Safe Step Act
Sponsored By: Representative Allen
Introduced
Summary
Mandatory exceptions process for medication step therapy. H.R. 5509 would require group health plans and related insurers to create a clear, fast, and reviewable process so patients can get a prescriber‑chosen drug when clinical reasons justify bypassing step therapy.
Your PRIA Score
Personalized for You
How does this bill affect your finances?
Sign up for a PRIA Policy Scan to see your personalized alignment score for this bill and every other piece of legislation we track. We analyze your financial profile against policy provisions to show you exactly what matters to your wallet.
Bill Overview
Analyzed Economic Effects
3 provisions identified: 2 benefits, 1 costs, 0 mixed.
Faster exceptions to step therapy in employer plans
If enacted, you or your prescriber could ask your employer plan to skip step therapy. Plans would have to decide in 72 hours, or 24 hours if your life, health, or maximum function is at risk. An exception would be allowed if required drugs failed, could cause harm, would block work or daily activities, or if you are stable on another drug already approved before, among other cases. The process would use a standard form, allow paper or online filing, limit requests to necessary info, and let a representative act for you. If approved, the plan would cover the drug using the plan year’s set cost-sharing, and keep that coverage for at least one year.
More transparency on step therapy decisions
If enacted, plans would report step therapy exception data to the Department within 3 years, and then every October 1. Reports would show counts by reason, approvals, denials, appeals, reversals, extra info requests, prescriber specialty, conditions, and PBM entities. The Secretary would publish an annual report to Congress and the public with trends by specialty and condition. Plans could not sign contracts with PBMs that block access to data needed for these reports.
When protections would start for workers
If enacted, these rules would apply to plan years that begin at least 6 months after enactment. That means some people could wait up to six months for the new protections to kick in. The Secretary of Labor would also issue final rules within 6 months to guide plans on how to comply.
Sponsors & CoSponsors
Sponsor
Allen
GA • R
Cosponsors
McBath
GA • D
Sponsored 9/19/2025
Miller-Meeks
IA • R
Sponsored 9/19/2025
Ruiz
CA • D
Sponsored 9/19/2025
Onder
MO • R
Sponsored 9/19/2025
Deluzio
PA • D
Sponsored 11/7/2025
Riley (NY)
NY • D
Sponsored 11/7/2025
Pingree
ME • D
Sponsored 11/7/2025
Wittman
VA • R
Sponsored 11/7/2025
McBride
DE • D
Sponsored 11/7/2025
Hayes
CT • D
Sponsored 11/7/2025
Harris (MD)
MD • R
Sponsored 11/7/2025
Kennedy (UT)
UT • R
Sponsored 11/7/2025
Cleaver
MO • D
Sponsored 11/7/2025
Vindman
VA • D
Sponsored 11/7/2025
Vasquez
NM • D
Sponsored 11/7/2025
Thanedar
MI • D
Sponsored 11/7/2025
Beatty
OH • D
Sponsored 11/7/2025
Gottheimer
NJ • D
Sponsored 11/7/2025
Fletcher
TX • D
Sponsored 11/7/2025
Dean (PA)
PA • D
Sponsored 11/7/2025
McClain Delaney
MD • D
Sponsored 11/7/2025
Walkinshaw
