LEGISLATIVE SERVICES AGENCY
OFFICE OF FISCAL AND MANAGEMENT ANALYSIS
200 W. Washington St., Suite 301
Indianapolis, IN 46204
(317) 233-0696
iga.in.gov
FISCAL IMPACT STATEMENT
LS 7105 NOTE PREPARED: Dec 31, 2020
BILL NUMBER: SB 295 BILL AMENDED:
SUBJECT: Organ Donation.
FIRST AUTHOR: Sen. Breaux BILL STATUS: As Introduced
FIRST SPONSOR:
FUNDS AFFECTED: X GENERAL IMPACT: State & Local
X DEDICATED
X FEDERAL
Summary of Legislation: The bill prohibits an insurer that issues a policy of life insurance, disability
insurance, or long term care insurance from taking certain actions with respect to the coverage of individuals
who are living organ donors. It specifies that certain actions constitute an unfair and deceptive act and
practice in the business of insurance when taken against a living organ donor by an insurer.
Effective Date: July 1, 2021.
Explanation of State Expenditures: Department of Insurance (DOI): This bill adds provisions concerning
organ transplant, the violations of which are actionable by the DOI as unfair and deceptive acts. The agency
workload would increase to investigate and adjudicate allegations to determine if an unfair or deceptive act
has been committed. Increases in DOI workload are within the routine administrative function of the agency
and expected to be accomplished within existing resource and funding levels. [The DOI is funded through
a dedicated agency fund.]
Medicaid and State Health Plans: If additional live organ donations are made as a result of the bill’s
provisions, surgical transplant costs for Medicaid and the state health plans could increase. The cost of
surgery may be mitigated when ongoing treatment is replaced by an organ transplant. Medicaid is jointly
funded by the state and federal governments. The effective state share of program expenditures will be
approximately 34% in FFY 2021 for most services. An increase in premium costs for additional procedures
incurred by the state health plans may be mitigated with adjustments to other benefits, or through the division
of premium costs between the state and state employees.
Explanation of State Revenues: Department of Insurance (DOI): The state insurance commissioner may
SB 295 1
take administrative actions concerning unfair and deceptive acts that will impact revenue to the state General
Fund and the DOI’s agency fund. The penalty for engaging in an unfair and deceptive act is a civil penalty
between $25,000 and $50,000 for each act or violation. The revocation of a insurers license or certificate of
authority for knowingly engaged in an unfair or deceptive act would result in a reduction in fee revenue to
the DOI agency fund.
Premiums: If additional transplant surgeries result and the difference between continuing treatment and
surgery places upward pressure on premiums overall, revenues to the state General Fund would increase from
either adjusted gross income tax or insurance premium tax collections.
Explanation of Local Expenditures:
Explanation of Local Revenues: Surgery Expense: The bill potentially impacts local units of government
who offer health insurance coverage for employees through a nonERISA plan. Added local health coverage
costs may be mitigated with adjustments to other benefits or to the total employee compensation packages,
or through the division of costs between the local unit and employees.
State Agencies Affected: DOI; State Personal Department for the state health plans; Medicaid.
Local Agencies Affected: Local units offering health insurance coverage.
Information Sources: https://www.in.gov/medicaid/files/surgical%20services.pdf;
https://khn.org/news/michelle-andrews-on-insurance-for-living-organ-donors/;
https://www.federalregister.gov/documents/2020/09/22/2020-20804/removing-financial-disincentives-to-
living-organ-donation.
Fiscal Analyst: Karen Rossen, 317-234-2106.
SB 295 2


Statutes affected:
1. Introduced Senate Bill (S): 27-4-1-4