# 119-hr-5509: Safe Step Act

119-hr-5509, Safe Step Act, is a 119th Congress bill sponsored by Rep. Allen, Rick W. [R-GA-12] (R-GA); status introduced; PRIA reads it as touching household money (as of 2026-10-07).

- Canonical: https://policyrisk.com/legislation/119-hr-5509
- As of: 2026-10-07
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-hr-5509
- Congress: 119
- Title: Safe Step Act
- Status: introduced
- Introduced: 2025-09-19
- Sponsor: Rep. Allen, Rick W. [R-GA-12] (R-GA)
- Cosponsors: 169
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2026-10-07

## 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.

## Cosponsors (169)

- Rep. Carey, Mike [R-OH-15] (R-OH), 2026-10-05T00:00:00.000Z
- Rep. Randall, Emily [D-WA-6] (D-WA), 2026-10-05T00:00:00.000Z
- Rep. Crow, Jason [D-CO-6] (D-CO), 2026-10-05T00:00:00.000Z
- Rep. Van Duyne, Beth [R-TX-24] (R-TX), 2026-10-05T00:00:00.000Z
- Rep. Ocasio-Cortez, Alexandria [D-NY-14] (D-NY), 2026-10-05T00:00:00.000Z
- Rep. Graves, Sam [R-MO-6] (R-MO), 2026-10-05T00:00:00.000Z
- Rep. Houchin, Erin [R-IN-9] (R-IN), 2026-10-05T00:00:00.000Z
- Rep. McBath, Lucy [D-GA-6] (D-GA), 2025-09-19T00:00:00.000Z
- Rep. Miller-Meeks, Mariannette [R-IA-1] (R-IA), 2025-09-19T00:00:00.000Z
- Rep. Ruiz, Raul [D-CA-25] (D-CA), 2025-09-19T00:00:00.000Z
- Rep. Onder, Robert F. [R-MO-3] (R-MO), 2025-09-19T00:00:00.000Z
- Rep. Deluzio, Christopher R. [D-PA-17] (D-PA), 2025-11-07T00:00:00.000Z
- Rep. Riley, Josh [D-NY-19] (D-NY), 2025-11-07T00:00:00.000Z
- Rep. Pingree, Chellie [D-ME-1] (D-ME), 2025-11-07T00:00:00.000Z
- Rep. Wittman, Robert J. [R-VA-1] (R-VA), 2025-11-07T00:00:00.000Z
- Rep. McBride, Sarah [D-DE-At Large] (D-DE), 2025-11-07T00:00:00.000Z
- Rep. Hayes, Jahana [D-CT-5] (D-CT), 2025-11-07T00:00:00.000Z
- Rep. Harris, Andy [R-MD-1] (R-MD), 2025-11-07T00:00:00.000Z
- Rep. Kennedy, Mike [R-UT-3] (R-UT), 2025-11-07T00:00:00.000Z
- Rep. Cleaver, Emanuel [D-MO-5] (D-MO), 2025-11-07T00:00:00.000Z
- Rep. Vindman, Eugene Simon [D-VA-7] (D-VA), 2025-11-07T00:00:00.000Z
- Rep. Vasquez, Gabe [D-NM-2] (D-NM), 2025-11-07T00:00:00.000Z
- Rep. Thanedar, Shri [D-MI-13] (D-MI), 2025-11-07T00:00:00.000Z
- Rep. Beatty, Joyce [D-OH-3] (D-OH), 2025-11-07T00:00:00.000Z
- Rep. Gottheimer, Josh [D-NJ-5] (D-NJ), 2025-11-07T00:00:00.000Z
- Rep. Fletcher, Lizzie [D-TX-7] (D-TX), 2025-11-07T00:00:00.000Z
- Rep. Dean, Madeleine [D-PA-4] (D-PA), 2025-11-07T00:00:00.000Z
- Rep. McClain Delaney, April [D-MD-6] (D-MD), 2025-11-07T00:00:00.000Z
- Rep. Walkinshaw, James R. [D-VA-11] (D-VA), 2025-11-07T00:00:00.000Z
- Rep. Castor, Kathy [D-FL-14] (D-FL), 2025-11-07T00:00:00.000Z
- Rep. Simon, Lateefah [D-CA-12] (D-CA), 2025-11-07T00:00:00.000Z
- Rep. Lynch, Stephen F. [D-MA-8] (D-MA), 2025-11-07T00:00:00.000Z
- Rep. Mullin, Kevin [D-CA-15] (D-CA), 2025-11-07T00:00:00.000Z
- Rep. Peters, Scott H. [D-CA-50] (D-CA), 2025-11-07T00:00:00.000Z
- Rep. Scholten, Hillary J. [D-MI-3] (D-MI), 2025-11-07T00:00:00.000Z
