Truly Giving Your Heart (or Kidney) on Valentine’s Day

By Courtney Burke

On this Valentine’s Day, perhaps instead of giving your heart to someone, you can give a kidney. It will be easier to do that this Valentine’s Day than last in New York State because of a new law. At the very end of 2022, New York’s Governor signed what is known as the Living Donor Support Act (S1594). Many people are already volunteer organ donors if they pass away. These donors are identifiable by a little heart shape on their Driver’s License. But living donors are rare.

Over the last decade or so, most states have put in place some kind of policy or policies to promote living organ donation. Of these policies, the most popular has been instituting paid leave for donors that are state employees. In total, as of 2022, 38 states have policies that provide or promote leave for public employees. Thirteen states have also included leave for private employees for organ donation, with six states offering employer tax credits. Living donor protection laws that prohibit discrimination against donors by insurance have also been widely adopted and are in place in 28 states. In addition to these policies, 21 states have adopted tax deductions or reimbursements that cover costs related to unreimbursed medical or other related expenses to organ donation up to a certain amount. Most of these policies allow for up to $10,000 as a tax deduction (the actual value of which depends on your tax rate, but if it’s 6 percent it would equal $600). Only seven states have not adopted any of these policies, and just five have only adopted one, meaning the majority of states have adopted two or more of these policies.

New York pre-existing law encompassed four of the five types of policies outlined above, including a $10,000 tax deduction for donors. But, saliently, the new law allows people in the state who make a kidney or liver donation to another New Yorker to instead choose to be reimbursed for the expenses associated with their donation up to at least $14,000. Just two other states provide a tax credit and not a deduction: Idaho (up to $5,000) and Louisiana (up to $7,200). This may seem like a minor gesture given the magnitude of the act being done, but the costs related to donating can be a barrier for people in their decision to donate. Medicare and private insurers often cover some of the costs associated with such a donation but not all. For example, they may not cover lost wages for taking time off when making a donation, lodging required near where a surgery donation may take place, reimbursement for childcare or elder care expenses, and the costs of medications associated with the surgery—costs that may quickly exceed the value of a $10,000 deduction.

There are currently more than 8,500 New Yorkers on waiting lists for organs. Kidney donations, which represent the largest need at roughly 7,200 people, can also be given by living donors.

With the signing of this bill, New York State is the first state in the nation to make significant strides toward providing support that can eliminate some of the financial barriers that may deter organ donation.

Which is good because organ donations are needed in New York. There are currently more than 8,500 New Yorkers on waiting lists for organs. Kidney donations, which represent the largest need at roughly 7,200 people, can also be given by living donors.

Nationally, over 100,000 people are awaiting donations and 17 people die every day while waiting for a donation. Interestingly, organ donations are not allocated on a state-by-state basis. Rather, the United States is split into 11 regions and allocations are generally made within those regions. The allocations consider medical factors, such as blood type, immune system compatibility, size of the organ, or medical need. Allocations also consider waiting times or distance to a donor hospital.

New York’s new law could not only help save more lives, but also save money. Right now, people whose kidneys have failed and require dialysis qualify for Medicare coverage. Studies have shown that providing an organ transplant, as opposed to ongoing dialysis, results in the benefits exceeding costs by a factor of three.

In the coming state legislative sessions, perhaps other states or even the federal government will follow New York’s lead or even find new ways to remove barriers and increase the number of people donating organs. For New York State, a visible symbol of the state’s success will be the number of new people who choose to be living donors by next Valentine’s Day.


Courtney Burke is senior fellow for health policy at the Rockefeller Institute of Government