South Carolina Adopts Insurance Rules Protecting Living Organ Donors

South Carolina has become the 34th state to set rules life insurers must follow when taking applications for coverage from living organ donors.

Gov. Henry McMaster signed H. 2355, the bill creating the state's new Living Donor Protection Act, May 13.

The act blocks insurers from making decisions about life insurance, disability insurance or long-term care insurance based "based solely and without any additional actuarial risks upon the status of such person as a living organ donor."

The act affects product premiums and terms as well as insurers' decisions about whether to offer applicants coverage.

South Carolina has become the 34th state to adopt a living organ donor bill, and Congress is considering two similar bills, S. 1384 and H.R. 2923.

What it means: Measures like H. 2355 could make it a little easier for clients who need organ transplants to find donors, and they could make life easier for clients who want to be the donors.

The background: Living donors are people who donate their kidneys, lungs, parts of their livers, parts of their pancreas or parts of their intestines while they are still alive.

The United States has 108,000 people on organ transplant waiting lists, and 17 of those people die every day, according to data cited by members of the National Council of Insurance Legislators in a resolution supporting federal living donor protection legislation.

U.S. surgeons performed 46,630 organ transplants in 2023, and 6,958 of the 23,294 donors who provided the organs were living donors, according to the United Network for Organ Sharing, a transplant support services organization.

For people thinking about becoming living donors, one obstacle has been the possibility that they could have trouble getting medically underwritten insurance, such as life insurance, later in life.

The South Carolina legislation: The National Kidney Foundation has tried to increase the number of organs available for transplant by developing the Living Donor Protection Act model legislation, which served as the model for South Carolina's new law.

The American Kidney Fund, an organization that tracks state adoption of donor protection bills, has given South Carolina a B for living donor protection efforts.

The state now protects donors from insurance discrimination but does not provide tax incentives for the donors or their employers, and it does not provide paid leave for the donors, according to the fund.

The federal legislation: S. 1384, the Senate version of the bill, was introduced by Sen. Kirsten Gillibrand, D-N.Y., and has 24 co-sponsors who are Democrats or caucus with the Democrats and 15 Republican co-sponsors.

H.R. 2923 was introduced by Rep. Jerrold Nadler, D-N.Y. The House bill has 148 Democratic co-sponsors and 36 Republican co-sponsors.

The two bills have a total of 235 sponsors and co-sponsors but have not yet come up in committee hearings or markups, according to Congress.gov.

Reactions: The National Council of Insurance Legislators adopted a resolution supporting the federal version of the living donor protection legislation in 2021, and the American Council of Life Insurers endorsed the NCOIL resolution, saying it strikes the right balance between the needs of the donors for insurance and the need for insurers to underwrite fairly.

The South Carolina State House. Credit: Adobe Stock