A complete substitute amendment, v2 fundamentally restructures the bill's approach to prohibiting organ transplant discrimination. While retaining the core purpose, v2 shifts from establishing new, parallel definitions and prohibitions to explicitly integrating its requirements within existing federal disability laws like the Americans with Disabilities Act and the Rehabilitation Act of 1973. This includes a revised definition of 'covered entity' and new reporting requirements for the Department of Health and Human Services.
Charlotte Woodward Organ Transplant Discrimination Prevention Act
- Sponsor
- Sen. Moody, Ashley [R-FL]
- Committees
- Health, Education, Labor, and Pensions Committee (primary)
- Last action
- Jun 22, 2026
Bottom line
The bill aims to ensure equitable access to organ transplants and related services for individuals with disabilities by explicitly prohibiting discrimination and requiring accommodations.
What it actually does
This bill prohibits discrimination against individuals with disabilities in organ transplant processes by covered entities. It mandates reasonable modifications and auxiliary aids, clarifies exceptions for medical judgment based on individualized assessments, and establishes enforcement mechanisms through the Office for Civil Rights (OCR) at the Department of Health and Human Services (HHS). It also amends the Public Health Service Act to prevent the Organ Procurement and Transplantation Network (OPTN) from establishing discriminatory allocation criteria.
Proponents argue
Supporters argue that the bill closes a critical gap in anti-discrimination law, ensuring that individuals with disabilities are not unfairly denied life-saving organ transplants based on stereotypes or misconceptions. They emphasize that medical decisions should be based on individualized assessments of a patient's medical needs and their available support networks, rather than broad generalizations about disability.
Opponents contend
While the principle of non-discrimination is widely supported, potential critics might raise concerns about the administrative burden on healthcare providers to implement extensive 'reasonable modifications' and provide 'auxiliary aids and services.' Some might also argue that the bill could potentially complicate complex medical decision-making processes by limiting the scope of factors physicians can consider, even if those factors are indirectly related to disability, though direct organized opposition is not prominent.
The bill is relatively concise and clearly structured, allowing an informed reader to understand its core provisions and implications within a reasonable timeframe.
Section 1
Short Title
This section formally names the act the 'Charlotte Woodward Organ Transplant Discrimination Prevention Act.' This provides a common and recognizable name for the legislation, often honoring an individual whose experience inspired the bill.
Supporters argue
Proponents argue that naming the bill after Charlotte Woodward honors an individual whose experience highlights the critical need for this legislation, giving it a human face and emphasizing its purpose to prevent discrimination.
Critics contend
No specific opposition is typically raised against the short title of a bill, as it is primarily a naming convention.
Tradeoffs
None apparent for a short title.
Section 2
Key Definitions
This section defines critical terms used throughout the Act, such as 'auxiliary aids and services,' 'covered entity,' 'disability,' 'organ,' 'qualified individual with a disability,' 'reasonable modifications,' and 'related services.' Notably, 'covered entity' is defined as entities receiving federal financial assistance or public entities covered by Title II of the Americans with Disabilities Act (ADA), aligning the bill's scope with existing federal disability law.
Section 3
Amends Organ Procurement and Transplantation Network (OPTN) Criteria
This section amends Section 372(b)(2)(B) of the Public Health Service Act. It explicitly states that the Organ Procurement and Transplantation Network (OPTN) board's medical criteria for allocating organs 'shall not include medical criteria that would discriminate on the basis of disability in access to an organ transplant.' This directly targets systemic discrimination at the policy level within the organ allocation system.
Section 4(a)
General Prohibition of Discrimination in Organ Transplants
This core provision prohibits covered entities from discriminating against qualified individuals with disabilities in any part of the organ transplant process. Specifically, it forbids determining ineligibility, denying transplants or related services, refusing referrals, or refusing to place individuals on waiting lists, solely based on disability. It explicitly links these prohibitions to existing federal disability laws like Section 504 of the Rehabilitation Act and the Americans with Disabilities Act (ADA).
Section 4(b)
Exception for Individualized Medical Assessment
This section outlines an exception to the general prohibition, allowing covered entities to take a disability into account *only* after an individualized assessment and *only* if it is consistent with existing disability laws. Crucially, it clarifies that an individual's inability to independently comply with post-transplant health requirements cannot be a factor if reasonable modifications or auxiliary aids and services would enable compliance. This ensures the exception for medical judgment is narrowly tailored.
Section 4(c)
Mandate for Reasonable Modifications and Supported Decision-Making
This section requires covered entities to make 'reasonable modifications to policies, practices, or procedures' to avoid discrimination, unless doing so would fundamentally alter the nature of the program. It explicitly includes the use of 'supported decision-making' as a possible reasonable modification, allowing individuals with disabilities to use support persons to assist in making health care decisions, communicating information, or ascertaining their wishes.
Section 4(d) and (e)
Enforcement and Reporting Requirements
This section directs the Office for Civil Rights (OCR) of the Department of Health and Human Services (HHS) to consider complaints of discrimination for expedited or early resolution, with remedies consistent with existing disability laws. It also mandates annual reports from the Secretary of HHS to Congress, detailing the number of complaints received, resolution processes, results, necessary resources for OCR, and recommendations for improving enforcement of the Act.
The definition of 'covered entity' in the amended bill is significantly different from the original text. The amended text defines 'covered entity' as any entity operating a program or activity involving an organ transplant or related services that receives Federal financial assistance, or any public entity covered by Title II of the Americans with Disabilities Act of 1990. This narrows the scope compared to the original bill, which included any licensed provider of health care services in interstate commerce.
Section 2(2)
Why it matters:This is standard legislative practice for defining scope, but the change from the original bill suggests a deliberate narrowing or clarification of jurisdiction, likely to align with existing federal enforcement mechanisms for disability rights.
Case for: Supporters of this change might argue it clarifies jurisdiction, focusing federal oversight on entities directly supported by federal funds or public entities, aligning with existing federal disability law enforcement frameworks. It might also reduce potential legal challenges regarding the scope of federal authority over private healthcare providers.
Case against: Critics might argue that this narrowing could leave a gap in protection, as private healthcare providers not receiving federal financial assistance (and not otherwise covered by ADA Title II as a public entity) might fall outside the explicit scope of this Act, even if they engage in organ transplant activities.
Estimated impact: Potentially significant impact on the number and type of healthcare providers directly regulated by this Act, and thus the breadth of its anti-discrimination protections across the healthcare system.
While Section 4(c)(1)(A) generally mandates reasonable modifications, subparagraph (B) specifically calls out 'supported decision-making' as an explicit inclusion for the purposes of the exception in 4(b)(2) and the general reasonable modifications. This means that if a qualified individual with a disability needs support to comply with health requirements, the use of supported decision-making must be considered as a reasonable modification.
Section 4(c)(1)(B)
Why it matters:This is standard legislative practice for providing specific examples or clarifications within broader mandates, ensuring that a particular important concept (supported decision-making) is explicitly covered.
Case for: Proponents emphasize that this ensures individuals with cognitive disabilities are not unfairly excluded from transplants due to assumptions about their ability to manage complex post-operative care, recognizing the value of personal support networks and promoting self-determination.
Case against: Some healthcare providers might express concerns about the practical implementation of supported decision-making, including potential legal liabilities, ensuring the support person acts in the patient's best interest, and the administrative burden of coordinating with multiple support individuals while maintaining patient privacy.
Estimated impact: Potentially significant impact on the autonomy and access to care for individuals with cognitive disabilities, requiring healthcare systems to adapt their patient engagement, consent, and post-operative support processes.