Johnson, Lawler Introduce Bipartisan Prior Authorization Reform for Autoimmune & Blood Disorders Act

WASHINGTON, D.C. - Today, Congresswoman Julie Johnson (TX-32) and Congressman Mike Lawler (NY-17) announced the introduction of their bipartisan Prior Authorization Reform for Autoimmune & Blood Disorders Act. The legislation will limit the number of prior authorizations required by private health insurance plans to once per year for patients with autoimmune diseases or blood disorders.

"No American living with an autoimmune disease should have to go through the repeated and burdensome process of prior authorization just to prove they still have the same chronic condition within the same year," said Congresswoman Julie Johnson. "For patients managing lifelong illnesses, unnecessary prior authorization requirements can delay access to treatment, create stress and uncertainty, and force doctors to spend valuable time on paperwork instead of patient care. This commonsense, bipartisan legislation will help reduce administrative barriers, streamline access to medically necessary treatments, and ensure patients can focus on their health rather than fighting with their insurance company."

"Patients living with autoimmune diseases and blood disorders shouldn't have to fight their insurance company to get the medications their doctors prescribe," said Congressman Mike Lawler. "This commonsense legislation would curb insurance delays and administrative hurdles by limiting prior authorization for autoimmune and blood disorder prescriptions to once per year, ensuring patients get faster, more consistent access to essential medications."

The bill is endorsed by the American Medical Association (AMA), the Texas Medical Association, the Autoimmune Association, the American College of Osteopathic Family Physicians, the American College of Osteopathic Internists, the American Society for Gastrointestinal Endoscopy, and the North American Society for Pediatric Gastroenterology - Hepatology and Nutrition.

"Prior authorization, especially repeat requests, contributes significantly to physician burnout and, more importantly, jeopardizes patients' timely access to care," said Dr. Bobby Mukkamala, president of the American Medical Association. "An American Medical Association survey found that 95% of physicians report prior authorization requirements delay necessary treatment. Additionally, 79% of the survey respondents said prior authorization can at least sometimes result in patients abandoning recommended treatment altogether. Given these alarming findings, the AMA commends Reps. Julie Johnson (D-TX) and Mike Lawler (R-NY) for introducing the Prior Authorization Reform for Autoimmune and Blood Disorders Act to ensure the commercial market does not inappropriately use utilization management techniques for these two important areas of patient care."

"More than 50 million Americans live with an autoimmune disease, and delays in care can lead to permanent disease progression," said Molly Murray, President and CEO, Autoimmune Association. "Patients already navigate complex care and treatment plans, and prior authorization only adds more burden and unpredictability. The Autoimmune Association is proud to support the Prior Authorization Reform for Autoimmune and Blood Disorders Act and grateful to Congresswoman Johnson and Congressman Lawler for standing up for patients by addressing this harmful insurance practice."

"Children with chronic immune-mediated gastrointestinal diseases such as inflammatory bowel disease, eosinophilic esophagitis, and autoimmune hepatitis depend on uninterrupted access to lifelong therapy. Repeated insurer reauthorization requirements - sometimes several times each year - create unnecessary administrative burden and can delay treatment approvals, resulting in gaps in care that place children at risk for hospitalization and loss of disease control," said Vicky Ng, MD, President of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN). "NASPGHAN commends Congresswoman Julie Johnson and Congressman Mike Lawler for their introduction of the Prior Authorization Reform for Autoimmune and Blood Disorders Act that will put patient well-being over unnecessary paperwork."

To read the full text of the legislation, click here.

Congresswoman Julie Johnson represents Texas's 32nd Congressional District in the United States House of Representatives, serving on the Homeland Security Committee, Foreign Affairs Committee, and the House Administration Committee. Her district includes parts of Collin, Dallas, and Denton Counties.

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