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.
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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
Rep. Miller-Meeks, Mariannette [R-IA-1]
IA • R
Sponsored 9/19/2025
Rep. Ruiz, Raul [D-CA-25]
CA • D
Sponsored 9/19/2025
Onder
MO • R
Sponsored 9/19/2025
Rep. Deluzio, Christopher R. [D-PA-17]
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
Rep. Hayes, Jahana [D-CT-5]
CT • D
Sponsored 11/7/2025
Rep. Harris, Andy [R-MD-1]
MD • R
Sponsored 11/7/2025
Rep. Kennedy, Mike [R-UT-3]
UT • R
Sponsored 11/7/2025
Rep. Cleaver, Emanuel [D-MO-5]
MO • D
Sponsored 11/7/2025
Rep. Vindman, Eugene Simon [D-VA-7]
VA • D
Sponsored 11/7/2025
Rep. Vasquez, Gabe [D-NM-2]
NM • D
Sponsored 11/7/2025
Rep. Thanedar, Shri [D-MI-13]
MI • D
Sponsored 11/7/2025
Rep. Beatty, Joyce [D-OH-3]
OH • D
Sponsored 11/7/2025
Rep. Gottheimer, Josh [D-NJ-5]
NJ • D
Sponsored 11/7/2025
Fletcher
TX • D
Sponsored 11/7/2025
Rep. Dean, Madeleine [D-PA-4]
PA • D
Sponsored 11/7/2025
Rep. McClain Delaney, April [D-MD-6]
MD • D
Sponsored 11/7/2025
Rep. Walkinshaw, James R. [D-VA-11]
VA • D
Sponsored 11/7/2025
Rep. Castor, Kathy [D-FL-14]
FL • D
Sponsored 11/7/2025
Simon
CA • D
Sponsored 11/7/2025
Rep. Lynch, Stephen F. [D-MA-8]
MA • D
Sponsored 11/7/2025
Mullin
CA • D
Sponsored 11/7/2025
Peters
CA • D
Sponsored 11/7/2025
Rep. Scholten, Hillary J. [D-MI-3]
MI • D
Sponsored 11/7/2025
Cohen
TN • D
Sponsored 11/7/2025
Rep. Mann, Tracey [R-KS-1]
KS • R
Sponsored 11/7/2025
Mrvan
IN • D
Sponsored 11/17/2025
Rep. Lee, Summer L. [D-PA-12]
PA • D
Sponsored 11/17/2025
Rep. Tokuda, Jill N. [D-HI-2]
HI • D
Sponsored 11/17/2025
Rep. Davids, Sharice [D-KS-3]
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
Rep. Gillen, Laura [D-NY-4]
NY • D
Sponsored 12/16/2025
Rep. Krishnamoorthi, Raja [D-IL-8]
IL • D
Sponsored 12/16/2025
Davis (NC)
NC • D
Sponsored 12/16/2025
Rep. Correa, J. Luis [D-CA-46]
CA • D
Sponsored 12/16/2025
Rep. Luna, Anna Paulina [R-FL-13]
FL • R
Sponsored 12/16/2025
Rep. Johnson, Julie [D-TX-32]
TX • D
Sponsored 1/7/2026
Rep. Lawler, Michael [R-NY-17]
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
Rep. Schneider, Bradley Scott [D-IL-10]
IL • D
Sponsored 1/20/2026
Rep. Panetta, Jimmy [D-CA-19]
CA • D
Sponsored 1/22/2026
Rep. Mast, Brian J. [R-FL-21]
FL • R
Sponsored 2/4/2026
Rep. Houlahan, Chrissy [D-PA-6]
PA • D
Sponsored 2/4/2026
Smith (WA)
WA • D
Sponsored 2/10/2026
Rep. Bynum, Janelle S. [D-OR-5]
OR • D
Sponsored 2/10/2026
Kennedy (NY)
NY • D
Sponsored 2/10/2026
Langworthy
NY • R
Sponsored 2/12/2026
Rep. Fitzpatrick, Brian K. [R-PA-1]
PA • R
Sponsored 2/12/2026
Rep. Case, Ed [D-HI-1]
HI • D
Sponsored 2/12/2026
Rep. Pocan, Mark [D-WI-2]
WI • D
Sponsored 2/12/2026
McCollum
MN • D
Sponsored 2/12/2026
Rep. Owens, Burgess [R-UT-4]
UT • R
Sponsored 2/12/2026
Rep. Ross, Deborah K. [D-NC-2]
NC • D
Sponsored 2/12/2026
Rep. Beyer, Donald S. [D-VA-8]
VA • D
Sponsored 2/12/2026
Budzinski
IL • D
Sponsored 2/12/2026
Rep. Dingell, Debbie [D-MI-6]
MI • D
Sponsored 2/20/2026
McGovern
MA • D
Sponsored 2/20/2026
Rep. Williams, Nikema [D-GA-5]
GA • D
Sponsored 2/20/2026
Rep. Frost, Maxwell [D-FL-10]
FL • D
Sponsored 2/20/2026
Adams
NC • D
Sponsored 2/20/2026
Himes
CT • D
Sponsored 2/20/2026
Rep. Fine, Randy [R-FL-6]
FL • R
Sponsored 2/20/2026
