IN PRINT: The Impact of Tax Policies on Living Organ Donations October 2012

The Impact of Tax Policies on Living Organ Donations in the United States

Published in the American Journal of Transplantation

By Erika G. Martin and others

James W. Fossett and Michelle N. Meyer

ABSTRACT:Tax incentives to increase living organ donation are not increasing donation rates, according to this study by Institute Fellow Erika G. Martin and three other researchers at Massachusetts General Hospital and Washington University School of Medicine.

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Erika G. Martin is an Institute Fellow and an assistant professor at the Rockefeller College of Public Affairs & Policy. The full article referenced here is available at the American Journal of Transplantation site; access is for subscribers only. Massachusetts General Hospital issued this press release on the article. National Public Radio's Health Blog ran this story. And this story appeared in Science Daily.

In an effort to increase living organ donation, 15 states passed tax deductions of up to $10,000 and one state a tax credit to help defray potential medical, lodging and wage loss costs associated with living organ donation between 2004 and 2008. To assess the impact of these policies on living donation rates, Martin and her colleagues compared the pre- and post-legislation change in the number of living donations in states that passed legislation against the same change in those states that did not.

They found no statistically significant effect of these tax policies on living or deceased donation rates, even under different assumptions about the length of time between when the policy was enacted and effects would be seen. They found no evidence that these policies had an impact in specific sub-populations defined by gender, race or donor relationship.

The researchers hypothesize the following causes for their findings:

  • The cash value of the tax deduction may be too low to defray costs faced by living donors. For example, a tax deduction of $10,000 for a family of four at the median income in the state of Wisconsin translates to an actual cash value of just over $600. 

  • The public may be largely unaware about the existence of these policies. 

  • States that were proactive enough to pass tax policy laws may have already enacted other measures to increase donation rates, and already depleted their pool of donors.

  • Some potential donors may react negatively to financial incentives for what they believe is a fundamentally altruistic act. In other words, the incentives could have had the opposite of their intended effect.


The Nelson A. Rockefeller Institute of Government, the public policy research arm of the State University of New York, conducts fiscal and programmatic research on American state and local governments. It works closely with federal, state, and local government agencies nationally and in New York, and draws on the State University’s rich intellectual resources and on networks of public policy academic experts throughout the country.