[House Report 119-159]
[From the U.S. Government Publishing Office]
119th Congress } { Report
HOUSE OF REPRESENTATIVES
1st Session } { 119-159
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CHARLOTTE WOODWARD ORGAN TRANSPLANT
DISCRIMINATION PREVENTION ACT
_______
June 12, 2025.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Mr. Guthrie, from the Committee on Energy and Commerce, submitted the
following
R E P O R T
[To accompany H.R. 1520]
The Committee on Energy and Commerce, to whom was referred
the bill (H.R. 1520) to prohibit discrimination on the basis of
mental or physical disability in cases of organ transplants,
having considered the same, reports favorably thereon without
amendment and recommends that the bill do pass.
CONTENTS
Page
Purpose and Summary.............................................. 1
Background and Need for Legislation.............................. 2
Committee Action................................................. 2
Committee Votes.................................................. 3
Oversight Findings and Recommendations........................... 5
New Budget Authority, Entitlement Authority, and Tax Expenditures 5
Congressional Budget Office Estimate............................. 5
Federal Mandates Statement....................................... 5
Statement of General Performance Goals and Objectives............ 5
Duplication of Federal Programs.................................. 5
Related Committee and Subcommittee Hearings...................... 5
Committee Cost Estimate.......................................... 6
Earmark, Limited Tax Benefits, and Limited Tariff Benefits....... 6
Advisory Committee Statement..................................... 6
Applicability to Legislative Branch.............................. 6
Section-by-Section Analysis of the Legislation................... 6
PURPOSE AND SUMMARY
H.R. 1520 prohibits health care providers and other
entities from denying or restricting an individual's access to
organ transplants solely on the basis of the individual's
disability, except in limited circumstances.
BACKGROUND AND NEED FOR LEGISLATION
According to the National Council on Disability,
individuals with disabilities are often denied equal access to
organ transplants based solely on disability status. The
denials are usually based on assumptions that these
individuals' lives are of poorer quality than individuals
without disabilities and on misinterpretations regarding the
ability for these individuals to comply with postoperative
care.\1\ Existing federal laws, including the Americans with
Disabilities Act of 1990, the Rehabilitation Act of 1973, and
the Patient Protection and Affordable Care Act, prohibit organ
transplant centers from discriminating on the basis of
disability.\2\ However, there is limited enforcement and a lack
of federal guidance to ensure patients are protected. Some
states have laws banning organ transplant discrimination, but
the state patchwork can lead to further confusion, and
disability-based discrimination in the organ transplant system
continues to occur. For instance, an infant with Down syndrome
in Florida needed a heart transplant due to a congenital heart
defect. The infant was denied a heart transplant by three
physicians and tragically passed away.\3\ H.R. 1520 will
clarify that individuals with disabilities shall not be denied
an organ transplant or related services based solely on the
individual's disability and includes an expedited review and
enforcement mechanism, as appropriate, through the Department
of Health and Human Services Office of Civil Rights.
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\1\National Council on Disability, Organ Transplant Discrimination
Against People with Disabilities, Part of the Bioethics and Disability
Series (Sept. 25, 2019), https://www.ncd.gov/assets/uploads/reports/
2019/ncd_organ_transplant_508.pdf.
\2\See Americans with Disabilities Act of 1990, Pub. L. No. 101-336
(1990); Rehabilitation Act of 1973, Pub. L. No. 93-112 (1973); Patient
Protection and Affordable Care Act, Pub. L. No. 111-148 (2010).
\3\Emma Delamo, Ocala couple inspires NCFL Congresswoman to push
forward bill for those with disabilities, WCJB, (Feb. 22, 2024, 6:04
PM), https://www.wcjb.com/2024/02/22/ocala-couple-inspire-ncfl-
congresswoman-push-forward-bill-those-with-disabilities/.
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COMMITTEE ACTION
On February 14, 2024, the Subcommittee on Health held a
hearing on H.R. 2706.\4\ The title of the hearing was
``Legislative Proposals to Support Patients and Caregivers.''
The Subcommittee received testimony from:
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\4\Provisions of H.R. 2706 were reintroduced in the 119th Congress
as H.R. 1520.
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Andy Shih, PhD, Chief Science Officer,
Autism Speaks;
Corey Feist, JD, MBA, Co-Founder and CEO,
Dr. Lorna Breen Heroes' Foundation;
Joanne Pike, DrPH, President and CEO,
Alzheimer's Association;
Gordon Tomaselli, MD, Former President,
American Heart Association; Marilyn and Stanley M.
Katz, Dean Emeritus and Professor of Medicine, Albert
Einstein College of Medicine; Adjunct Professor of
Medicine, Johns Hopkins University School of Medicine;
Michelle Whitten, President, CEO, and Co-
Founder, Global Down Syndrome Foundation;
Randy Strozyk, President, American Ambulance
Association; and
Christina Annunziata, MD, PhD, Senior Vice
President of Extramural Discovery Science, American
Cancer Society.
On March 12, 2024, the Subcommittee on Health met in open
markup session and forwarded H.R. 2706, as amended, to the full
Committee by voice vote.
On March 20, 2024, the full Committee on Energy and
Commerce met in open markup session and ordered H.R. 2706, as
amended, favorably reported to the House by a record vote of 46
yeas and 0 nays.
On April 29, 2025, the full Committee on Energy and
Commerce met in open markup session and ordered H.R. 1520
favorably reported to the House by a record vote of 46 yeas and
1 nay.
