Julie Johnson (D-TX)
Prior Authorization Reform for Autoimmune and Blood Disorders Act
A Democratic bill with 2 Republican cosponsors · See all 2 cosponsors
Last activity — Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and Workforce, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
In committee
Introduced and handed to a committee in the chamber it started in.
The committee holds it, and most bills are never heard from again. A hearing or a committee vote would be news; silence is the usual outcome, and it kills the bill without anyone voting against it.
Its path through Congress
- Introduced
- In Committee
What this bill would do
The "Prior Authorization Reform for Autoimmune and Blood Disorders Act" requires health insurance plans to cover drugs used to treat autoimmune diseases, hemophilia, and Von Willebrand disease. It limits how often insurance companies can require prior authorization for these drugs, generally restricting it to once every 12 months. There are exceptions to this limit for certain drug types, such as opioids or those with specific risk strategies. The bill amends the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986. These changes would apply to plan years starting on or after January 1, 2027.
Yes· 3 of 24
- Scored +8
Does this make health care easier to get in general?
Guarantees coverage and simplifies access to critical medications for autoimmune and blood disorders.
- Scored +7
Would people with disabilities be better off under this?
Significantly improves access to life-sustaining medication for those with chronic blood and autoimmune conditions.
- Scored +7
Does this expand the rights of people with disabilities?
Provides better insurance access for individuals with chronic blood and autoimmune conditions.
The opposite
- Scored -3
Does this leave more decisions to the states?
Imposes federal mandates on insurance issuers regardless of state-level regulations.
- Scored -2
Would business owners be better off under this?
May increase the cost of providing group health insurance for employees.
- Scored -2
Does this lower what people pay for private health insurance?
Mandating coverage and limiting prior authorization may lead insurers to increase premiums to cover higher costs.
Who it would affect, and how
Potential Positive Impacts for People
-
Guaranteed Coverage: Group health plans and insurance issuers must provide coverage for drugs prescribed for autoimmune diseases, hemophilia, or Von Willebrand disease (Section 2(a), (b), and (c)).
-
Reduced Administrative Burden: Patients generally only need to obtain prior authorization for these specific drugs once every 12-month period, which reduces the frequency of paperwork for long-term treatments (Section 2(a), (b), and (c)).
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Flexible Dispensing: Coverage is required regardless of whether the drug is provided by a pharmacy or given during another service for which benefits are available (Section 2(a), (b), and (c)).
Potential Negative Impacts for People
- Limited Scope of Relief: The restrictions on prior authorization do not apply to certain drugs, including opioids, benzodiazepines, barbiturates, carisoprodol, drugs used for 12 months or less, or those with a risk evaluation and mitigation strategy (Section 2(a), (b), and (c)).
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Tap or hover a score for the reason it gave.
- Demographic And Interest Groups
- Would people with disabilities be better off under this? — Significantly improves access to life-sustaining medication for those with chronic blood and autoimmune conditions. Would households on low incomes be better off under this? — Ensures coverage for expensive specialty drugs that would otherwise be unaffordable. Would children be better off under this? — Benefits children with hemophilia or autoimmune disorders through guaranteed drug coverage. Would people in middle age be better off under this? — Reduces administrative burden for adults managing long-term autoimmune or blood disorders. Would middle-income households be better off under this? — Reduces the risk of insurance denial for necessary high-cost treatments. Would people over 65 be better off under this? — Improves access to critical medications for seniors with autoimmune conditions. Would women be better off under this? — Many autoimmune diseases disproportionately affect women, who will benefit from guaranteed coverage. Would people in their twenties and thirties be better off under this? — Benefits young adults with these chronic conditions by easing medication access. Would Black Americans be better off under this? — Improves healthcare access for minority populations affected by autoimmune and blood disorders. Would Asian Americans be better off under this? — Improves healthcare access for minority populations affected by autoimmune and blood disorders. Would Hispanic Americans be better off under this? — Improves healthcare access for minority populations affected by autoimmune and blood disorders. Would men be better off under this? — Benefits men with blood disorders like hemophilia through guaranteed coverage. Would Native Americans be better off under this? — Improves healthcare access for minority populations affected by autoimmune and blood disorders. Would retired people be better off under this? — Improves access to medication for those on group or individual retirement health plans. Would union members be better off under this? — Union workers with group health plans will have better access to these medications. Would white Americans be better off under this? — Improves healthcare access for patients affected by autoimmune and blood disorders. Would billionaires be better off under this? — Increases ease of access to medication. Would high-income households be better off under this? — Provides convenience in medication access but provides less relative economic benefit. Would people with substantial wealth be better off under this? — Increases ease of access to medication. Would the very wealthiest people be better off under this? — Increases ease of access to medication. Would business owners be better off under this? — May increase the cost of providing group health insurance for employees.
- Social Issues And Justice
- Does this expand the rights of people with disabilities? — Provides better insurance access for individuals with chronic blood and autoimmune conditions.
- Healthcare
- Does this make health care easier to get in general? — Guarantees coverage and simplifies access to critical medications for autoimmune and blood disorders. Does this lower what people pay for private health insurance? — Mandating coverage and limiting prior authorization may lead insurers to increase premiums to cover higher costs.
- Economy And Finance
- Does this give people more protection from unfair business practices? — Increases protections for consumers by guaranteeing insurance coverage for specific chronic disease medications.
- Governance And Ideology
- Does this give the federal government more power? — Increases federal oversight by mandating specific insurance coverage and limiting prior authorization requirements. Does this leave more decisions to the states? — Imposes federal mandates on insurance issuers regardless of state-level regulations.
- 10/15/2026
- 1 Cosponsor added.
- 6/8/2026
- Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and Workforce, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 1 Cosponsor added.
- Introduced in House
Robert BresnahanRepublican · Pennsylvania
Michael LawlerRepublican · New York