- Rep. Cohen, Steve [D-TN-9] (D-TN), 2025-11-07T00:00:00.000Z
- Rep. Mann, Tracey [R-KS-1] (R-KS), 2025-11-07T00:00:00.000Z
- Rep. Mrvan, Frank J. [D-IN-1] (D-IN), 2025-11-17T00:00:00.000Z
- Rep. Lee, Summer L. [D-PA-12] (D-PA), 2025-11-17T00:00:00.000Z
- Rep. Tokuda, Jill N. [D-HI-2] (D-HI), 2025-11-17T00:00:00.000Z
- Rep. Davids, Sharice [D-KS-3] (D-KS), 2025-11-20T00:00:00.000Z
- Rep. Loudermilk, Barry [R-GA-11] (R-GA), 2025-11-21T00:00:00.000Z
- Rep. Levin, Mike [D-CA-49] (D-CA), 2025-12-09T00:00:00.000Z
- Rep. DelBene, Suzan K. [D-WA-1] (D-WA), 2025-12-10T00:00:00.000Z
- Rep. Craig, Angie [D-MN-2] (D-MN), 2025-12-10T00:00:00.000Z
- Rep. Bonamici, Suzanne [D-OR-1] (D-OR), 2025-12-12T00:00:00.000Z
- Rep. Cherfilus-McCormick, Sheila [D-FL-20] (D-FL), 2025-12-12T00:00:00.000Z
- Rep. Keating, William R. [D-MA-9] (D-MA), 2025-12-12T00:00:00.000Z
- Rep. Castro, Joaquin [D-TX-20] (D-TX), 2025-12-12T00:00:00.000Z
- Rep. Gillen, Laura [D-NY-4] (D-NY), 2025-12-16T00:00:00.000Z
- Rep. Krishnamoorthi, Raja [D-IL-8] (D-IL), 2025-12-16T00:00:00.000Z
- Rep. Davis, Donald G. [D-NC-1] (D-NC), 2025-12-16T00:00:00.000Z
- Rep. Correa, J. Luis [D-CA-46] (D-CA), 2025-12-16T00:00:00.000Z
- Rep. Luna, Anna Paulina [R-FL-13] (R-FL), 2025-12-16T00:00:00.000Z
- Rep. Johnson, Julie [D-TX-32] (D-TX), 2026-01-07T00:00:00.000Z
- Rep. Lawler, Michael [R-NY-17] (R-NY), 2026-01-13T00:00:00.000Z
- Del. Norton, Eleanor Holmes [D-DC-At Large] (D-DC), 2026-01-14T00:00:00.000Z
- Rep. Hudson, Richard [R-NC-9] (R-NC), 2026-01-20T00:00:00.000Z
- Rep. Schneider, Bradley Scott [D-IL-10] (D-IL), 2026-01-20T00:00:00.000Z
- Rep. Panetta, Jimmy [D-CA-19] (D-CA), 2026-01-22T00:00:00.000Z
- Rep. Mast, Brian J. [R-FL-21] (R-FL), 2026-02-04T00:00:00.000Z
- Rep. Houlahan, Chrissy [D-PA-6] (D-PA), 2026-02-04T00:00:00.000Z
- Rep. Smith, Adam [D-WA-9] (D-WA), 2026-02-10T00:00:00.000Z
- Rep. Bynum, Janelle S. [D-OR-5] (D-OR), 2026-02-10T00:00:00.000Z
- Rep. Kennedy, Timothy M. [D-NY-26] (D-NY), 2026-02-10T00:00:00.000Z
- Rep. Langworthy, Nicholas A. [R-NY-23] (R-NY), 2026-02-12T00:00:00.000Z
- Rep. Fitzpatrick, Brian K. [R-PA-1] (R-PA), 2026-02-12T00:00:00.000Z
- Rep. Case, Ed [D-HI-1] (D-HI), 2026-02-12T00:00:00.000Z
- Rep. Pocan, Mark [D-WI-2] (D-WI), 2026-02-12T00:00:00.000Z
- Rep. McCollum, Betty [D-MN-4] (D-MN), 2026-02-12T00:00:00.000Z
- Rep. Owens, Burgess [R-UT-4] (R-UT), 2026-02-12T00:00:00.000Z
- Rep. Ross, Deborah K. [D-NC-2] (D-NC), 2026-02-12T00:00:00.000Z
- Rep. Beyer, Donald S. [D-VA-8] (D-VA), 2026-02-12T00:00:00.000Z
- Rep. Budzinski, Nikki [D-IL-13] (D-IL), 2026-02-12T00:00:00.000Z
- Rep. Dingell, Debbie [D-MI-6] (D-MI), 2026-02-20T00:00:00.000Z
- Rep. McGovern, James P. [D-MA-2] (D-MA), 2026-02-20T00:00:00.000Z
- Rep. Williams, Nikema [D-GA-5] (D-GA), 2026-02-20T00:00:00.000Z
- Rep. Frost, Maxwell [D-FL-10] (D-FL), 2026-02-20T00:00:00.000Z
- Rep. Adams, Alma S. [D-NC-12] (D-NC), 2026-02-20T00:00:00.000Z
