State Issues

As federal policy making on access to care issues continues to shift, the states are proactively and reactively responding by taking action on a range of health care issues that impact the psoriatic community. In response to the states increasing role in health care, the National Psoriasis Foundation (NPF) started a concerted program to advocate for those living with psoriatic disease through efforts targeted at state and local government. In the years since the creation of our state government relations department, we have successfully enacted thirteen bills that have the potential to improve access to care for 3,217,698 psoriatic disease patients.

Access to Appropriate Treatment

Photo: NPF advocate leads a dialogue on access legislation with Texas House Speaker Joe Straus.

The NPF state advocacy team elevates the patient voice in an effort to create a better environment for those living with psoriatic disease, so they have better access to health care in order to appropriately treat their disease to target. Elected officials want to hear from you, the voters in their districts, who are personally impacted by the issues they are setting policy on. Our efforts are guided by NPF’s strategic plan, which boldly seeks to increase the number of people receiving appropriate treatment. Together, we can impact policies that will improve access to treatment and enable people to better manage their disease!

Photo: Governor and Ambassador to China Terry Branstad signs a step therapy bill in to law.

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Current State Priorities

At the core of our work is the desire to dramatically improve the health outcomes of individuals living with psoriatic disease. Driven by our medical board’s Access to Care statement, we elevate the patient and provider voice on a number of key and emerging policy issues that impact our community. Among those, NPF advocates for policy solutions that address access to care issues including step therapy and prior authorization, high out of pocket costs, switching stable patients off therapies or non-medical switching, and legislation that seeks to limit access to patient assistance programs. NPF advocacy also works to ensure that people with chronic conditions like psoriatic disease are not discriminated against because of their pre-existing conditions. We know that finding a treatment that works makes all the difference. Our work centers on making sure that our community can access the treatment their doctor recommends and stay on it if it is efficacious – all without breaking the budget.

Step Therapy

The NPF advocacy team is a leader in a nationwide campaign to pass legislation that ensures patients can get the medication they need, when they need it, without having to go through medically inappropriate steps or fail first on insurance plan preferred treatments.

Whether it is crafting policy or leading a state campaign, our thoughtful, deliberate and bipartisan work seeks to put the power of prescribing medications back into the hands of the physician. We work to restore the importance of personalized care by affirming the physician and patient relationship is the core driver of treatment decisions. Our leadership on step therapy efforts has resulted in curbing this practice in over ten states and has led to a groundswell of bipartisan support across the nation.

Learn more about the practice of step therapy and what’s happening in your state by visiting

Out-of-Pocket Costs

As health care costs continue to rise, high out-of-pocket costs are increasingly forcing many patients to stop taking their medications. Without treatment, many psoriasis and psoriatic arthritis patients risk serious health complications. NPF supports reigning in and limiting the maximum co-insurance, out-of-pocket expenses, and deductibles for individuals to enable them to have real access to affordable medications. Our state team works in targeted states across the country in support of well thought out, data supported, legislative solutions to high out-of-pocket costs.

To hear more about our work in curbing high out-of-pocket costs, watch our webinar here.

Emerging Issues

Healthcare is a complex system with many moving parts. Adequate, affordable, and accessible health care for our community is pivotal to our quality of life. More and more we are seeing innovative ideas around healthcare start at the state level that directly impact our patient population. NPF opposes unnecessary and restrictive bureaucratic barriers that negatively impacts individuals living with psoriatic disease and their caregivers as well as policies that intentionally discriminate based on psoriatic disease. The NPF advocacy team works alongside other patient and provider advocates to ensure access to care is a top priority.


Photo: NPF advocates and partners in Georgia at a lobby day in 2018.

At NPF, we know that success means working in partnership. We are proud to partner with a diverse group of stakeholders while amplifying the voice of those living with psoriatic disease in statehouse’s across the nation. As new issues emerge, we remain committed to working with any stakeholder that shares our goals - to cure psoriatic disease and to improve access to care for our patient community. These partners include nationally recognized nonprofits that represent patients with other chronic conditions, legislators, the pharmaceutical industry, pharmacy benefit managers, insurance companies, associations that represent health care industry related businesses, provider organizations, large employers, and local non-profit or advocacy groups.

In 2014 – NPF played a pivotal role in founding the State Access to Innovative Medicine (SAIM) Coalition. NPF also co-chaired the coalition from 2016 - 2018 and currently sits on the new member committee. Comprised of patient advocacy organizations, healthcare provider societies and biopharmaceutical companies, the SAIM Coalition crafts and implements comprehensive strategies to improve patients’ access to treatments. SAIM works in states across the country to advance laws and regulations that protect and improve this access.

How you can support our efforts

There are various ways you can support our NPF State Advocacy work. To learn more, to speak with staff from your region, please contact [email protected] or following us on Twitter via @NPF and #NPFAdvocacy.

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