H.R. 7868

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7868 Introduced in House (IH)]

<DOC>

119th CONGRESS
2d Session
H. R. 7868

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

_______________________________________________________________________

IN THE HOUSE OF REPRESENTATIVES

March 9, 2026

Ms. DelBene (for herself, Mrs. Miller of West Virginia, and Ms. 
Schrier) introduced the following bill; which was referred to the 
Committee on Energy and Commerce, and in addition to the Committee on 
Ways and Means, for a period to be subsequently determined by the 
Speaker, in each case for consideration of such provisions as fall 
within the jurisdiction of the committee concerned

_______________________________________________________________________

A BILL

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

Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the ``Expanding Support for Living Donors 
Act of 2026''.

SEC. 2. EXPANDING SUPPORT FOR LIVING DONORS.

Section 377 of the Public Health Service Act (42 U.S.C. 274f) is 
amended--
(1) by redesignating subsections (f) through (h) as 
subsections (h) through (j), respectively;
(2) by inserting after subsection (e) the following:
``(f) Eligibility of Donating Individuals Based on Household 
Income.--
``(1) In general.--In providing reimbursement to donating 
individuals using funds from grant awards under this section, 
the recipient of the grant award shall not limit the 
eligibility of a donating individual for such reimbursement 
based on the individual's income if the individual's household 
income is at or below 700 percent of the poverty line.
``(2) Definition.--In this subsection, the term `poverty 
line' means the applicable poverty line as set forth in the 
most recent poverty guidelines of the Department of Health and 
Human Services published under the authority of section 673(2) 
of the Community Services Block Grant Act.
``(g) Reimbursement Amount.--
``(1) In general.--The amount of reimbursement of 
qualifying expenses provided by a recipient of a grant award 
under this section to each such donating individual shall be 
the lesser of--
``(A) the total amount of the donating individual's 
qualifying expenses; and
``(B) the maximum permissible amount described in 
paragraph (2).
``(2) Maximum permissible amount.--
``(A) Rule.--Subject to subparagraph (B), the 
maximum permissible amount described in this section 
is--
``(i) for fiscal year 2027, $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.
``(B) Exception for recipients based on 
insufficient funds.--The Secretary may, with respect to 
reimbursement provided by a recipient of a grant award 
under this section to donating individuals, lower the 
maximum permissible amount under subparagraph (A) for a 
fiscal year if the Secretary--
``(i) determines that such recipient has 
insufficient funds to provide the full amount 
that would otherwise apply under paragraph (1) 
to all donating individuals; and
``(ii) at least 30 days before making such 
determination effective, provides to the 
Congress written notice of such determination, 
including a justification.
``(C) Special rules.--If the Secretary, with 
respect to reimbursement provided by a recipient of a 
grant award under this section to donating individuals, 
makes a determination under subparagraph (B) to lower 
the maximum permissible amount under subparagraph (A) 
for a fiscal year--
``(i) such determination shall not affect 
the amount of reimbursement for any approved 
donating individual prior to the effective date 
of such determination; and
``(ii) the maximum permissible amount under 
subparagraph (A)(ii) for any subsequent year 
shall be calculated without regard to such 
lowered amount.'';
(3) in subsection (i), as so redesignated, 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 
2028 through 2037''; and
(4) by amending subsection (j), as so redesignated, to read 
as follows:
``(j) Annual Report.--Not later than December 31 of each year, 
beginning in fiscal year 2027, the Secretary shall--
``(1) prepare, submit to the Congress, and make public a 
report on--
``(A) whether grants under this section provided 
adequate funding during the preceding fiscal year to 
reimburse all donating individuals participating in the 
grant program under this section for all qualifying 
expenses; and
``(B) the impacts, ongoing activities, challenges, 
and future needs of the program under this section; and
``(2) include in each such report, for the fiscal year 
covered by the report--
``(A) the estimated number of all donating 
individuals participating in the grant program under 
this section who did not receive reimbursement for all 
qualifying expenses;
``(B) the total amount of funding that is estimated 
to be necessary to fully reimburse all donating 
individuals participating in the grant program under 
this section for all qualifying expenses;
``(C) an overview of the program under this 
section;
``(D) current and trended historical information 
about the program under this section, including--
``(i) the total number of donating 
individuals applying for reimbursement;
``(ii) the average and median reimbursement 
amount provided to donating individuals;
``(iii) demographic information regarding--
``(I) donating individuals applying 
for reimbursement; and
``(II) donating individuals 
approved for reimbursement;
``(iv) the types of expenses for which 
reimbursement was requested (including requests 
for reimbursement of non-qualifying expenses);
``(v) the amount of funding provided to 
donating individuals with respect to each such 
type of expenses;
``(vi) the amount of funding provided to 
donating individuals with respect to each organ 
category; and
``(vii) the total amount expended to carry 
out this section, disaggregated by--
``(I) the amount expended by the 
Secretary and the recipients of grants 
under this section on administrative 
expenses; and
``(II) the amount provided to 
donating individuals as reimbursement;
``(E) the impacts of the program under this 
section, including--
``(i) the number of completed donations for 
which reimbursement was provided;
``(ii) the proportion of living donor 
transplants in the United States in which the 
donor received reimbursement through the 
program under this section; and
``(iii) an estimate of the savings to the 
Medicare program under title XVIII of the 
Social Security Act resulting from the program 
under this section, both--
``(I) for the fiscal year covered 
by the report; and
``(II) cumulatively since the 
program's creation;
``(F) the types of donations made by donating 
individuals receiving reimbursement, disaggregated 
according to--
``(i) the type of organ donated; and
``(ii) whether the donations were directed, 
non-directed, or a paired exchange;
``(G) a description of any efforts to expand or 
improve the program under this section;
``(H) a description of the efforts of the Secretary 
and recipients of grants under this section to increase 
awareness of the program under this section;
``(I) a description of challenges experienced by 
the program under this section, including--
``(i) the number and percentage of donating 
individuals applying for reimbursement whose 
qualifying expenses approached or exceeded the 
maximum amount allowed under subsection (g); 
and
``(ii) an estimate of the total funding 
needed to fully reimburse, without regard to 
the maximum amount allowed under subsection (g) 
or donor income eligibility caps, all donating 
individuals in the United States for all 
qualifying expenses;
``(J) areas of concern regarding, and identified 
barriers to, the elimination of financial disincentives 
to living organ donation; and
``(K) such other matters as the Secretary 
determines appropriate.''.

SEC. 3. GAO STUDY.

Not later than 1 year after the date of enactment of this Act, the 
Comptroller General of the United States shall--
(1) conduct a study on how the Medicare program under title 
XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) 
could, under existing statutory authorities, pay costs that 
would otherwise be paid through the Living Organ Donation 
Reimbursement Program under section 377 of the Public Health 
Service Act (42 U.S.C. 274f); and
(2) submit to the Congress a report on the results of such 
study, including recommendations for any changes needed to 
achieve such purpose.
<all>