- Rep. Himes, James A. [D-CT-4] (D-CT), 2026-02-20T00:00:00.000Z
- Rep. Fine, Randy [R-FL-6] (R-FL), 2026-02-20T00:00:00.000Z
- Rep. Balint, Becca [D-VT-At Large] (D-VT), 2026-02-20T00:00:00.000Z
- Rep. Scanlon, Mary Gay [D-PA-5] (D-PA), 2026-02-20T00:00:00.000Z
- Rep. Goldman, Daniel S. [D-NY-10] (D-NY), 2026-02-20T00:00:00.000Z
- Rep. Salazar, Maria Elvira [R-FL-27] (R-FL), 2026-02-20T00:00:00.000Z
- Rep. Hill, J. French [R-AR-2] (R-AR), 2026-02-24T00:00:00.000Z
- Rep. Friedman, Laura [D-CA-30] (D-CA), 2026-02-24T00:00:00.000Z
- Rep. Huizenga, Bill [R-MI-4] (R-MI), 2026-02-24T00:00:00.000Z
- Rep. Kim, Young [R-CA-40] (R-CA), 2026-03-04T00:00:00.000Z
- Rep. Omar, Ilhan [D-MN-5] (D-MN), 2026-03-04T00:00:00.000Z
- Rep. Conaway, Herbert C. [D-NJ-3] (D-NJ), 2026-03-04T00:00:00.000Z
- Rep. Sykes, Emilia Strong [D-OH-13] (D-OH), 2026-03-04T00:00:00.000Z
- Rep. Sherman, Brad [D-CA-32] (D-CA), 2026-03-04T00:00:00.000Z
- Rep. Moore, Gwen [D-WI-4] (D-WI), 2026-03-04T00:00:00.000Z
- Rep. Ezell, Mike [R-MS-4] (R-MS), 2026-03-04T00:00:00.000Z
- Rep. Tonko, Paul [D-NY-20] (D-NY), 2026-03-04T00:00:00.000Z
- Rep. Stevens, Haley M. [D-MI-11] (D-MI), 2026-03-18T00:00:00.000Z
- Rep. Wasserman Schultz, Debbie [D-FL-25] (D-FL), 2026-03-18T00:00:00.000Z
- Rep. Figures, Shomari [D-AL-2] (D-AL), 2026-03-18T00:00:00.000Z
- Rep. Van Orden, Derrick [R-WI-3] (R-WI), 2026-03-18T00:00:00.000Z
- Rep. Foushee, Valerie P. [D-NC-4] (D-NC), 2026-03-18T00:00:00.000Z
- Rep. Turner, Michael R. [R-OH-10] (R-OH), 2026-03-18T00:00:00.000Z
- Rep. Kean, Thomas H. [R-NJ-7] (R-NJ), 2026-03-18T00:00:00.000Z
- Rep. Suozzi, Thomas R. [D-NY-3] (D-NY), 2026-03-18T00:00:00.000Z
- Rep. Nadler, Jerrold [D-NY-12] (D-NY), 2026-03-18T00:00:00.000Z
- Rep. Trahan, Lori [D-MA-3] (D-MA), 2026-03-18T00:00:00.000Z
- Rep. Mace, Nancy [R-SC-1] (R-SC), 2026-03-18T00:00:00.000Z
- Rep. Schmidt, Derek [R-KS-2] (R-KS), 2026-03-25T00:00:00.000Z
- Rep. Rutherford, John H. [R-FL-5] (R-FL), 2026-03-25T00:00:00.000Z
- Rep. Wilson, Joe [R-SC-2] (R-SC), 2026-03-26T00:00:00.000Z
- Rep. Tlaib, Rashida [D-MI-12] (D-MI), 2026-03-26T00:00:00.000Z
- Rep. Thompson, Glenn [R-PA-15] (R-PA), 2026-03-26T00:00:00.000Z
- Rep. Goodlander, Maggie [D-NH-2] (D-NH), 2026-03-26T00:00:00.000Z
- Rep. Murphy, Gregory F. [R-NC-3] (R-NC), 2026-04-15T00:00:00.000Z
- Rep. McGuire, John J. [R-VA-5] (R-VA), 2026-04-15T00:00:00.000Z
- Rep. Yakym, Rudy [R-IN-2] (R-IN), 2026-04-15T00:00:00.000Z
- Rep. Harshbarger, Diana [R-TN-1] (R-TN), 2026-04-15T00:00:00.000Z
- Rep. Pappas, Chris [D-NH-1] (D-NH), 2026-04-15T00:00:00.000Z
- Rep. Perez, Marie Gluesenkamp [D-WA-3] (D-WA), 2026-04-15T00:00:00.000Z
- Rep. Moulton, Seth [D-MA-6] (D-MA), 2026-04-15T00:00:00.000Z
- Rep. Torres, Ritchie [D-NY-15] (D-NY), 2026-04-15T00:00:00.000Z
- Rep. Meng, Grace [D-NY-6] (D-NY), 2026-04-15T00:00:00.000Z
- Rep. Newhouse, Dan [R-WA-4] (R-WA), 2026-04-15T00:00:00.000Z
- Rep. Matsui, Doris O. [D-CA-7] (D-CA), 2026-04-15T00:00:00.000Z