VA • D
Sponsored 11/7/2025
Castor (FL)
FL • D
Sponsored 11/7/2025
Simon
CA • D
Sponsored 11/7/2025
Lynch
MA • D
Sponsored 11/7/2025
Mullin
CA • D
Sponsored 11/7/2025
Peters
CA • D
Sponsored 11/7/2025
Scholten
MI • D
Sponsored 11/7/2025
Cohen
TN • D
Sponsored 11/7/2025
Mann
KS • R
Sponsored 11/7/2025
Mrvan
IN • D
Sponsored 11/17/2025
Lee (PA)
PA • D
Sponsored 11/17/2025
Tokuda
HI • D
Sponsored 11/17/2025
Davids (KS)
KS • D
Sponsored 11/20/2025
Loudermilk
GA • R
Sponsored 11/21/2025
Levin
CA • D
Sponsored 12/9/2025
DelBene
WA • D
Sponsored 12/10/2025
Craig
MN • D
Sponsored 12/10/2025
Bonamici
OR • D
Sponsored 12/12/2025
Cherfilus-McCormick
FL • D
Sponsored 12/12/2025
Keating
MA • D
Sponsored 12/12/2025
Castro (TX)
TX • D
Sponsored 12/12/2025
Gillen
NY • D
Sponsored 12/16/2025
Krishnamoorthi
IL • D
Sponsored 12/16/2025
Davis (NC)
NC • D
Sponsored 12/16/2025
Correa
CA • D
Sponsored 12/16/2025
Luna
FL • R
Sponsored 12/16/2025
Johnson (TX)
TX • D
Sponsored 1/7/2026
Lawler
NY • R
Sponsored 1/13/2026
Del. Norton, Eleanor Holmes [D-DC-At Large]
DC • D
Sponsored 1/14/2026
Hudson
NC • R
Sponsored 1/20/2026
Schneider
IL • D
Sponsored 1/20/2026
Panetta
CA • D
Sponsored 1/22/2026
Mast
FL • R
Sponsored 2/4/2026
Houlahan
PA • D
Sponsored 2/4/2026
Smith (WA)
WA • D
Sponsored 2/10/2026
Bynum
OR • D
Sponsored 2/10/2026
Kennedy (NY)
NY • D
Sponsored 2/10/2026
Langworthy
NY • R
Sponsored 2/12/2026
Fitzpatrick
PA • R
Sponsored 2/12/2026
Case
HI • D
Sponsored 2/12/2026
Pocan
WI • D
Sponsored 2/12/2026
McCollum
MN • D
Sponsored 2/12/2026
Owens
UT • R
Sponsored 2/12/2026
Ross
NC • D
Sponsored 2/12/2026
Beyer
VA • D
Sponsored 2/12/2026
Budzinski
IL • D
Sponsored 2/12/2026
Dingell
MI • D
Sponsored 2/20/2026
McGovern
MA • D
Sponsored 2/20/2026
Williams (GA)
GA • D
Sponsored 2/20/2026
Frost
FL • D
Sponsored 2/20/2026
Adams
NC • D
Sponsored 2/20/2026
Himes
CT • D
Sponsored 2/20/2026
Fine
FL • R
Sponsored 2/20/2026
Balint
VT • D
Sponsored 2/20/2026
Scanlon
PA • D
Sponsored 2/20/2026
Goldman (NY)
NY • D
Sponsored 2/20/2026
Salazar
FL • R
Sponsored 2/20/2026
Hill (AR)
AR • R
Sponsored 2/24/2026
Friedman
CA • D
Sponsored 2/24/2026
Huizenga
MI • R
Sponsored 2/24/2026
Kim
CA • R
Sponsored 3/4/2026
Omar
MN • D
Sponsored 3/4/2026
Conaway
NJ • D
Sponsored 3/4/2026
Sykes
OH • D
Sponsored 3/4/2026
Sherman
CA • D
Sponsored 3/4/2026
Moore (WI)
WI • D
Sponsored 3/4/2026
Ezell
MS • R
Sponsored 3/4/2026
Tonko
NY • D
Sponsored 3/4/2026
Stevens
MI • D
Sponsored 3/18/2026
Wasserman Schultz
FL • D
Sponsored 3/18/2026
Figures
AL • D
Sponsored 3/18/2026
Van Orden
WI • R
Sponsored 3/18/2026
Foushee
NC • D
Sponsored 3/18/2026
Turner (OH)
OH • R
Sponsored 3/18/2026
Kean
NJ • R
Sponsored 3/18/2026
Suozzi
NY • D
Sponsored 3/18/2026
Nadler
NY • D
Sponsored 3/18/2026
Trahan
MA • D
Sponsored 3/18/2026
Mace
SC • R
Sponsored 3/18/2026
Roll Call Votes
No roll call votes available for this bill.
View on Congress.govTake It Personal
Get Your Personalized Policy View
Start a Free Government Policy Watch to see how policy affects your household, then upgrade to PRIA Full Coverage for year-round monitoring.
Already have an account? Sign in