Bill · H.R. 9192· House(119-HR-9192)
Prior Authorization Reform for Autoimmune and Blood Disorders Act
- Introduced
- 6/8/2026
- Last activity
- 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.
- Sponsored by
- Julie Johnson
- Cosponsors
- - 0 - 1
- 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
Does this make health care easier to get in general?+8
Guarantees coverage and simplifies access to critical medications for autoimmune and blood disorders.
Would people with disabilities be better off under this?+7
Significantly improves access to life-sustaining medication for those with chronic blood and autoimmune conditions.
Does this expand the rights of people with disabilities?+7
Provides better insurance access for individuals with chronic blood and autoimmune conditions.
The opposite
Does this leave more decisions to the states?-3
Imposes federal mandates on insurance issuers regardless of state-level regulations.
Would business owners be better off under this?-2
May increase the cost of providing group health insurance for employees.
Does this lower what people pay for private health insurance?-2
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)).
-
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. Hover a score for the reason it gave.
- Demographic And Interest Groups
- Good For People With Disabilities+7Good For Low Income Households+6Good For Children+5Good For Middle Aged+5Good For Middle Class Households+5Good For Seniors+5Good For Women+5Good For Young Adults+5Good For African Americans+4Good For Asian Americans+4Good For Hispanic Americans+4Good For Men+4Good For Native Americans+4Good For Retirees+4Good For Union Workers+4Good For White Americans+4Good For Billionaires+3Good For High Income Households+3Good For High Net Worth Individuals+3Good For Ultra High Net Worth Individuals+3Good For Business Owners-2
- Social Issues And Justice
- Improves Disability Rights+7
- Healthcare
- Improves Healthcare Access+8Reduces Private Insurance Premiums-2
- Economy And Finance
- Improves Consumer Protection+5
- Governance And Ideology
- Increases Federal Power+3Increase States Rights-3
- 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
Michael LawlerRepublican · New York