- Rep. Carbajal, Salud O. [D-CA-24] (D-CA), 2026-04-15T00:00:00.000Z
- Rep. Kiggans, Jennifer A. [R-VA-2] (R-VA), 2026-04-15T00:00:00.000Z
- Rep. Lieu, Ted [D-CA-36] (D-CA), 2026-04-15T00:00:00.000Z
- Rep. Hinson, Ashley [R-IA-2] (R-IA), 2026-04-15T00:00:00.000Z
- Rep. Rouzer, David [R-NC-7] (R-NC), 2026-04-15T00:00:00.000Z
- Rep. Carter, Earl L. "Buddy" [R-GA-1] (R-GA), 2026-04-27T00:00:00.000Z
- Rep. Moore, Tim [R-NC-14] (R-NC), 2026-04-27T00:00:00.000Z
- Rep. LaLota, Nick [R-NY-1] (R-NY), 2026-04-27T00:00:00.000Z
- Rep. Meeks, Gregory W. [D-NY-5] (D-NY), 2026-04-27T00:00:00.000Z
- Rep. Flood, Mike [R-NE-1] (R-NE), 2026-04-27T00:00:00.000Z
- Rep. Steube, W. Gregory [R-FL-17] (R-FL), 2026-04-28T00:00:00.000Z
- Rep. Harrigan, Pat [R-NC-10] (R-NC), 2026-04-29T00:00:00.000Z
- Rep. Kelly, Mike [R-PA-16] (R-PA), 2026-04-29T00:00:00.000Z
- Rep. Crank, Jeff [R-CO-5] (R-CO), 2026-05-13T00:00:00.000Z
- Rep. Grijalva, Adelita S. [D-AZ-7] (D-AZ), 2026-05-13T00:00:00.000Z
- Rep. Norcross, Donald [D-NJ-1] (D-NJ), 2026-05-13T00:00:00.000Z
- Rep. Stansbury, Melanie A. [D-NM-1] (D-NM), 2026-05-13T00:00:00.000Z
- Rep. Guest, Michael [R-MS-3] (R-MS), 2026-05-13T00:00:00.000Z
- Rep. Bera, Ami [D-CA-6] (D-CA), 2026-05-13T00:00:00.000Z
- Rep. Shreve, Jefferson [R-IN-6] (R-IN), 2026-05-21T00:00:00.000Z
- Rep. LaHood, Darin [R-IL-16] (R-IL), 2026-05-21T00:00:00.000Z
- Rep. Joyce, John [R-PA-13] (R-PA), 2026-06-04T00:00:00.000Z
- Rep. Green, Al [D-TX-9] (D-TX), 2026-06-11T00:00:00.000Z
- Rep. Balderson, Troy [R-OH-12] (R-OH), 2026-06-11T00:00:00.000Z
- Rep. Stanton, Greg [D-AZ-4] (D-AZ), 2026-06-11T00:00:00.000Z
- Rep. Mackenzie, Ryan [R-PA-7] (R-PA), 2026-06-23T00:00:00.000Z
- Rep. Raskin, Jamie [D-MD-8] (D-MD), 2026-06-23T00:00:00.000Z
- Rep. Mejia, Analilia [D-NJ-11] (D-NJ), 2026-06-23T00:00:00.000Z
- Rep. Sánchez, Linda T. [D-CA-38] (D-CA), 2026-06-24T00:00:00.000Z
- Rep. Schrier, Kim [D-WA-8] (D-WA), 2026-06-30T00:00:00.000Z
- Rep. Sorensen, Eric [D-IL-17] (D-IL), 2026-06-30T00:00:00.000Z
- Rep. Espaillat, Adriano [D-NY-13] (D-NY), 2026-07-14T00:00:00.000Z
- Rep. Bishop, Sanford D. [D-GA-2] (D-GA), 2026-07-14T00:00:00.000Z
- Rep. Gonzalez, Vicente [D-TX-34] (D-TX), 2026-07-14T00:00:00.000Z
- Rep. Amo, Gabe [D-RI-1] (D-RI), 2026-07-14T00:00:00.000Z
- Rep. Vargas, Juan [D-CA-52] (D-CA), 2026-07-14T00:00:00.000Z
- Rep. Strickland, Marilyn [D-WA-10] (D-WA), 2026-07-22T00:00:00.000Z
- Rep. Johnson, Henry C. "Hank" [D-GA-4] (D-GA), 2026-07-22T00:00:00.000Z
- Rep. Dunn, Neal P. [R-FL-2] (R-FL), 2026-09-01T00:00:00.000Z
- Rep. Clarke, Yvette D. [D-NY-9] (D-NY), 2026-09-01T00:00:00.000Z
- Rep. Ryan, Patrick [D-NY-18] (D-NY), 2026-09-01T00:00:00.000Z
- Rep. McClellan, Jennifer L. [D-VA-4] (D-VA), 2026-09-14T00:00:00.000Z
- Rep. Morrison, Kelly [D-MN-3] (D-MN), 2026-09-14T00:00:00.000Z
- Rep. Soto, Darren [D-FL-9] (D-FL), 2026-09-14T00:00:00.000Z
- Rep. Miller, Carol D. [R-WV-1] (R-WV), 2026-09-14T00:00:00.000Z