Rep. Balint, Becca [D-VT-At Large]
VT • D
Sponsored 2/20/2026
Rep. Scanlon, Mary Gay [D-PA-5]
PA • D
Sponsored 2/20/2026
Rep. Goldman, Daniel S. [D-NY-10]
NY • D
Sponsored 2/20/2026
Salazar
FL • R
Sponsored 2/20/2026
Rep. Hill, J. French [R-AR-2]
AR • R
Sponsored 2/24/2026
Friedman
CA • D
Sponsored 2/24/2026
Rep. Huizenga, Bill [R-MI-4]
MI • R
Sponsored 2/24/2026
Rep. Kim, Young [R-CA-40]
CA • R
Sponsored 3/4/2026
Rep. Omar, Ilhan [D-MN-5]
MN • D
Sponsored 3/4/2026
Conaway
NJ • D
Sponsored 3/4/2026
Rep. Sykes, Emilia Strong [D-OH-13]
OH • D
Sponsored 3/4/2026
Rep. Sherman, Brad [D-CA-32]
CA • D
Sponsored 3/4/2026
Rep. Moore, Gwen [D-WI-4]
WI • D
Sponsored 3/4/2026
Rep. Ezell, Mike [R-MS-4]
MS • R
Sponsored 3/4/2026
Rep. Tonko, Paul [D-NY-20]
NY • D
Sponsored 3/4/2026
Rep. Stevens, Haley M. [D-MI-11]
MI • D
Sponsored 3/18/2026
Rep. Wasserman Schultz, Debbie [D-FL-25]
FL • D
Sponsored 3/18/2026
Rep. Figures, Shomari [D-AL-2]
AL • D
Sponsored 3/18/2026
Rep. Van Orden, Derrick [R-WI-3]
WI • R
Sponsored 3/18/2026
Rep. Foushee, Valerie P. [D-NC-4]
NC • D
Sponsored 3/18/2026
Turner (OH)
OH • R
Sponsored 3/18/2026
Kean
NJ • R
Sponsored 3/18/2026
Rep. Suozzi, Thomas R. [D-NY-3]
NY • D
Sponsored 3/18/2026
Rep. Nadler, Jerrold [D-NY-12]
NY • D
Sponsored 3/18/2026
Trahan
MA • D
Sponsored 3/18/2026
Rep. Mace, Nancy [R-SC-1]
SC • R
Sponsored 3/18/2026
Schmidt
KS • R
Sponsored 3/25/2026
Rutherford
FL • R
Sponsored 3/25/2026
Rep. Wilson, Joe [R-SC-2]
SC • R
Sponsored 3/26/2026
Rep. Tlaib, Rashida [D-MI-12]
MI • D
Sponsored 3/26/2026
Rep. Thompson, Glenn [R-PA-15]
PA • R
Sponsored 3/26/2026
Rep. Goodlander, Maggie [D-NH-2]
NH • D
Sponsored 3/26/2026
Rep. Murphy, Gregory F. [R-NC-3]
NC • R
Sponsored 4/15/2026
McGuire
VA • R
Sponsored 4/15/2026
Rep. Yakym, Rudy [R-IN-2]
IN • R
Sponsored 4/15/2026
Rep. Harshbarger, Diana [R-TN-1]
TN • R
Sponsored 4/15/2026
Rep. Pappas, Chris [D-NH-1]
NH • D
Sponsored 4/15/2026
Rep. Perez, Marie Gluesenkamp [D-WA-3]
WA • D
Sponsored 4/15/2026
Rep. Moulton, Seth [D-MA-6]
MA • D
Sponsored 4/15/2026
Rep. Torres, Ritchie [D-NY-15]
NY • D
Sponsored 4/15/2026
Rep. Meng, Grace [D-NY-6]
NY • D
Sponsored 4/15/2026
Rep. Newhouse, Dan [R-WA-4]
WA • R
Sponsored 4/15/2026
Rep. Matsui, Doris O. [D-CA-7]
CA • D
Sponsored 4/15/2026
Rep. Carbajal, Salud O. [D-CA-24]
CA • D
Sponsored 4/15/2026
Rep. Kiggans, Jennifer A. [R-VA-2]
VA • R
Sponsored 4/15/2026
Rep. Lieu, Ted [D-CA-36]
CA • D
Sponsored 4/15/2026
Rep. Hinson, Ashley [R-IA-2]
IA • R
Sponsored 4/15/2026
Rep. Rouzer, David [R-NC-7]
NC • R
Sponsored 4/15/2026
Rep. Carter, Earl L. "Buddy" [R-GA-1]
GA • R
Sponsored 4/27/2026
Moore (NC)
NC • R
Sponsored 4/27/2026
LaLota
NY • R
Sponsored 4/27/2026
Rep. Meeks, Gregory W. [D-NY-5]
NY • D
Sponsored 4/27/2026
Rep. Flood, Mike [R-NE-1]
NE • R
Sponsored 4/27/2026
Rep. Steube, W. Gregory [R-FL-17]
FL • R
Sponsored 4/28/2026
Rep. Harrigan, Pat [R-NC-10]
NC • R
Sponsored 4/29/2026
Kelly (PA)
PA • R
Sponsored 4/29/2026
Rep. Crank, Jeff [R-CO-5]
CO • R
Sponsored 5/13/2026
Grijalva
AZ • D
Sponsored 5/13/2026
Norcross
NJ • D
Sponsored 5/13/2026
Stansbury
NM • D
Sponsored 5/13/2026
Rep. Guest, Michael [R-MS-3]
MS • R
Sponsored 5/13/2026
Rep. Bera, Ami [D-CA-6]
CA • D
Sponsored 5/13/2026
Roll Call Votes
No roll call votes available for this bill.
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