Removing financial barriers to organ and bone marrow donation: the effect of leave and tax legislation in the U.S

J Health Econ. 2014 Jan;33:43-56. doi: 10.1016/j.jhealeco.2013.10.006. Epub 2013 Oct 28.


Many U.S. states have passed legislation providing leave to organ and bone marrow donors and/or tax benefits for live and deceased organ and bone marrow donations and to employers of donors. We exploit cross-state variation in the timing of such legislation to analyze its impact on organ donations by living and deceased persons, on measures of the quality of the transplants, and on the number of bone marrow donations. We find that these provisions do not have a significant impact on the quantity of organs donated. The leave laws, however, do have a positive impact on bone marrow donations, and the effect increases with the size of the population of beneficiaries and with the generosity of the legislative provisions. Our results suggest that this legislation works for moderately invasive procedures such as bone marrow donation, but these incentives may be too low for organ donation, which is riskier and more burdensome.

Keywords: Bone marrow donation; Leave and tax legislation; Organ donation; Policy evaluation.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Bone Marrow Transplantation / economics
  • Bone Marrow Transplantation / legislation & jurisprudence*
  • Bone Marrow Transplantation / statistics & numerical data
  • Female
  • Health Policy
  • Humans
  • Kidney Transplantation / statistics & numerical data
  • Liver Transplantation / statistics & numerical data
  • Male
  • Organ Transplantation / economics
  • Organ Transplantation / legislation & jurisprudence
  • Organ Transplantation / statistics & numerical data
  • Sick Leave / economics
  • Sick Leave / legislation & jurisprudence*
  • State Government
  • Taxes / economics
  • Taxes / legislation & jurisprudence*
  • Tissue Donors / legislation & jurisprudence
  • Tissue and Organ Procurement / economics
  • Tissue and Organ Procurement / legislation & jurisprudence*
  • Tissue and Organ Procurement / statistics & numerical data
  • United States