Protect Living Donors' Access to Insurance

Summary#

This bill (Living Donor Protection Act of 2025) forbids insurers from treating a person worse in life, disability, or long-term care insurance just because they are a living organ donor, unless the donor status creates an actual, unique, and material actuarial risk. It also requires the Secretary of Health and Human Services to update public education materials about the risks and benefits of living donation and how donation affects access to insurance. The broad goal is to protect living donors from insurance discrimination and to inform the public about donation and insurance issues.

Important changes:

  • Insurance rule: Insurers may not deny, cancel, refuse to issue, change price, or otherwise vary terms of life, disability, or long-term care insurance solely because someone is a living organ donor, unless donor status truly increases actuarial risk.
  • Enforcement: State insurance regulators enforce the rule under state law. The bill does not create a federal private right to sue in the text.
  • Definitions: The bill defines “living organ donor,” and the three types of insurance covered (life, disability, long-term care).
  • Education update: HHS must review and update public materials within 6 months to include benefits and risks of living donation and information on the new insurance protections.
  • Scope: The bill addresses insurance discrimination. It does not change rules about medical eligibility for donation or federal health insurance programs in the text.

What it means for you#

  • Living organ donors: If you donate an organ while alive, insurers cannot treat you worse in life, disability, or long-term care policies just because you donated, unless there is a clear actuarial reason. This could make it easier to buy or keep those policies.
  • People considering donation: The bill could reduce one barrier (fear of losing insurance or paying higher premiums) when deciding whether to donate. HHS will update public materials to explain this.
  • Insurers: Companies that sell life, disability, or long-term care insurance must not base coverage decisions solely on a person’s donor status unless they can show an actual, unique, and material actuarial risk. They may need to change underwriting rules and train staff.
  • State insurance regulators: Regulators must enforce the new rule under each state’s enforcement powers. That may change their workload or priorities.
  • Employers and group plans: The bill speaks to insurers. It does not explicitly address employer self-insured plans governed by federal law (ERISA). It is unclear how the rule applies to group policies or self-funded employer plans.

Expenses#

No direct public cost estimate is identified in the available material.

  • HHS must review and update educational materials within 6 months; this creates some federal administrative work, but no cost estimate is provided.
  • State insurance regulators could incur enforcement costs under their existing authority; no estimate is provided.
  • Insurers may face compliance costs (revising underwriting, training staff, recordkeeping). No specific estimates are provided.
  • There may be legal or litigation costs if disputes arise over what counts as an “actual, unique, and material actuarial risk.” No fiscal note is available.

No publicly available information on total costs or savings is included in the bill text or summary materials provided.

Proponents' View#

The bill appears intended to solve the problem that living donors may face higher premiums, denial, or cancellation of some insurance because they donated an organ. Possible arguments in favor, based on the bill text, include:

  • It could protect donors from insurance discrimination and reduce a practical barrier to donation.
  • It focuses on life, disability, and long-term care insurance — areas where donors have reported difficulty — while allowing insurers to act when there is a real actuarial reason.
  • Updating HHS educational materials could give potential donors clearer, federally updated information about risks, benefits, and insurance access.

Opponents' View#

The bill’s text raises several questions and possible concerns that opponents might highlight:

  • Enforcement is left to state regulators under state law. The bill does not create a federal private right of action in its text, so it is unclear how individuals would directly challenge violations at the federal level.
  • The phrase “actual, unique, and material actuarial risks” is vague. Disputes could arise about what counts as a valid actuarial reason to treat a donor differently, possibly leading to litigation.
  • The bill says “notwithstanding any other provision of law,” which could create tension with state insurance rules or with federal laws that govern employer self-insured plans (ERISA). The bill does not clarify its reach to group or employer-sponsored plans.
  • Insurers and actuaries may argue that limiting their use of donor status could interfere with risk-based pricing if donor status affects mortality or disability risk in some cases.
  • The bill does not address health insurance or medical eligibility for donation. It focuses only on certain insurance types, leaving other coverage questions unchanged.