Blog post

What's happening in the states: April 2022

Welcome to our What's happening in the states blog series, where we provide monthly legislative updates on what the American Kidney Fund (AKF) is working on across the country to improve the lives of those living with kidney disease and protect living organ donors.
Map of Ohio with blog title on top of it

Welcome to our What's happening in the states blog series, where we provide monthly legislative updates on what the American Kidney Fund (AKF) is working on across the country to improve the lives of those living with kidney disease and protect living organ donors.

Legislative wins this session

It is that time of year when the legislative sessions in some states are starting to wind down and adjourn for the year. During this time, some of the bills introduced during the session have passed the legislature and are making their way to governors to ultimately be signed into law. Alternatively, some bills ran out of time getting through the legislative process and have "died" for the session. The silver lining, though, is that these bills can always be reintroduced for a chance to pass the following year or legislative session.

So far, four states have passed bills with living organ donor protections: Florida, Ohio,Virginia,Nebraska and Delaware. We are thrilled to see the progress in these states, and all of them had their grade in our Living Donor Protection Report Card bumped up to one letter grade. Excitingly, the passage of these bills also moved the national grade average from a D to a C. But with more than 106,000 people waiting for an organ transplant — including nearly 92,000 who are waiting for a kidney — it is clear that much more needs to be done. Until federal legislation is enacted to give baseline protections to living donors nationwide, states are operating with a patchwork of living donor protection laws.

Legislation moving through the states

In 2022, we are focused on two types of legislation at the state level: living donor protections and access to Medigap, which is a type of Medicare supplemental insurance. Right now, we are working on more than 30 of these bills in half of the states. We have testified in Georgia, Kentucky, Virginia, Rhode Island, South Carolina and Louisiana so far this year.

As of the end of April, living donor protection legislation has passed the state legislature in Georgia, and the bill is awaiting the governor's signature. This bill prevents life, disability and long-term care insurance companies in their respective states from discriminating against living organ donors by charging higher premiums or refusing to insure them altogether. The bill also provides a living donor tax credit of $25,000 for non-medical expenses such as childcare, elder care, travel and lodging. Providing incentives and removing financial burdens for living donors can lead to an increase in organ donations, which ultimately saves more lives.

We are expecting more states to pass living donor protection legislation in the coming months as well, including South Carolina, Louisiana and Minnesota.

Currently, Rhode Island has Medigap legislation pending. The bill has passed the House and is currently in the Senate. Medigap legislation is critical to making health care affordable for people who are younger than 65 and qualify for Medicare because they have kidney failure. Typically, a Medicare supplemental plan like Medigap can ease the burden of high costs and allow a person to get on the transplant waiting list, as many transplant centers require a transplant recipient to have supplementary insurance to cover the costs.

How can you help?

All these bills have a better chance of moving through the legislative process with your help! If you would like to contact your state lawmakers about these bills or help with written or live testimony during bill hearings, please reach out to Lindsay Gill, AKF's associate director of state policy & advocacy at

Also please follow us @akf_advocacy on Twitter, where we provide real time updates on state activity and other important advocacy information.

And of course, don't forget to join us right from your cell phone by texting "KIDNEY" to 52886 or clicking here. We look forward to working with you!


Lindsay Gill

Lindsay Gill is the associate director of state policy & advocacy at the American Kidney Fund.