Arthritis Foundation Celebrates Lawmaker Unity on the Safe Step Act Introduction 

WASHINGTON, D.C. (September 25, 2025) – Patient and health care provider groups from across the country, including the Arthritis Foundation, are applauding the reintroduction in both the House and Senate of legislation aimed at putting reasonable reform around the insurance industry protocol known as “step therapy” or “fail first.”   
 
“The Safe Step Act” mirrors legislation passed in more than three dozen states across the country. When passed into law, the measure will bring similar patient protections to employer health plans that are regulated on the federal level.   

Currently, health plans can require patients to try and fail one or more medications before the plan will cover the treatment initially selected by the patient and their health care provider. Delays in getting the proper treatment can lead to irreversible disease progression and worsening of a patient’s medical condition.   

“We often hear from patients having difficulty getting the medication their doctor has prescribed,” says Anna Hyde, vice president of advocacy and access for the Arthritis Foundation. “In many cases, patients are expected to fail multiple treatments before they can get the one originally prescribed, and each medication change takes time, allowing their disease to get worse and risk permanent damage.”   

Hyde went on to say: “In some cases, patients have to step through a drug they’ve already tried and failed, or they have to wait weeks while their insurance provider reviews their appeal. State legislatures throughout the country have passed step therapy reform, establishing common sense solutions to help patients get the medications they need without unnecessary delays. It’s time for Congress to do the same to give all patients streamlined access.”   

Although the Safe Step Act did not make it into the final legislative package last year, advocates and patient groups made significant progress in elevating the issue. With a majority of the House already signed on as co-sponsors, there is clear, bipartisan recognition that reforming step therapy is urgently needed to protect patients from harmful delays and disruptions in care. 

“It can take a long time to make change happen,” said Deb Constien, Arthritis Foundation Platinum Ambassador and rheumatoid arthritis patient. “This will be my third time going to the Arthritis Foundation Advocacy Summit, asking, and thanking my representatives for supporting this piece of legislation. While here in Wisconsin, we have adopted step therapy reform into state law, passage of the Safe Step Act at the federal level would be a tremendous win for all arthritis patients.” 

The Safe Step Act does not ban the use of step therapy but instead puts common sense parameters and reasonable timelines around the practice. The legislation will give patients and their doctors a transparent and standardized process to appeal step therapy requirements for patients needing a particular treatment. 

The Safe Step Act is supported by more than 200 patient and provider organizations. The bill (S.2903) is sponsored in the Senate by Senators Lisa Murkowski (R-AK), Maggie Hassan (D-NH), Roger Marshall (R-KS), Jacky Rosen (D-NV), Alex Padilla (D-CA), John Hickenlooper (D-CO), Jeff Merkley (D-OR), Raphael Warnock (D-GA), Dan Sullivan (R-AK), Cindy Hyde-Smith (R-MS), Catherine Cortez Masto (D-NV), Jerry Moran (R-KS), Kevin Cramer (R-ND), Tim Kaine (D-VA), Ted Budd (R-NC), Jeanne Shaheen (D-NH), Cory Booker (D-NJ), Ron Wyden (D-OR) and Chris Coons (D-DE).  

The House version of the bill (H.R.5509) is sponsored by Representatives Rick Allen (R-GA-12), Lucy McBath (D-GA-6), Mariannette Miller-Meeks (R-IA-1), Raul Ruiz (D-CA-25), and Robert Onder (R-MO-3). During the 118th Congress, similar legislation had more than 230 co-sponsors in both chambers.