II 

108TH CONGRESS 

1ST SESSION S. 186

To amend the Employee Retirement Income Security Act of 1974, the Public 

Health Service Act, and the Internal Revenue Code of 1986 to provide 

health insurance protections for individuals who are living organ donors. 

IN THE SENATE OF THE UNITED STATES 

JANUARY 16, 2003

Mr. DEWINE (for himself and Mr. DURBIN) introduced the following bill; 

which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL

To amend the Employee Retirement Income Security Act 

of 1974, the Public Health Service Act, and the Internal 

Revenue Code of 1986 to provide health insurance protections for individuals who are living organ donors.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Living Organ Donor 

5 Protections Act’’. 
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•S 186 IS 

1 SEC. 2. AMENDMENTS TO THE EMPLOYEE RETIREMENT IN2 COME SECURITY ACT OF 1974. 

3 (a) LIVING ORGAN DONATION PROTECTED BY LIM4 ITS ON PREEXISTING CONDITION.—Section 701(b)(1)(A) 

5 of the Employee Retirement Income Security Act of 1974 

6 (29 U.S.C. 1181(b)(1)(A)) is amended by inserting ‘‘(in7 cluding the living donation of an organ or a condition re8 sulting from the donation of an organ by a living organ 

9 donor)’’ after ‘‘relating to a condition’’. 

10 (b) PROHIBITION ON DISCRIMINATION BASED ON

11 HEALTH STATUS.—

12 (1) ENROLLMENT.—Section 702(a)(1) of the 

13 Employee Retirement Income Security Act of 1974 

14 (29 U.S.C. 1182(a)(1)) is amended by adding at the 

15 end the following: 

16 ‘‘(I) Living organ donor status.’’. 

17 (2) PREMIUMS.—Section 702(b) of the Em18 ployee Retirement Income Security Act of 1974 (29 

19 U.S.C. 1182(b)) is amended by adding at the end 

20 the following: 

21 ‘‘(3) NO DISCRIMINATION IN GROUP PREMIUMS

22 BASED ON ORGAN DONATION.—For purposes of this 

23 section, a group health plan, or a health insurance 

24 issuer offering group health insurance coverage in 

25 connection with a group health plan, shall not adjust 

26 premium or contribution amounts for a group on the 
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•S 186 IS 

1 basis of the living organ donor status of an indi2 vidual in the group or a family member of the indi3 vidual.’’. 

4 (c) DEFINITION.—Section 733(d) of the Employee 

5 Retirement Income Security Act of 1974 (29 U.S.C. 

6 1191b(d)) is amended—

7 (1) by redesignating paragraphs (3) and (4) as 

8 paragraphs (4) and (5), respectively; and 

9 (2) by inserting after paragraph (2), the fol10 lowing: 

11 ‘‘(3) LIVING ORGAN DONOR.—The term ‘living 

12 organ donor’ means, with respect to coverage, any 

13 individual who donates all or part of an organ, as 

14 defined by section 374(d)(2) of the Public Health 

15 Service Act.’’. 

16 SEC. 3. AMENDMENTS TO THE PUBLIC HEALTH SERVICE 

17 ACT. 

18 (a) LIVING ORGAN DONATION PROTECTED BY LIM19 ITS ON PREEXISTING CONDITION.—Section 

20 2701(b)(1)(A) of the Public Health Service Act (42 

21 U.S.C. 300gg(b)(1)(A)) is amended by inserting ‘‘(includ22 ing the living donation of an organ or a condition resulting 

23 from the donation of an organ by a living organ donor)’’ 

24 after ‘‘relating to a condition’’. 
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•S 186 IS 

1 (b) PROHIBITION ON DISCRIMINATION BASED ON

2 HEALTH STATUS.—

3 (1) ENROLLMENT.—Section 2702(a)(1) of the 

4 Public Health Service Act (42 U.S.C. 300gg–

5 1(a)(1)) is amended by adding at the end the fol6 lowing: 

7 ‘‘(I) Living organ donor status.’’. 

8 (2) PREMIUMS.—Section 2702(b) of the Public 

9 Health Service Act (42 U.S.C. 300gg–1(b)) is 

10 amended by adding at the end the following: 

11 ‘‘(3) NO DISCRIMINATION IN GROUP PREMIUMS

12 BASED ON ORGAN DONATION.—For purposes of this 

13 section, a group health plan, or a health insurance 

14 issuer offering group health insurance coverage in 

15 connection with a group health plan, shall not adjust 

16 premium or contribution amounts for a group on the 

17 basis of the living organ donor status of an indi18 vidual in the group or a family member of the indi19 vidual.’’. 

20 (c) DEFINITION.—Section 2791(d) of the Public 

21 Health Service Act (42 U.S.C. 300gg–91(d)) is amend22 ed—

23 (1) by redesignating paragraphs (10) through 

24 (14) as paragraphs (11) through (15), respectively; 

25 and 
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1 (2) by inserting after paragraph (9), the fol2 lowing: 

3 ‘‘(10) LIVING ORGAN DONOR.—The term ‘living 

4 organ donor’ means, with respect to coverage, any 

5 individual who donates all or part of an organ, as 

6 defined by section 374(d)(2).’’. 

7 SEC. 4. AMENDMENTS TO THE INTERNAL REVENUE CODE 

8 OF 1986. 

9 (a) LIVING ORGAN DONATION PROTECTED BY LIM10 ITS ON PREEXISTING CONDITION.—Section 

11 9801(b)(1)(A) of the Internal Revenue Code of 1986 is 

12 amended by inserting ‘‘(including the living donation of 

13 an organ or a condition resulting from the donation of 

14 an organ by a living organ donor)’’ after ‘‘relating to a 

15 condition’’. 

16 (b) PROHIBITION ON DISCRIMINATION BASED ON

17 HEALTH STATUS.—

18 (1) ENROLLMENT.—Section 9802(a)(1) of the 

19 Internal Revenue Code of 1986 is amended by add20 ing at the end the following: 

21 ‘‘(I) Living organ donor status.’’. 

22 (2) PREMIUMS.—Section 9802(b) of the Inter23 nal Revenue Code of 1986 is amended by adding at 

24 the end the following: 
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1 ‘‘(3) NO DISCRIMINATION IN GROUP PREMIUMS

2 BASED ON ORGAN DONATION.—For purposes of this 

3 section, a group health plan shall not adjust pre4 mium or contribution amounts for a group on the 

5 basis of the living organ donor status of an indi6 vidual in the group or a family member of the indi7 vidual.’’. 

8 (c) DEFINITION.—Section 9832(d) of the Internal 

9 Revenue Code of 1986 is amended—

10 (1) by redesignating paragraphs (3), (4), and 

11 (5) as paragraphs (4), (5), and (6), respectively; and 

12 (2) by inserting after paragraph (2), the fol13 lowing: 

14 ‘‘(3) LIVING ORGAN DONOR.—The term ‘living 

15 organ donor’ means, with respect to coverage, any 

16 individual who donates all or part of an organ, as 

17 defined by section 374(d)(2) of the Public Health 

18 Service Act.’’. 

19 SEC. 5. REGULATIONS AND EFFECTIVE DATE. 

20 (a) REGULATIONS.—The Secretary of Labor, the 

21 Secretary of Health and Human Services, and the Sec22 retary of the Treasury shall promulgate regulations nec23 essary to carry out the amendments made by this Act as 

24 such amendments apply to each such respective Secretary. 
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1 (b) EFFECTIVE DATE.—The amendments made by 

2 this Act shall apply to group health plans and health in3 surance coverage with respect to plan years beginning on 

4 or after January 1, 2004.

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