S-1782-119
Placed on Senate Legislative Calendar under General Orders. Calendar No. 441.
Sponsored by Ashley Moody (R-FL)
What it does
This bill would prohibit covered entities — defined as programs receiving federal financial assistance and public entities under the ADA — from denying organ transplants or related services (evaluation, listing, counseling, post-operative care) to a qualified individual solely on the basis of a physical or mental disability. It would also amend the Public Health Service Act to bar the organ transplant network's governing board from setting medical criteria that discriminate on the basis of disability. Covered entities would be required to make reasonable modifications to policies and provide auxiliary aids and services to ensure access, unless doing so would fundamentally alter the program or create an undue burden. Complaints would be routed to HHS's Office for Civil Rights for expedited resolution, and the Secretary would be required to submit annual reports to Congress on enforcement activity.
Who benefits
People with physical or mental disabilities — including intellectual and developmental disabilities, Down syndrome (the bill is named for Charlotte Woodward, a Down syndrome advocate), autism, and other conditions — who have historically been denied transplant evaluations or waitlist placement. Disability rights organizations that have documented such denials. Family members and caregivers who support transplant candidates. Transplant centers that currently lack clear federal guidance on disability-based decisions. Patients with conditions like HIV or hepatitis C that were once used as automatic disqualifiers.
Who is hurt
Transplant hospitals and federally funded health programs that would face new compliance obligations, potential complaints, and administrative costs. The Organ Procurement and Transplantation Network (OPTN), whose medical criteria-setting authority would be constrained. Physicians who argue that some disability-related factors are legitimately medically significant and who may face liability risk for individualized clinical judgments. Patients without disabilities who compete for scarce organs, to the extent the waitlist expands — though the bill does not change organ allocation priority rules. Smaller transplant programs with limited resources to provide auxiliary aids and services.
Supporters argue
Supporters argue that documented cases — including people with Down syndrome, autism, and other disabilities being denied transplant evaluations outright — demonstrate that existing ADA and Rehabilitation Act protections have not been consistently applied in transplant medicine. They contend this bill closes that gap by explicitly extending well-established disability civil rights frameworks to the transplant context, requiring individualized assessments rather than categorical exclusions, and creating a clear federal enforcement pathway through HHS's Office for Civil Rights. Advocates point to studies showing disability alone is not a reliable predictor of transplant outcomes when support systems are in place.
Opponents argue
Opponents argue that transplant medicine involves uniquely scarce resources and complex post-operative compliance requirements, and that the bill's "reasonable modifications" and "individualized assessment" standards may not give physicians sufficient clarity to make life-or-death allocation decisions without legal exposure. They contend that existing law — the ADA, Section 504 of the Rehabilitation Act, and ACA Section 1557 — already prohibits unjustified disability discrimination in federally funded healthcare, making this bill largely duplicative while adding compliance uncertainty. Critics also argue that constraining the OPTN's medical criteria authority could interfere with evidence-based allocation standards developed by transplant specialists.
Constitutional context
Congress grounds this bill in its Spending Clause authority (Art. I, §8, cl. 1) by limiting coverage to entities receiving federal financial assistance — the same jurisdictional hook used in Section 504 of the Rehabilitation Act and ACA Section 1557. The Commerce Clause (Art. I, §8, cl. 3) provides an additional basis for regulating public entities under the ADA framework. No novel constitutional authority is claimed; the bill explicitly operates within and reinforces existing statutory frameworks upheld under these powers.
Checks and balances
Congress sets the anti-discrimination mandate; HHS's Office for Civil Rights gains enforcement authority over complaints; the OPTN's board loses discretion to set disability-based medical criteria; federal courts retain review authority over HHS enforcement actions and individual complaints under existing ADA and Rehabilitation Act remedies.
Historical precedent
Section 504 of the Rehabilitation Act of 1973 and the ADA (1990) established the foundational framework this bill extends; several states, including California and Maryland, have enacted transplant-specific disability non-discrimination laws that served as models for this federal legislation.