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Blunt: Changes to National Liver Allocation Policy Rushed, Shortsighted & Wrong

February 12, 2020

WASHINGTON – Today, U.S. Senator Roy Blunt (Mo.), Chairman of the Senate Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies (Labor/HHS), joined U.S. Senator Jerry Moran (Kan.) on the Senate floor to slam the flawed changes to the national liver allocation policy.
Under the new policy, livers donated primarily in Midwestern, Southern, and rural areas will be redistributed to other parts of the country, which could result in up to 32% fewer liver transplants in Missouri and 45% fewer liver transplants in Kansas. In January 2020, Blunt and Moran urged Health and Human Services Secretary Alex Azar to delay implementation of the changes, which subsequently went into effect on February 4th.
The Blunt-led Labor/HHS appropriations bill, which was signed into law in December 2019, included funding for a new National Academies of Sciences, Engineering, and Medicine study on organ allocation policies, particularly related to livers. Blunt and Moran also requested that the Government Accountability Office review the policy. Blunt has repeatedly pressed HHS to review OPTN’s policy-making process and HHS’ oversight of the program, and warned of the harmful impact the new policy will have on Midwestern and Southern states: click here for more on Blunt’s efforts.
Following Are Excerpts From Blunt’s Remarks:
“Mr. President, Missourians and many of our closest neighbors waiting for the life-changing moment that happens when you have a liver transplant now have to have one more hurdle in the process that they have to go through to make that happen. There's a new and, I think, terribly flawed organ allocation policy.
“Senator Moran and I have really led an effort to slow this down. We've both been the chairmen of the Health and Human Services appropriating committee, we think we understand how that agency is supposed to work and how some of these health care issues are supposed to be handled.
“Frankly, I don't think either one of us think that this one has been handled in the right way. The policy we see today, really nearly half the country is disadvantaged by a new policy that's been put into place. It used to be that when someone donated a liver, those organs were matched with the transplant candidates first at the local level, then regionally, and finally at the national level. And it's my belief, and I think Senator Moran's belief, that when you know that your neighbors are going to benefit from that decision, you're more likely to make the decision that you want to be part of that organ donor community. …
“In Missouri 73% of people are organ donors or at least willing to be organ donors. Other states in the Midwest and the South, and frankly the rural parts of the country, just simply have the highest donation rates of being willing to be an organ donor. That's not the case everywhere.
“In New York, for example, 32% of people are organ donors. There’s a big difference in 73% and 32%. I don't know how much of that difference relates to the fact that in Missouri and Kansas and Arkansas and other places, people look at this, and they think ‘if I am willing to be an organ donor, people that I know, people my kids go to school with, people we go to church with, people we see in the grocery store have a better chance if they have that crisis in their life to benefit from it than others do.’ But on the fourth of February, a new policy went into effect that will take livers specifically donated by Missourians and allocate them to other parts of the country. …
“In the change in liver allocations, roughly 32% fewer liver transplants will happen in Missouri than will happen otherwise. And Senator Moran is joining me here on the floor and we have both talked about this a lot. We've had the group come into our offices that are supposed to be making this system work.
“You know in Missouri, we have six transplant centers. We currently have 109 people on the transplant list, ten of them are younger than 18 years old. And they simply won't have as good a likelihood to have a transplanted life-saving liver than they would have had before. And it's not just Missouri who suffered, as much as 40% of the country will see a decrease in what was available to them.
“Now my view, this was not decided by transplant experts, most of them have talked to us in fact about their concerns about having to transport, in this case again, livers longer distances, having to have more time and expense to get that organ than they would otherwise. But it was decided by what appears to be an unaccountable government contractor, or at least they've been unaccountable to us, Senator Moran. And we've talked to them about this, tried to make a case that makes sense, tried to get them not to rush through this, but they did.
“Now, you know the contractor in this case serves as both the administrator of the organ allocation system and the determiner of who gets the organ. It seems like to me there's a conflict there. The contractor has held the contract for nearly 35 years. Again, it seems to me that competition might be a good thing here.
“This policy became a policy without due process, without transparency, or I think without fully evaluating the consequences. I think it was rushed. In fact even the Department of Health and Human Services, who I’ll mention again, Senator Moran and I have chaired their appropriating committee and shared our concerns on this, I think failed to fully exercise the authority they had. …
“In closing, Mr. President, I'd say this policy is shortsighted, it's wrong, it was rushed to implementation, and there was no reason for any of those things to happen.”

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