The Securing the U.S. Organ Procurement and Transplantation Network Act

I remember where I was when this bill passed. On March 23, 2023, President Biden signed the Securing the U.S. Organ Procurement and Transplantation Network Act into law. This legislation passed both chambers of Congress with overwhelming bipartisan support — 375 to 3 in the House, unanimous consent in the Senate — ending UNOS's 37-year monopoly. When 17 people die every day waiting for organs, there shouldn't be partisan disagreement about fixing the system that's failing them. And for once, there wasn't.

What the Law Does

The act directs the Department of Health and Human Services (HHS) to modernize the Organ Procurement and Transplantation Network (OPTN) by allowing multiple contractors to manage different functions of the system. Instead of one organization handling everything from organ matching to data management to logistics, these functions can now be split among specialized organizations that compete for contracts.

"This is the most significant reform to our organ transplant system since it was created. It will save lives." — President Biden, upon signing the act

Key Provisions

Breaking the monopoly: HHS can now award the OPTN contract to multiple entities, ending the single-contractor model.

Technology modernization: The law requires the adoption of modern technology for organ matching, tracking, and logistics.

Accountability measures: New oversight mechanisms hold contractors accountable for performance, including organ utilization rates and equity in allocation.

Board governance reform: The act restructures governance to include more patient advocates and reduce conflicts of interest.

Bipartisan Achievement

In an era of deep political polarization, the OPTN Act passed the House 375–3 and the Senate by unanimous consent. Both parties agreed that the current system was failing patients and that reform was overdue. The legislation was supported by patient advocacy groups, transplant physicians, and major healthcare organizations. This is proof of something I say all the time: saving lives through better organ donation policy is not a partisan issue. It's a human one.

"When 17 people die every day waiting for an organ, this isn't a partisan issue. It's a moral imperative." — Senator Chuck Grassley

What Comes Next

HHS has begun the process of implementing the law, including issuing new requests for proposals from organizations that want to manage parts of the transplant network. The transition will take several years, but early indications suggest that multiple qualified organizations are interested in competing for contracts. We at YCOD are watching this closely because it connects directly to our mission. Federal reform of the transplant network plus state-level opt-out legislation like Bill A07954 — that's how you build a system that actually works. More donors coming in, and a better system to get those organs where they need to go. I couldn't stay on the sidelines knowing both pieces of this puzzle need to come together.