Trumpcare May Deter Organ Donors – We Shouldn’t Let It

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Six months ago today at Northwestern Medicine in Chicago, I donated my kidney to a stranger, and kicked off a chain of at least 3 kidney transplants. It was one of the best decisions I ever made, and the fact that I only have one kidney now hasn’t impacted my health in any real way. My one kidney does its job well, and no study to date has shown any indication that I’ll live a shorter life because I donated.

Despite that fact, being an organ donor means that I have a pre-existing condition under the terms of many major insurance providers. Thanks to Obamacare, my medical history can’t be used against me in determining my health care premiums.

But what will happen if Trumpcare becomes the law of the land?

The Affordable Health Care Act (AHCA) – the Republican’s plan for repealing and replacing the Affordable Care Act (ACA) – passed the House a few weeks ago with no support from a single Democrat and with many House Republicans admitting that they hadn’t read the full bill. The pundits insist that the bill is unlikely to make it through the Senate in its current form, but a whole slew of unlikely things have been happening in government lately.

So if you’re thinking about donating an organ, how would Trumpcare effect your premiums?

The short answer is, no one knows. President Trump insists that everything will come together with “phase two” and “phase three” of his health care plan, but no one is coughing up any details.

What we do know is that donating an organ can qualify you as having a pre-existing condition, and under the current form of the AHCA (Trumpcare), that could mean serious increases in your premiums.

Kevin O’Doherty of explained what would happen under the current Republican plan this way:

“If you are uninsured for more than 63 days, insurance carriers may charge a 30 percent late enrollment fee and, depending on the state, the applicant may be underwritten based on health status… [meaning] that the insurance carriers may take into account your past medical history to determine the rate at which you will pay for insurance. Currently, carriers are not allowed to use your past medical history in determining rates... [Under the new law] if they deem you ‘uninsurable,’ you would be forced into the state’s ‘high-risk’ pool.”

If you end up in one of those pools, you could be in big trouble.

Of course, if you currently have insurance and are able to consistently maintain it, it seems that you would be able to avoid this menacing loophole that lets insurers take your health status into account. The big problem, though, is that no one can predict the future. I’d imagine that most people who pay for health insurance don’t intend to have a 63-day gap – but things happen.

The moral of the story here is not to rule out organ donation. If I was scheduled to donate my kidney next week, I would still go through with it.

No, the moral here is that you should call your representative in Congress and tell them how Trumpcare would negatively affect you. Point out this problem with the proposed system. (One of many problems, if you ask me.) And make sure they understand that organ donation actually saves everyone money. Kidney transplant is less expensive over the long run than dialysis, it causes fewer serious health problems, and it has been proven to have better outcomes. On average, people who receive kidney transplants live ten to fifteen years longer than people who stay on dialysis.

Again, even with the possible pre-existing condition obstacles, I think organ donation is the right choice. But that doesn’t mean we organ donors and potential donors should just accept these terms. I believe we should be making it easier for people to donate organs, not burdening their choice with financial stress.

What do you think? What can we do to make insurance options for organ donors fair and affordable?

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