## Provisions PRIA read

- Faster exceptions to step therapy in employer plans: benefit, medium. 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 activit…
- More transparency on step therapy decisions: benefit, medium. 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…
- When protections would start for workers: cost, low. 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.

## Related bills

- 119-hr-3514: Improving Seniors’ Timely Access to Care Act of 2025
- 119-hr-842: Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act
- 119-hr-2102: Major Richard Star Act
- 119-hr-1262: Mikaela Naylon Give Kids a Chance Act
- 119-hr-909: Crime Victims Fund Stabilization Act of 2025
- 119-hr-2048: Metastatic Breast Cancer Access to Care Act

## Sources
- [119-hr-5509 on Congress.gov](https://www.congress.gov/bill/119th-congress/house-bill/5509)

## Related
- [119-hr-3514: Improving Seniors’ Timely Access to Care Act of 2025](https://policyrisk.com/legislation/119-hr-3514)
- [119-hr-842: Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage A…](https://policyrisk.com/legislation/119-hr-842)
- [119-hr-2102: Major Richard Star Act](https://policyrisk.com/legislation/119-hr-2102)
- [119-hr-1262: Mikaela Naylon Give Kids a Chance Act](https://policyrisk.com/legislation/119-hr-1262)
- [119-hr-909: Crime Victims Fund Stabilization Act of 2025](https://policyrisk.com/legislation/119-hr-909)
- [119-hr-2048: Metastatic Breast Cancer Access to Care Act](https://policyrisk.com/legislation/119-hr-2048)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-hr-5509 (as of 2026-10-07).