2019-2020 Emerging Fellow Emma Tucker explains how an organ donation tax credit in Georgia will work toward removing financial burdens for prospective living donors, ensuring that anyone who wishes to donate an organ is able to do so.
Living-donor kidney transplant is the best treatment option for patients suffering from End Stage Renal Disease (ESRD), but this option has become increasingly inaccessible for most patients. Over the past two decades, the rate of living-donor kidney donation has gradually declined in the United States, while ESRD prevalence has simultaneously increased by 67.4 percent (United States Renal Data System 2018). This decline in living-donor transplants is largely due to the financial barriers faced by prospective donors, as the average donor will incur $5,000 in unreimbursed, out-of-pocket expenses associated with donation (Tushla et al. 2015). Such expenses, which include the cost of lost wages, childcare, and elder care, are generally not eligible for reimbursement by private insurers or Medicare, leaving prospective donors without financial recourse (HHS 2019). The resulting shortage of living-donor organs is especially critical in Georgia, the state with the lowest adjusted transplant rate in the nation and a high prevalence of ESRD patients (Patzer and Pastan 2015). Georgia currently offers living donors up to $10,000 in tax deductions in order to incentivize transplant (Georgia Code 2010). However, such tax deductions disproportionately benefit those in higher tax brackets, leaving low-income donors with unmet financial needs. To remove the financial disincentive towards organ transplant, Georgia should replace its $10,000 organ donor tax deduction with a $5,000 tax credit to reflect the true out-of-pocket costs of donation. Similar tax incentives have shown success in increasing organ donation rates in Louisiana and Israel, indicating both the feasibility and the effectiveness of this approach (Louisiana State Legislature; Lavee et al. 2013). The creation of an organ donation tax credit presents a proven and cost-effective solution for increasing access to kidney transplant in Georgia, which will translate to a more equitable system and fewer lives lost to ESRD.