Patient Advocates and Health Care Provider Groups Applaud Filing of the ‘Safe Step Act’ in U.S. House and Senate  

Legislation puts common sense guidelines around insurance industry practice of “step therapy.”  

WASHINGTON, D.C. (April 17, 2023) – Patient and health care provider groups from across the country, including the Arthritis Foundation, are applauding the reintroduction of legislation aimed at putting reasonable parameters 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 on 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 hear every day from patients experiencing challenges getting the treatment their doctor has prescribed,” said Steven Taylor, president and CEO of the Arthritis Foundation. “All too often, patients are asked to fail on two, three or even four medications before they can get the one originally prescribed, all the while experiencing worsening disease.” 

Taylor went on to say: “Further, patients are sometimes asked to step through a drug they’ve already failed on or have to wait weeks before their appeal is reviewed. State legislatures across the country have passed step therapy reform, putting in place common sense solutions to help patients get their medications in a timely manner. It’s time for Congress to do the same.” 

Other leaders from the ad hoc coalition supporting the Safe Step Act also weighed in.

“NPF applauds Congress for reintroducing the Safe Step Act in the 118th Congress,” said Leah M. Howard, JD, president and CEO of the National Psoriasis Foundation (NPF). “Step therapy places an enormous barrier between the 8 million people in the U.S. who live with psoriatic disease and the treatments they need.”   

“Under-served and minority patients face unique challenges to cardiovascular care and treatment that impact their health outcomes,” said Anekwe E. Onwuanyi, MD, president of the Association of Black Cardiologists. “These challenges create unique barriers to care for African American cardiovascular patients and exacerbate existing treatment and health outcome disparities. The Association of Black Cardiologists endorses the Safe Step Act as a reasonable approach that prioritizes patient care and safety.” 

“Rationing health care is never a good thing for patients, especially for patients living with chronic health conditions such as HIV/AIDS,” said Brandon M. Macsata, CEO of the ADAP Advocacy Association. “Sadly, such requirements not only undermine the provider-patient relationship, they also have proven to be less cost-effective in the long run.” 

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.652) is sponsored in the Senate by Senators Lisa Murkowski (R-AK), Maggie Hassan (D-NH), Doc Marshall (R-KS) and Jacky Rosen (D-NV). The House version of the bill (H.R.2630) is sponsored by Representatives Brad Wenstrup (R-OH-2), Raul Ruiz (D-CA-36), Lori Chavez-DeRemer (R-OR-05), Lucy McBath (D-GA-6), Mariannette Miller Meeks (R-IA-2) and Earl Blumenauer (D-OR-03). During the 117th Congress, similar legislation had more than 230 co-sponsors in both chambers. 

About the Arthritis Foundation

The Arthritis Foundation is fighting for all people who live with arthritis. As Champions of Yes, the Arthritis Foundation’s mission is to turn the obstacles arthritis causes into opportunities. The Arthritis Foundation champions life-changing solutions and medical advancements, and it also provides ways for people to connect, break down barriers in health care and join the fight to conquer arthritis — uniting hearts, minds and resources to change the future of arthritis. To join the fight to conquer arthritis, visit

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