Overview

Title

To amend the Public Health Service Act with respect to the Living Organ Donation Reimbursement Program.

ELI5 AI

The Expanding Support for Living Donors Act of 2024 wants to make it easier for people who give an organ to someone else by giving them money back for doing so, without worrying about how much the organ receiver earns. It also promises to keep checking on how this money is used and see if other health programs can help pay for these costs.

Summary AI

H.R. 10282, titled the “Expanding Support for Living Donors Act of 2024,” seeks to amend the Public Health Service Act to make it easier for people who donate organs to receive financial reimbursement. The bill removes considerations of the organ recipient's income when deciding reimbursements for donors and ensures that donors from households earning up to 700% of the poverty line are eligible for reimbursement. It sets a maximum reimbursement limit of $10,000 adjusted for inflation and requires annual reports on the program’s impact and finances. Additionally, the bill extends funding for these provisions through fiscal year 2035 and mandates a study on how existing Medicare programs could help cover these costs.

Published

2024-12-04
Congress: 118
Session: 2
Chamber: HOUSE
Status: Introduced in House
Date: 2024-12-04
Package ID: BILLS-118hr10282ih

Bill Statistics

Size

Sections:
8
Words:
2,057
Pages:
11
Sentences:
23

Language

Nouns: 536
Verbs: 166
Adjectives: 88
Adverbs: 17
Numbers: 86
Entities: 99

Complexity

Average Token Length:
4.05
Average Sentence Length:
89.43
Token Entropy:
4.96
Readability (ARI):
45.61

AnalysisAI

The proposed legislation, "Expanding Support for Living Donors Act of 2024" (H.R. 10282), aims to improve and refine the framework within which the Living Organ Donation Reimbursement Program operates. It seeks to amend the Public Health Service Act with a primary focus on enhancing financial protection and incentives for living organ donors. This comes at a time when the need for organ donations significantly outweighs available donations, making it crucial to address any financial barriers that potential donors face.

General Summary of the Bill

The bill introduces several key amendments to the existing Public Health Service Act. Firstly, it prohibits the consideration of an organ recipient's income when providing reimbursement to organ donors. It removes certain expectations around payments by organ recipients and ensures that donors with household income at or below 700% of the poverty line cannot be excluded from reimbursement programs. The legislation also sets a cap on the reimbursement amount for donors, adjusts this amount to inflation, and requires annual reporting on the program's operation. Finally, it extends the authorization for appropriations and commissions a Government Accountability Office (GAO) study to explore extending Medicare coverage for these costs.

Summary of Significant Issues

Several issues arise from this proposed legislation. Section 7's shift from a fixed funding amount to "such sums as may be necessary" could open the door for unrestricted spending and complicates budget oversight. In Section 4, lacking clear limits on reimbursements for low-income donors and a robust verification system might lead to excessive or mismanaged funds. The provision allowing the Secretary to adjust reimbursement maximums based on available funds could result in inconsistent and potentially unfair implementation for donors across different fiscal years, as noted in Section 5.

Additionally, the removal of specific expectations around recipient payments without fully understanding the potential consequences could lead to unforeseen issues, especially regarding donor and recipient rights. The requirement for detailed reporting in Section 6 could present logistical challenges, while the lack of clear criteria for the GAO study might affect its effectiveness.

Potential Public Impact

For the general public, this bill could potentially reduce financial hurdles for those wishing to become living organ donors. By alleviating some of the economic burdens associated with organ donation, more individuals might be encouraged to donate, ultimately increasing available organs for those in need and potentially saving lives. Nevertheless, without strict financial oversight and clear administration guidelines, there is a risk of misused taxpayer money, which might impact public trust in how health funds are managed.

Impact on Specific Stakeholders

Living Donors: The bill could significantly benefit living donors by minimizing financial barriers and providing more comprehensive reimbursement for their expenses. For low-income donors, the bill seems particularly advantageous as it broadens eligibility for reimbursement.

Healthcare Providers and Administrators: The changes may impose increased administrative duties on health organizations responsible for the program, requiring precise documentation and reporting to remain compliant with the new regulations.

Government agencies: Agencies like the Department of Health and Human Services may experience increased pressure to ensure the program's effective oversight and minimize discrepancies in resource allocation.

Taxpayers: As more funds could potentially be directed towards this program, taxpayers may be affected as appropriations increase, contingent upon proper justification and demonstrated program success.

Overall, while the bill has the potential to advance the cause of organ donation significantly, several areas require additional clarity and oversight to maximize its intended benefits and ensure equitable, efficient implementation.

Financial Assessment

In H.R. 10282, several financial aspects are highlighted regarding the Living Organ Donation Reimbursement Program. The bill proposes adjustments to the Public Health Service Act with a focus on financial reimbursements for living organ donors.

Summary of Financial Provisions

The bill establishes a maximum reimbursement limit of $10,000 for qualifying expenses for living organ donors, which will be adjusted annually based on inflation using the Consumer Price Index. Furthermore, the bill authorizes funding for these adjustments through fiscal years 2026 to 2035, moving away from a previous fixed amount of $5,000,000 per year to a more open-ended "such sums as may be necessary" approach.

Issues Related to Financial Allocations

Unrestricted Spending Concerns: The change in funding from a fixed annual amount to an unspecified sum raises potential concerns over unrestricted or wasteful spending. Without a cap, there is a risk of budget overruns, impacting fiscal planning and potentially leading to inefficiencies. This lack of financial guidance could create challenges in overseeing the program's expenses and ensuring responsible fund allocation.

Lack of Controls on Reimbursements: The bill ensures reimbursement eligibility for donors with household incomes at or below 700% of the poverty line. However, it does not outline how eligibility is verified, risking the allocation of funds without adequate oversight. This absence of controls might lead to excessive spending without clear criteria, making fund distribution potentially ambiguous.

