Bipartisan Legislation Places Commonsense Guardrails On Step Therapy, Supporting 160 Million Americans Living with Chronic Conditions
September 19, 2025 - Alexandria, VA - The National Psoriasis Foundation (NPF), the leading nonprofit dedicated to curing psoriatic disease and improving the lives of those affected, applauds bipartisan leadership in the House of Representatives for introducing the Safe Step Act today. This critical bill builds on years of state-level progress and represents the strongest federal effort yet to ensure that patients can access the treatments they need, when they need them.
NPF has been a national leader in step therapy reform, working alongside other leading patient and provider organizations to pass patient protection laws in nearly 40 states. The Safe Step Act will extend those hard-won safeguards to millions of Americans covered by employer health plans who still face harmful “fail-first” requirements. For over a decade, NPF has championed federal legislation to extend protections throughout the United States.
Step therapy, an insurance practice that requires patients to try and fail on insurer-preferred medications before receiving the treatment their doctor prescribed, remains one of the most common barriers to care. A 2020 NPF survey found that 70% of people with psoriatic disease who take a biologic have experienced step therapy. When misapplied, this policy can have negative impacts on patients including delays in care for the most effective treatment, severe side effects, and potentially irreversible disease progression.
The Safe Step Act would not eliminate step therapy but would establish commonsense guardrails to protect patients through:
- Transparency: requiring insurers to clearly outline step therapy protocols.
- Timely Access: ensuring a clear, rapid appeals process when step therapy is inappropriate.
- Patient Safety: granting exceptions when delayed care could cause harm.
“We commend the bipartisan group of lawmakers who continue to champion this issue and put patients first,” said Leah M. Howard, J.D., President and CEO of the National Psoriasis Foundation. “This bill was close to becoming law last year and this Congress has a powerful opportunity to finish the work we helped start more than ten years ago. The NPF is proud to lead a coalition of more than 200 patient and provider groups calling on Congress to move with urgency and extend these vital protections nationwide to protect tens of millions of Americans. No one should have to fail before they heal.”
The bill has strong bipartisan support in the House, with leadership from Representatives Rick Allen (R-Georgia), Lucy McBath (D-Georgia), Mariannette Miller-Meeks (R-Iowa), Raul Ruiz (D-Arizona), and Bob Onder (R-Missouri). The bill also enjoys strong bipartisan support in the Senate where the bill is expected to be introduced soon.
NPF and its partners in the Safe Step Ad Hoc Coalition are encouraging Congress to move quickly to pass this critical legislation. With millions of Americans affected by chronic conditions, including 8 million Americans living with psoriasis and psoriatic arthritis, the Safe Step Act represents a vital measure in protecting patients and strengthening trust in the American healthcare system.
To learn more about how NPF works to reform step therapy visit: https://steptherapy.com/.
About the National Psoriasis Foundation
The National Psoriasis Foundation is the leading nonprofit representing individuals with psoriasis and psoriatic arthritis. The mission of NPF is to drive efforts to cure psoriatic disease and improve the lives of more than 8 million individuals in the United States affected by this chronic immune-mediated disease. Learn more at psoriasis.org.