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 6172 NOTE PREPARED: Nov 27, 2023
BILL NUMBER: SB 41 BILL AMENDED:
SUBJECT: Coverage for Living Organ Donors.
FIRST AUTHOR: Sen. Breaux BILL STATUS: As Introduced
FIRST SPONSOR:
FUNDS AFFECTED:XGENERAL IMPACT: State & Local
XDEDICATED
XFEDERAL
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, 2024.
Explanation of State Expenditures: Department of Insurance (DOI): Violations of the coverage protections
for organ donors are actionable by the DOI as unfair and deceptive acts. The agency workload may increase
to investigate and adjudicate allegations to determine if an unfair or deceptive act has been committed. The
bill’s requirements are within the agency’s routine administrative functions and should be able to be
implemented with no additional appropriations, assuming near customary agency staffing and resource 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 offset by reductions in ongoing treatment due to organ transplants.
Medicaid and the Children’s Health Insurance Program (CHIP) are jointly funded between the state and
federal governments. The state share of costs for most Medicaid medical services for FFY 2023 is 34%, 10%
for the age 19 to 64 expansion population within the Healthy Indiana Plan (HIP), and 24% for CHIP. The
state share of administrative costs is 50%. The state share of most Medicaid and CHIP expenditures is paid
from General Fund appropriations, and state dedicated funds primarily cover HIP costs. An increase in
SB 41 1 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
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, which is deposited in the state General Fund.
The revocation of an insurer’s license or certificate of authority for knowingly engaging 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: 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.
Explanation of Local Revenues:
State Agencies Affected: Department of Insurance; State Personal Department; Family and Social Services
Administration.
Local Agencies Affected: Local units offering health insurance coverage.
Information Sources:
https://www.in.gov/medicaid/providers/files/modules/surgical-services.pdf
Fiscal Analyst: Jasmine Noel, 317-234-1360.
SB 41 2