ASN celebrates legislation introduced on Wednesday, December 5, that would substantially bolster and expand support for living donors through an existing government program, commonly known as the National Living Donor Assistance Center. 

The bipartisan bill—introduced by Congressional Kidney Caucus co-chairs Rep. Suzan DelBene and Rep. Larry Bucshon, MD, as well as kidney champions Rep. Carole Miller and Rep. Kim Schrier, MD—would make substantial inroads to achieving ASN’s goal of cost-neutrality for all living donors. 

In summary, the bill would:

• Remove the recipient income test the program currently uses Ensuring living donors’ own incomes are used as the basis for eligibility to have the costs they incur in donating reimbursed
• Ensure eligibility of donors whose household income is at or below 700% of the poverty line (up from 350% under current regs) Expanding the number of Americans who can donate without paying out-of-pocket
• Increase maximum reimbursement level to $10,000, pegged to inflation Aiming to keep donation cost-neutral even for donors whose donation-related costs are above-average
• Require an annual report on various metrics related to the program Keeping Congress apprised of how its funds are being used and where more funding is needed 
• Reauthorize the program for 10 years through 2035 Reaffirming Congressional support for the program and adhering to best legislative practices 
• Require GAO to conduct a study on how Medicare could be changed to pay for donor reimbursement costs, and submit a report to Congress with recommendations Understanding how more predictable, sustainable funds could be provided to support living donors 

Together, these changes will strengthen the program, allow Congressional appropriators to allocate more funds to the program than statute currently permits, and enable more Americans to consider donation with the removal of financial impediments. 

“In 2019, ASN celebrated the ambitious goals set by the Advancing American Kidney Health Initiative Executive Order, particularly having 80 percent of incident patients with kidney failure accessing to transplantation (or home dialysis) by 2025,” observed Roslyn B. Mannon, MD, FASN, transplant nephrologist and chair of the ASN Policy and Advocacy Committee. “Yet today, on the cusp of 2025, we have not achieved that milestone, and the annual number of living kidney donors has remained relatively flat for years, at approximately just under 6,000. I am hopeful that the expanded support this bill provides living donors will allow us to grow that number and enable meaningful progress towards achievement of that goal.” 

Dr. Mannon also noted that one section of the bill directly builds upon pivotal progress made as part of the Executive Order, which expanded eligibility for the program to 350% of the poverty level. 

ASN worked closely with lead sponsoring Congressional offices in crafting the legislation, reflective of cost-neutrality for living donors as one of the society’s top policy objectives. 

“We are fortunate to have voices in Congress who are deeply committed to improving kidney and transplant care—as well as collaboration with the kidney and transplant community in shaping policies that help us all advance that shared objective,” said ASN Health Policy Scholar-in-Residence Suzanne Watnick, MD, FASN. “I anticipate this bill will be a top legislative priority for ASN in the 119th Congress and look forward to building bipartisan support for this crucial legislation.”