COMMITTEE VOTES
Clause 3(b) of rule XIII requires the Committee to list the
record votes on the motion to report legislation and amendments
thereto. The following reflects the record vote taken during
the Committee consideration:
OVERSIGHT FINDINGS AND RECOMMENDATIONS
Pursuant to clause 2(b)(1) of rule X and clause 3(c)(1) of
rule XIII, the Committee held a hearing and made findings that
are reflected in this report.
NEW BUDGET AUTHORITY, ENTITLEMENT AUTHORITY, AND TAX EXPENDITURES
Pursuant to clause 3(c)(2) of rule XIII, the Committee
finds that H.R. 1520 would result in no new or increased budget
authority, entitlement authority, or tax expenditures or
revenues.
CONGRESSIONAL BUDGET OFFICE ESTIMATE
Pursuant to clause 3(c)(3) of rule XIII, at the time this
report was filed, the cost estimate prepared by the Director of
the Congressional Budget Office pursuant to section 402 of the
Congressional Budget Act of 1974 was not available.
FEDERAL MANDATES STATEMENT
The Committee adopts as its own the estimate of Federal
mandates prepared by the Director of the Congressional Budget
Office pursuant to section 423 of the Unfunded Mandates Reform
Act.
STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES
Pursuant to clause 3(c)(4) of rule XIII, the general
performance goal or objective of this legislation is to
prohibit health care practices that discriminate against
individuals with a disability during the organ transplant
process.
DUPLICATION OF FEDERAL PROGRAMS
Pursuant to clause 3(c)(5) of rule XIII, no provision of
H.R. 1520 is known to be duplicative of another Federal
program, including any program that was included in a report to
Congress pursuant to section 21 of Public Law 111-139 or the
most recent Catalog of Federal Domestic Assistance.
RELATED COMMITTEE AND SUBCOMMITTEE HEARINGS
Pursuant to clause 3(c)(6) of rule XIII, the following
hearing was used to develop or consider H.R. 1520:
On February 14, 2024, the Subcommittee on
Health held a hearing on H.R. 2706.\5\ The title of the
hearing was ``Legislative Proposals to Support Patients
and Caregivers.'' The Subcommittee received testimony
from:
---------------------------------------------------------------------------
\5\Provisions of H.R. 2706 were reintroduced in the 119th Congress
as H.R. 1520.
---------------------------------------------------------------------------
Andy Shih, PhD, Chief Science
Officer, Autism Speaks;
Corey Feist, JD, MBA, Co-Founder
and CEO, Dr. Lorna Breen Heroes' Foundation;
Joanne Pike, DrPH, President and
CEO, Alzheimer's Association;
Gordon Tomaselli, MD, Former
President, American Heart Association; Marilyn
and Stanley M. Katz, Dean Emeritus and
Professor of Medicine, Albert Einstein College
of Medicine; Adjunct Professor of Medicine,
Johns Hopkins University School of Medicine;
Michelle Whitten, President,
CEO, and Co-Founder, Global Down Syndrome
Foundation;
Randy Strozyk, President,
American Ambulance Association; and
Christina Annunziata, MD, PhD,
Senior Vice President of Extramural Discovery
Science, American Cancer Society.
COMMITTEE COST ESTIMATE
Pursuant to clause 3(d)(1) of rule XIII, the Committee
adopts as its own the cost estimate prepared by the Director of
the Congressional Budget Office pursuant to section 402 of the
Congressional Budget Act of 1974. At the time this report was
filed, the estimate was not available.
EARMARK, LIMITED TAX BENEFITS, AND LIMITED TARIFF BENEFITS
Pursuant to clause 9(e), 9(f), and 9(g) of rule XXI, the
Committee finds that H.R. 1520 contains no earmarks, limited
tax benefits, or limited tariff benefits.
ADVISORY COMMITTEE STATEMENT
No advisory committees within the meaning of section 5(b)
of the Federal Advisory Committee Act were created by this
legislation.
APPLICABILITY TO LEGISLATIVE BRANCH
The Committee finds that the legislation does not relate to
the terms and conditions of employment or access to public
services or accommodations within the meaning of section
102(b)(3) of the Congressional Accountability Act.
SECTION-BY-SECTION ANALYSIS OF THE LEGISLATION
Section 1. Short title
Section 1 provides a short title of ``Charlotte Woodward
Organ Transplant Discrimination Prevention Act''.
Section 2. Definitions
Section 2 provides definitions for various terms used
throughout the bill text.
Section 3. Prohibition of discriminatory policy
Section 3 prohibits the Board of Directors of the Organ
Procurement and Transplantation Network from issuing policies
that would prohibit a qualified individual from accessing an
organ transplant solely on the basis of that individual's
disability.
Section 4. Prohibition of discrimination
Section 4 prohibits a covered entity from determining an
individual is ineligible to receive an organ transplant,
denying an individual an organ, refusing to refer an individual
to a transplant center, and refusing to place the individual on
the transplant waitlist based solely on the individual's
disability, except in certain circumstances. It also requires
the Office of Civil Rights within the Department of Health and
Human Services to expedite claims allowed under this Act, as
appropriate, to provide for stronger enforcement.
Section 5. Application to each part of process
Section 5 clarifies that certain provisions of this Act
also apply to the evaluation and listing of qualified
individuals, post-organ-transplant treatment of such an
individual, and the process of receipt of related services.
Section 6. Effect on other laws
Section 6 clarifies that nothing in this Act shall be
construed to supersede any provision of state or local law that
provides further protections to individuals with disabilities.
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