Ken Montgomery

As many of you may have read last year in these very pages, I am one of only a few hundred Americans each year who chooses to donate a kidney to a stranger. I went through almost a year of testing. I had surgery. I missed work. I did all of this for someone I never met, simply because I could. I became just the seventh person in Wyoming history to have donated a kidney to a stranger. 

Donating was one of the most fulfilling things I have ever done. But I also saw firsthand how hard it is for most people to do what I did. That is why I am urging Rep. Harriet Hageman, Sen. John Barrasso, and Sen. Cynthia Lummis to cosponsor and champion the End Kidney Deaths Act (H.R. 2687).

This bill is a 10-year pilot program that would provide living kidney donors with $10,000 per year for five years, a total of $50,000, if they donate to a stranger who has been waiting the longest. These are the patients most likely to die without a transplant. The bill would transform the lives of up to 100,000 Americans who would otherwise die waiting. It would also save taxpayers an estimated $37 billion by reducing dependence on dialysis, which is far more expensive than transplant. A bipartisan bill that saves both lives and money? Yes! This is a unique opportunity that will make the United States a country where no one dies while waiting for a kidney. 

Understandably, because of the rural nature of this wonderful place we call home, Wyoming is one of only two states without a transplant center. The other is Alaska. This makes it even harder for our friends and family here to access the care they need. Right now, around 670 Wyomingites are living with kidney failure. About 460 of them are on dialysis. By the fifth year of dialysis, only 40% are still alive. Since 2010, the total number of Wyomingites living with kidney failure has increased by 40%; over 80 will die annually. This is a public health emergency hiding in plain sight. And it should be so easy to cure.

As someone who lives in small town Wyoming (which is to say, Wyoming!), I have seen what happens when neighbors step up for each other. That spirit of sacrifice and community is in part what inspired me to donate. But we cannot rely on rare acts of heroism alone. Right now, half of the 90,000 people on the kidney waitlist will die before getting a transplant. We have not seen an increase in living kidney donation in 25 years. Nothing, not education campaigns, not public awareness events, has moved the needle. It is time to try something bold.

The End Kidney Deaths Act is bold. It is also practical, humane, and fiscally responsible.

Some people worry that compensating donors might be coercive or unethical. But I ask: Is it ethical to let 100,000 Americans die when we have a solution? Is it coercive to offer people fair compensation for time-consuming, painful, and selfless work, especially when they are thoroughly screened by medical professionals and reminded throughout the process that they can walk away at any time? We do not question the motives of nurses or doctors because they earn a salary. Saving lives is still saving lives.

The truth is, the people who most often oppose this bill fall into two camps. One group misunderstands it. They assume we are talking about organ trafficking, when this legislation is actually about helping more people do what I did, safely, voluntarily, and with proper oversight. The second group benefits from the status quo. Dialysis generates massive profits. The longer the kidney shortage continues, the more money some hospitals, companies, and consultants stand to make.

We can do better. The End Kidney Deaths Act reflects the values Wyoming holds dear: self-reliance, compassion and respect for those who do hard things to help others. This is not a handout. It is a fair thank you. And it is a solution that works.

If a wildfire, flood, or explosion were to kill over six dozen Wyoming residents each year, we would mobilize everything we had to stop it. But that is exactly what is happening with kidney failure, a slow-motion disaster that is preventable.

I am proud to be a kidney donor. But I honestly don’t want to be the one in a million (which is what donating a kidney today is!). I want more people to follow in my footsteps; to do that we need to make it easier, not harder. We need to recognize that for many potential donors, financial barriers are, quite reasonably a, if not the, deciding factor. Offering compensation for this extraordinary act is not just urgently needed — it is morally justified!

Rep. Hageman, Sen. Barrasso, and Sen. Lummis have long stood up for the rights and needs of Wyoming families. Sen. Barrasso sent me a personal note after my donation (how many states have senators who will do that!). So, now I humbly ask them to stand up for the 605 people on dialysis in our state, and for the tens of thousands more nationwide who are hoping to survive long enough to receive a transplant.

Let us end needless deaths. Let us end the kidney shortage. Let us pass the End Kidney Deaths Act.

(Ken Montgomery of Clark donated a kidney to an unknown recipient at Mayo Clinic in Arizona in the fall of 2023.)