A substantive refinement. v2 clarifies the definition of "living organ donor" with specific statutory references and significantly expands the scope of FMLA-qualifying activities related to organ donation to include preparation and other related activities, beyond just recovery from surgery. It also modifies the educational materials section, adding coordination with the Secretary of Labor and making outreach methods discretionary.
Living Donor Protection Act of 2025
- Sponsor
- Sen. Cotton, Tom [R-AR]
- Committees
- Health, Education, Labor, and Pensions Committee (primary)
- Last action
- Mar 11, 2026
Bottom line
The Living Donor Protection Act of 2025 aims to remove financial and employment barriers for individuals considering living organ or bone marrow donation by protecting them from insurance discrimination and ensuring FMLA coverage for their donation-related activities and recovery.
What it actually does
This bill prohibits life, disability, and long-term care insurance companies from discriminating against individuals solely based on their status as a living organ or bone marrow donor, unless there are actual, unique, and material actuarial risks. It also clarifies that organ donation, preparation, and recovery qualify as a serious health condition under the Family and Medical Leave Act (FMLA) for both private and federal sector employees. Furthermore, it mandates the updating of public educational materials to reflect these new protections.
Proponents argue
Supporters argue that this bill removes significant disincentives for living organ and bone marrow donation, thereby increasing the pool of available organs and saving lives. They contend that altruistic donors should not face unfair financial burdens or job insecurity as a consequence of their life-saving acts, and that these protections are essential to encourage more people to consider donation.
Opponents contend
While there is generally broad support for protecting living organ donors, some insurers might express concerns that the prohibition on varying terms or premiums, even with the 'actual, unique, and material actuarial risks' clause, could limit their ability to accurately assess risk, potentially impacting their business models or leading to adjustments for other policyholders. Employers might also face minor administrative adjustments related to FMLA leave for organ donation.
The bill is concise and clearly written, allowing for a quick and thorough understanding of its provisions.
Section 2
Prohibition on Insurance Discrimination Against Living Donors
This section prohibits life insurance, disability insurance, and long-term care insurance companies from denying coverage, canceling policies, refusing to issue new policies, or altering the price or terms of a policy for an individual simply because they are a living organ or bone marrow donor. This protection applies unless the insurer can demonstrate actual, unique, and material actuarial risks associated with the individual's donor status.
Supporters argue
Proponents argue that this provision is crucial for removing a major barrier to living donation. They assert that donors, who perform an altruistic act, should not be penalized with higher insurance costs or denial of coverage, which can deter potential donors and create financial hardship for those who have already donated.
Critics contend
While generally supportive of donor protections, some in the insurance industry might contend that the provision, despite its 'actual, unique, and material actuarial risks' clause, could still constrain their ability to accurately price policies based on individual health profiles. They might argue that any restrictions on risk assessment could lead to cross-subsidization or increased premiums for other policyholders, though the bill attempts to mitigate this with the 'actual risk' qualifier.
Tradeoffs
This provision balances the public interest in promoting living organ donation with the insurance industry's need to assess and price risk accurately. The tension lies in defining what constitutes 'actual, unique, and material actuarial risks' versus a blanket prohibition based solely on donor status.
Section 3
FMLA Coverage for Organ Donation
This section amends the Family and Medical Leave Act (FMLA) to explicitly include organ donation, preparation for and recovery from surgery related to organ donation, and other related activities as a 'serious health condition.' This ensures that both private sector employees (and certain public sector employees) and federal civil service employees are eligible for job-protected leave under FMLA for these purposes. For federal employees, it also clarifies that they can substitute available organ donor leave for FMLA leave taken for organ donation.
Section 4
Updating Educational Materials on Living Organ Donation
This section directs the Secretary of Health and Human Services (HHS), in coordination with the Secretary of Labor, to review and update public educational materials related to living organ donation within six months of the bill's enactment. The updated materials must include information about the new insurance protections established in Section 2 and the FMLA clarifications in Section 3.
The definition of 'living organ donor' is expanded to explicitly include individuals who have donated bone marrow, referencing specific sections of the National Organ Transplant Act and the Public Health Service Act for the definitions of 'human organ' and 'bone marrow' respectively.
Section 2(c)(3)
Why it matters:This is standard legislative practice for ensuring legal precision and avoiding redundancy by referencing existing statutory definitions. It's not intended to be evasive but can make the full scope less immediately apparent.
Case for: Including bone marrow donors ensures that a broader category of altruistic individuals who undergo a significant medical procedure for the benefit of others receive the same vital protections against insurance discrimination. This comprehensive approach supports all forms of living donation.
Case against: No significant case against this specific inclusion, as it broadens protections for a vulnerable group. Any arguments would likely be against the overall bill's impact on insurers, rather than this specific definitional expansion.
Estimated impact: Significantly expands the number of individuals covered by the insurance discrimination protections, encompassing both organ and bone marrow donors, thereby increasing the bill's overall reach and impact on the donor community.