summary
Introduced
09/19/2025
09/19/2025
In Committee
09/19/2025
09/19/2025
Crossed Over
Passed
Dead
Introduced Session
119th Congress
Bill Summary
A BILL To amend the Employee Retirement Income Security Act of 1974 to require a group health plan or health insurance coverage offered in connection with such a plan to provide an exceptions process for any medication step therapy protocol, and for other purposes.
AI Summary
This bill, known as the Safe Step Act, amends the Employee Retirement Income Security Act to require group health plans and health insurance providers to establish a clear, prompt, and transparent exceptions process for medication step therapy protocols. Step therapy is a process where patients must try less expensive medications before the insurance will cover more costly treatments. The bill mandates that plans must allow exceptions to step therapy under specific circumstances, such as: when previous treatments have been ineffective, when delaying treatment would cause severe health consequences, when prescribed treatments are contraindicated or likely to cause harm, when a treatment prevents a patient from maintaining functional ability, or when a patient is already stable on a current medication. The exceptions process must include a standard form, allow electronic and paper submissions, provide a response within 72 hours (or 24 hours in urgent cases), and cover the requested drug for at least one year if an exception is granted. Additionally, health plans must report annually to the Secretary of Labor about the number and types of exception requests, including approvals, denials, and the medical conditions involved. The law would take effect for plan years beginning at least 6 months after its enactment, with the Secretary of Labor required to issue implementing regulations within 6 months of the act's passage.
Committee Categories
Education
Sponsors (82)
Rick Allen (R)*,
Alma Adams (D),
Becca Balint (D),
Joyce Beatty (D),
Don Beyer (D),
Suzanne Bonamici (D),
Nikki Budzinski (D),
Janelle Bynum (D),
Ed Case (D),
Kathy Castor (D),
Joaquin Castro (D),
Sheila Cherfilus-McCormick (D),
Emanuel Cleaver (D),
Steve Cohen (D),
Lou Correa (D),
Angie Craig (D),
Sharice Davids (D),
Don Davis (D),
Madeleine Dean (D),
Suzan DelBene (D),
Chris Deluzio (D),
Debbie Dingell (D),
Randy Fine (R),
Brian Fitzpatrick (R),
Lizzie Fletcher (D),
Laura Friedman (D),
Maxwell Frost (D),
Laura Gillen (D),
Dan Goldman (D),
Josh Gottheimer (D),
Andy Harris (R),
Jahana Hayes (D),
French Hill (R),
Jim Himes (D),
Chrissy Houlahan (D),
Richard Hudson (R),
Bill Huizenga (R),
Julie Johnson (D),
Bill Keating (D),
Mike Kennedy (R),
Timothy Kennedy (D),
Raja Krishnamoorthi (D),
Nick Langworthy (R),
Mike Lawler (R),
Summer Lee (D),
Mike Levin (D),
Barry Loudermilk (R),
Anna Luna (R),
Stephen Lynch (D),
Tracey Mann (R),
Brian Mast (R),
Lucy McBath (D),
Sarah McBride (D),
April McClain-Delaney (D),
Betty McCollum (D),
Jim McGovern (D),
Mariannette Miller-Meeks (R),
Frank Mrvan (D),
Kevin Mullin (D),
Eleanor Holmes Norton (D),
Robert Onder (R),
Burgess Owens (R),
Jimmy Panetta (D),
Scott Peters (D),
Chellie Pingree (D),
Mark Pocan (D),
Josh Riley (D),
Deborah Ross (D),
Raul Ruiz (D),
María Salazar (R),
Mary Gay Scanlon (D),
Brad Schneider (D),
Hillary Scholten (D),
Lateefah Simon (D),
Adam Smith (D),
Shri Thanedar (D),
Jill Tokuda (D),
Gabe Vasquez (D),
Eugene Vindman (D),
James Walkinshaw (D),
Nikema Williams (D),
Rob Wittman (R),
Last Action
Referred to the House Committee on Education and Workforce. (on 09/19/2025)
Official Document
bill text
bill summary
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bill summary
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bill summary
| Document Type | Source Location |
|---|---|
| State Bill Page | https://www.congress.gov/bill/119th-congress/house-bill/5509/all-info |
| BillText | https://www.congress.gov/119/bills/hr5509/BILLS-119hr5509ih.pdf |
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