerful acts of generosity is the donation of a life-saving organ to another person,” said Rep. Obernolte. “Donating an organ, however, often requires an overwhelming financial obligation and extensive time to recover from the procedure. Unfortunately, current law disincentivizes individuals who would otherwise be motivated to become a living donor. With 100,000 Americans on the waiting list for an organ transplant, it’s critical that we make it easier for living donors to give the gift of life.”
“No one should have to choose between a paycheck and donating a lifesaving organ, but the current organ donation system fails to provide living donors the support and resources they need,” stated Congresswoman Suzan DelBene (WA-01). “Patients currently wait for years on the transplant list and many die because there aren’t enough people who are willing and can afford to donate. The House took a major step forward in addressing this disparity with today’s unanimous bipartisan vote in the Energy & Commerce Committee to advance legislation I introduced with Rep. Obernolte. I am hopeful we can pass this bill through the House of Representatives so we can give renewed hope to Americans waiting for organ donations.”
Currently, burdensome income restrictions limit who can be reimbursed as a living donor through the National Living Donor Assistance Center (NLDAC). A donor can only be reimbursed if both their income and that of the recipient combined is less than 350% of the HHS poverty level—approximately $53,000 annually for a family of four. Consequently, 91% of donors finance their own donation costs. The HOLD Act proposes removing these income-based eligibility limits based on recipient income.
This legislation could significantly impact over 37 million Americans living with kidney diseases, including more than 800,000 with kidney failure awaiting transplants while likely undergoing dialysis treatments. Medicare spends around $150 billion annually—over 18 percent of its total program spending—on patients with kidney diseases; managing kidney failure through dialysis accounts for roughly $50 billion each year.
Organizations have expressed support for this legislative change:
Waitlist Zero: “The Honor Our Living Donors (HOLD) Act will provide low-income living organ donors with cost-neutral organ donation by removing recipient income from NLDAC application criteria and focusing solely on donor income.”
American Society of Nephrology: “The Honor Our Living Donors Act will simplify access to financial support for living donors through NLDAC by using donors’ own income to determine their eligibility.”
National Kidney Foundation: “Under NLDAC’s current requirements, living donors sometimes must ask their prospective recipients for assistance with expenses such as hotel charges or lost wages,” stated NKF CEO Kevin Longino. “The potential tension and discomfort created by basing NLDAC eligibility on recipient’s income is burdensome and counterproductive.”
