House Bill 663, the Living Donor Protection Act, creates a package of incentives and protections for people who donate organs or bone marrow while living. It would prohibit insurers from refusing coverage, charging different rates, or otherwise discriminating against someone solely because they are a living organ donor, and it would apply this protection to health, life, accident and health, disability, disability income, and long-term care policies. The insurance provisions would take effect 30 days after enactment and apply to new, renewed, or amended policies.
The bill also creates a North Carolina income tax credit for unreimbursed expenses tied to live organ donation, including lost wages, transportation, lodging, and meals, up to $5,000 per donation. The credit could be claimed by the donor or by a taxpayer claiming the donor as a dependent, and unused credit could be carried forward for five years. To prevent double benefits, the bill disallows a medical expense deduction for donation expenses already used for the credit and bars estates and trusts from claiming the credit. The tax provisions would apply to taxable years beginning on or after January 1, 2025.
In addition, HB663 requires paid leave for State employees and State-supported personnel who serve as living organ donors or bone marrow donors. Eligible full-time employees could receive up to 30 days of paid leave for organ donation and up to seven days for bone marrow donation, with prorated leave for part-time employees. The leave would be in addition to other leave, would not require exhaustion of sick or vacation leave, would have no cash value at separation, and would not count toward retirement. The bill also directs state agencies and education boards to report annually on use of the program.
The bill’s overall effect would be to add new anti-discrimination rules in insurance law, a new personal income tax credit in Chapter 105, and a new paid-leave entitlement in Chapter 126 for state workers and state-supported personnel. It would also require implementing rules and policies from the State Human Resources Commission and governing boards for schools and community colleges. The measure appears designed to reduce financial and employment barriers to living organ and bone marrow donation.
There is little recorded committee or floor debate in the available materials, and no votes are listed, so the public sentiment cannot be measured from recorded roll calls. Based on the bill’s structure and sponsorship, the measure appears generally supportive of organ donation and donor protection. The main points of potential contention are likely fiscal and administrative: the cost of paid leave for public employees, the revenue impact of the tax credit, and whether insurers should be restricted from considering donor status absent additional actuarial risk. The bill was last referred back to the House Finance Committee, suggesting that funding and tax implications may be central to further review.
HB663 would amend North Carolina insurance law, tax law, and state personnel law. It adds a new prohibition in G.S. 58-3-25 against insurance discrimination based solely on living organ donor status, creates a new tax credit in G.S. 105-153.12 for unreimbursed live organ donation expenses, modifies the medical expense deduction to prevent double counting, and bars estates and trusts from claiming the credit. It also creates G.S. 126-8.7 to provide paid organ-donation and bone-marrow-donation leave for state employees and state-supported personnel, and expands applicability through G.S. 126-5 to public school and community college employees.
The available record suggests broadly favorable sentiment toward the bill’s purpose of encouraging living organ and bone marrow donation and protecting donors from financial harm. The bill’s sponsors frame it as a donor-protection measure, and the absence of recorded opposition or votes in the provided materials limits any evidence of organized resistance. At the same time, the referral to Finance indicates that lawmakers may be scrutinizing the bill’s fiscal effects, especially the tax credit and paid-leave provisions.
The likely areas of contention are cost, implementation, and scope. Fiscal concerns may arise from the $5,000 tax credit, the carryforward feature, and the obligation to provide paid leave to state employees and state-supported personnel. Administrative questions may include how agencies will verify donation-related expenses, how part-time leave will be prorated, and how the new leave interacts with existing leave systems. Insurers may also object to the restriction on underwriting or pricing based on donor status, though the bill limits that restriction to cases without additional actuarial risk.