A New Jersey lawmaker wants to offer tax credits to organ donors, but his no-strings approach is meeting opposition from groups who believe the practice runs afoul of federal law.
While the National Organ Transplant Act makes it illegal for hospitals to pay for organs, 19 states provide either a tax credit or deduction for verifiable, unreimbursed expenses related to living organ donations, said Troy Zimmerman, of the National Kidney Foundation. In some states, the benefit also includes the donor's lost wages.
Donor groups who support a cost-neutral approach have raised issues with New Jersey's proposal to provide residents with $1,000 in income tax credits for donating organs, or a $100 tax credit for donating blood, platelets or plasma because it does not specifically apply to a donor's expenses.
Breaking news and the stories that matter to your neighborhood.
"It falls into the category of well-intentioned legislatures looking to do something to increase the number of donors," said David Fleming, president of Donate Life America.
Fleming said he worries tax breaks could become bargaining chips to entice the families of dead donors, drive donors from neighboring states that don't offer financial incentives, prey on the poor or create a black market.
The World Health Organization estimates 8 to 10 percent of the 119,873 organs transplanted globally in 2014 were illegal, but WHO does not have precise numbers because black markets were involved.
The National Kidney Foundation said 19,059 people received kidney transplants in the U.S. last year and 5,628 were the result of living donors. There are nearly 120,000 people living in the U.S. awaiting organ donations, according to Donate Life America.
New Jersey Republican state Sen. Gerald Cardinale said he got the idea for the organ donation bill when a friend died waiting for a kidney while another friend of his lived after receiving a transplant.
"It's important to get something done that encourages the activity," he said, acknowledging that the bill's approach may violate the federal act and he's willing to make changes.
A 2012 study published in the American Journal of Transplantation found "no statistically significant effect" of tax policies on donation rates in 15 states that offered them at the time.
Dr. Scott Halpern, a doctor and medical ethicist at the University of Pennsylvania's Perelman School of Medicine, said the issue needs closer study.
"There are legitimate concerns with how incentives might affect people, but the stakes are way too high to allow conjecture and outdated legal precedent to rule the day," Halpern said.
He said people often respond similarly to payments that are reimbursements and incentives and it makes little sense to allow one but not the other.
[NATL] Top News Photos: Pope Visits Japan, and More
"We've advocated removing the cost to the donor and advocated for things like reimbursement of lost wages and direct costs," said Dr. Timothy Pruett, president of the American Society of Transplant Surgeons.
The National Living Donor Assistance Center provides assistance for verifiable, out-of-pocket expenses that are directly related to organ donation and are not covered by the transplant recipient's insurance or any other program. It is planning a study in which donors selected at random are offered wage reimbursement.
Groups, such as Donate Life America, are working to create partnerships with companies to get consumers to register as donors at checkout while some states reimburse for expenses.
Dan Weiniger, 55, of Westfield, is one of 75 people in New Jersey waiting for a heart transplant. He's been waiting 14 months and a pump helps keep him alive.
He likes the idea of tax credits — the proposed law in New Jersey would allow the family to receive credits after donors die — but still finds joy in the generosity of donors. He's "overwhelmed" when he meets recipients or the families of donors.
"I've met so many who have received organs, from children to adults, who are walking miracles of life," he said.