Bill · H.R. 5467· House(119-HR-5467)
PAAT Act
- Introduced
- 9/18/2025
- Last activity
- 9/18/2025 — Referred to the Committee on Energy and Commerce, and in addition to the Committee on 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.
- Sponsored by
- Julie Johnson
- Cosponsors
- - 4 - 1
- Introduced
- In Committee
What this bill would do
This bill, known as the "Patient Access to Autoimmune Treatments Act" or the "PAAT Act," seeks to amend the Social Security Act. It would require Medicare Part D prescription drug plans to include coverage for drugs used to treat autoimmune diseases, hemophilia, or Von Willebrand disease. This coverage requirement would begin in 2027 and continue for each subsequent year. Additionally, the bill aims to restrict how much prior authorization is required for these specific drugs.
Yes· 3 of 5
Would people over 65 be better off under this?+6
The bill ensures Medicare Part D coverage for autoimmune and blood disorder treatments starting in 2027.
Would retired people be better off under this?+6
The bill provides guaranteed coverage and reduces administrative hurdles for Medicare-eligible patients with specific conditions.
Does this put more money into Medicare, the health coverage for people over 65?+5
The bill mandates Medicare Part D plans to cover specific drugs for autoimmune diseases and blood disorders.
The opposite
No question was scored the opposite.
Who it would affect, and how
Potential Positive Impacts for People
-
Guaranteed Coverage for Specific Conditions: Under Section 2, subsection (b)(3)(J)(i), prescription drug plan sponsors would be required to include drugs indicated and prescribed for the treatment of autoimmune diseases, hemiahophilia, or Von Willebrand disease starting in 2027. This ensures that these specific treatments are part of Medicare Part D coverage.
-
Reduced Administrative Burdens: Under Section 2, subsection (c)(8), the bill prohibits plan sponsors and MA organizations from requiring prior authorization for these drugs more than once during a 12-month period. This could prevent patients from having to repeatedly seek approval for the same medication throughout the year.
Potential Negative Impacts for People
- Exceptions to Prior Authorization Restrictions: According to Section 2, subsection (c)(8), the prohibition on repeated prior authorization does not apply if the drug is typically used for a period of 12 months or less, is an opioid, a benzodiazepine, a barbiturate, or carisoprodol, or is a drug requiring a risk evaluation and mitigation strategy. This means patients using those specific types of drugs may still face frequent authorization requirements.
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Hover a score for the reason it gave.
- Demographic And Interest Groups
- Good For Retirees+6Good For Seniors+6Good For Low Income Households+4
- Healthcare
- Increases Medicare Funding+5Reduces Prescription Drug Costs+4
- 11/19/2025
- 2 Cosponsors added.
- 10/17/2025
- 1 Cosponsor added.
- 10/10/2025
- 1 Cosponsor added.
- 9/18/2025
- Referred to the Committee on Energy and Commerce, and in addition to the Committee on 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
Emanuel CleaverDemocrat · Missouri
Sarah ElfrethDemocrat · Maryland
Josh GottheimerDemocrat · New Jersey
Mike KennedyRepublican · Utah
Eleanor NortonDemocrat · District of Columbia