May 18, 2023

Young, Colleagues Introduce Bill to Enhance Competition in Organ Donation Network

WASHINGTON – U.S. Senators Todd Young (R-Ind.), Chuck Grassley (R-Iowa), Ron Wyden (D-Ore.), Ben Cardin (D-Md.), and Bill Cassidy (R-La.) introduced bipartisan legislation to crack down on anti-competitive practices in the U.S. organ donation system by modernizing the Organ Procurement and Transplantation Network (OPTN).

Since its inception decades ago, OPTN has exclusively contracted the United Network for Organ Sharing (UNOS) to oversee the U.S. transplantation network. However, Finance Committee investigations have revealed consistent mismanagement and underperformance on the part of UNOS.

“Our bipartisan legislation will help ensure accountability and transformation in the organ donation and transplant system. The important reforms included in our bill will provide the flexibility necessary to conduct a thoughtful, full, and open competition process for the OPTN contract, which will improve the system and help save lives,” said Senator Young.

“UNOS’s monopoly over the U.S. organ donation system has been disastrous. Decades of corruption and mismanagement have left vulnerable patients to die on the waiting list while unused organs from generous American donors go to waste. Building on the Senate Finance Committee’s investigation, I’m committed to working with my bipartisan colleagues to advance long-overdue competition in this life and death area of health care,” said Senator Grassley.

“Major changes are needed to modernize the organ procurement system on behalf of Americans on the waiting list for an organ transplant that will save their lives. For too long UNOS has had a stranglehold on this contract, and as the Finance Committee’s investigation showed, that lack of accountability has had dire consequences. It’s high time to bring in some competition so there can be more accountability and know-how to improve results and save lives,” said Senator Wyden.

“The grave disparities in access to organ transplants are unconscionable. Our bipartisan bill will move us toward a more transparent and equitable system that will save lives by improving timely access to needed transplant organs, particularly for patients in underserved communities,” said Senator Cardin.

“The management of the organ transplant system in the U.S. needs serious reform. Breaking up this monopoly will increase competition, save lives and improve the system. When it is referred to the HELP Committee, as ranking member and a physician who referred many patients for transplants, I look forward to advancing this legislation,” said Senator Cassidy. 

U.S. Senators Elizabeth Warren (D-Mass.), Jerry Moran (R-Kan.), and Cory Booker (D-N.J.) also cosponsored this legislation.

Companion legislation was introduced in the U.S. House of Representatives by Reps. Larry Bucshon (R-IN-08) and Robin Kelly (D-IL-02).


The Securing the U.S. Organ Procurement and Transplantation Network Act would remove barriers in OPTN contracting and give the Health Resources and Services Administration (HRSA) statutory authority to improve management of the organ transplantation system in the United States. The current OPTN contract is set to expire on September 30, 2023, making the proposed changes all the more urgent in order for HRSA to make meaningful reforms before a new contract is awarded.

The legislative text of the bill can be found here. A two-page summary of the bill can be found here and a section-by-section can be found here.