Maximum Reimbursement Variability: The Secretary of Health and Human Services is permitted to lower the maximum reimbursement amount if there are insufficient funds. While this provides flexibility, it could lead to inconsistencies yearly, affecting the fairness of reimbursements to donors and potentially discouraging participation.

Reporting and Accountability: Although the bill requires annual reports on the program's finances and impact, it lacks specific mention of accountability for grant recipients. Without clear reporting requirements, there could be transparency issues regarding how funds are used. Detailed and consistent reports are essential to ensure that funds are spent effectively and efficiently.

Evaluation and Study Limitations: The bill mandates a study by the Government Accountability Office (GAO) to explore how the Medicare program could potentially offset these costs. However, it does not specify criteria or methods for conducting this study, leading to possible ambiguity concerning its execution and findings.

Overall, while the bill aims to alleviate the financial burden on living organ donors by adjusting reimbursement provisions, it brings forth several financial management and oversight challenges that must be addressed to avoid inefficiencies and ensure effective use of taxpayer dollars.

Issues

  • The change in authorization of appropriations from a fixed $5,000,000 per fiscal year to 'such sums as may be necessary' in Section 7 could lead to unrestricted or potentially wasteful spending due to lack of budget constraints and clear funding guidance, impacting fiscal planning and oversight.

  • Section 4's lack of limits or controls on reimbursement amounts and the absence of a verification process for donors whose income is at or below 700 percent of the poverty line raises concerns about potential excessive spending and ambiguity in fund allocation.

  • The amendment in Section 5 allowing the Secretary to lower the maximum permissible reimbursement amount due to insufficient funds could lead to inconsistencies and potential unfairness in reimbursement amounts between fiscal years, affecting donor satisfaction.

  • The amendment in Section 2 regarding 'No consideration of income of organ recipient' might be ambiguous without proper clarification, possibly leading to misinterpretation of the reimbursement process and eligibility, impacting legal consistency.

  • Removal of the expected payment by organ recipients in Section 3 could have unintended consequences if Paragraph (3) contained provisions that protected against unfair practices or ensured fair treatment of donors.

  • Section 6's requirement for detailed annual reporting may create a bureaucratic burden and potential data reporting errors, with ambiguities in language around reimbursement limits and expense categories leading to inconsistent understanding and reporting.

  • The GAO study mandated in Section 8 does not specify criteria or methodology for analysis, possibly leading to execution ambiguities and concerns about study scope and focus.

  • Potential lack of transparency in the usage of funds as there is no explicit mention of accountability or reporting requirements for grant recipients in Section 4, which could lead to inefficiency in fund allocation and oversight.

  • In Section 5, there is a lack of specification of a minimum permissible reimbursement amount, risking excessively low reimbursements if the maximum permitted amount is adjusted downwards, impacting donor financial support.

Sections

Sections are presented as they are annotated in the original legislative text. Any missing headers, numbers, or non-consecutive order is due to the original text.

1. Short title Read Opens in new tab

Summary AI

This section states that the official name of the Act is the "Expanding Support for Living Donors Act of 2024".

2. No consideration of income of organ recipient Read Opens in new tab

Summary AI

Section 377 of the Public Health Service Act has been updated to ensure that when giving reimbursement to a person donating an organ, the grant recipient will not consider the income of the person receiving the organ. Additionally, certain subsections have been renumbered and updated to reflect these changes.

3. Removal of expectation of payments by organ recipients Read Opens in new tab

Summary AI

The text makes changes to a section of the Public Health Service Act regarding organ transplants. It removes the expectation that organ recipients need to make payments, simplifying the rules by modifying how certain paragraphs end and eliminating one of them.

4. Ensuring eligibility of donating individuals whose household income is at or below 700 percent of the poverty line Read Opens in new tab

Summary AI

The new amendment to the Public Health Service Act states that individuals donating and receiving reimbursement from grant awards cannot be denied based on their income if it is at or below 700% of the poverty line. The term "poverty line" refers to the latest guidelines from the Department of Health and Human Services.

5. Maximum amount of reimbursement Read Opens in new tab

Summary AI

The section outlines how much money can be reimbursed for expenses to people who donate under a specific grant. The reimbursement amount will be the lesser of the actual expenses or a set maximum limit, which starts at $10,000 for 2026 and will adjust each year based on inflation, but can be temporarily reduced if there isn't enough funding.

Money References

  • — “(A) RULE.—Subject to subparagraph (B), the maximum permissible amount described in this section is— “(i) for fiscal year 2026, $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. “

6. Annual report Read Opens in new tab

Summary AI

The section amends the Public Health Service Act to require the Secretary to submit an annual report to Congress by 2025 that details the program's impacts, activities, challenges, future needs, and specific information regarding donor reimbursements, demographics, and funding. The report will also discuss efforts to improve and expand the program and outline challenges and barriers related to financial disincentives for living organ donation.

7. Authorization of appropriations Read Opens in new tab

Summary AI

The amendment to section 377 of the Public Health Service Act changes the funding provision, allowing the necessary amount of money to be allocated for fiscal years 2026 to 2035, instead of a fixed amount previously set for fiscal years 2005 to 2009.

Money References

  • Subsection (j) of section 377 of the Public Health Service Act (42 U.S.C. 274f), as redesignated by section 2, is amended 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 2026 through 2035”. ---

8. GAO study Read Opens in new tab

Summary AI

The section requires the Comptroller General of the United States to conduct a study within one year to explore how the Medicare program could cover costs currently paid by the Living Organ Donation Reimbursement Program, and to provide a report to Congress with findings and possible recommendations for change.