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Reps. Jayapal and Khanna Introduce Bill to Ban Prior Authorization In Medicare Advantage Programs

Washington, DC — Today, Representatives Pramila Jayapal (WA-07) and Ro Khanna (CA-17) introduced the Stop Deadly Denials Act to no longer allow Medicare Advantage plans to require prior authorization for necessary medical items and services. The legislation would ensure patients are able to receive fair affordable coverage without added administrative burdens from prior authorization that frequently block care. 

“Medicare DisAdvantage makes it harder for patients to get the care they need – often leading to delays and denials of care that can be deadly. We’re now seeing the Trump Administration bring this tactic to Traditional Medicare as well, denying Americans care they need, and that they would have received before the implementation of the WISeR model. I’m leading the Stop Deadly Denials Act with Rep. Khanna because we must urgently ensure corporate insurers can’t deny care to those who need it. Patients, doctors, and advocates have been sounding the alarm about denials of care for years: it’s time for Congress to address these serious concerns,” said Rep. Pramila Jayapal.

“It’s time we stop allowing Medicare Advantage to profit off the Medicare name while denying critical coverage,” said Rep. Ro Khanna. “Affordable quality healthcare is a human right. I’m proud to introduce this legislation with Rep. Jayapal and stop Medicare Advantage from using prior authorization to delay and deny medically necessary care.”

“Since its inception, Medicare Advantage has gamed our health care system to profit off our seniors and people with disabilities,” said Jamie Brown, RN and NNU president. “Nurses applaud Representatives Pramila Jayapal and Ro Khanna for introducing the Stop Deadly Denials Act to put an end to prior authorization in Medicare Advantage. It’s time we take on corporate health insurers who use delaying and denying care to exploit our patients, and we have to stand firm in our commitment to ensure these same tactics are not used in Traditional Medicare. We must protect Medicare in our fight to pass Medicare for All!”

“Prior authorization is a tool used by Big Insurance to delay and deny care, often standing between patients and the care they need. By aligning Medicare Advantage with traditional Medicare, blocking harmful experiments like WISeR, and stopping the use of unaccountable algorithms to override physicians, this legislation will make it harder for Big Insurance to deny care to those who need it.  It also ensures transparency and accountability by requiring full public input before any future models move forward. We thank Congressman Ro Khanna for introducing this vital bill and urge Congress to pass it without delay,” said Rachel Madley, PhD, Executive Director, Center for Health and Democracy.

“Insurers shouldn’t be profiting from denying seniors the care that they need and are entitled to receive. We know that privatized Medicare plans overturn around 80 percent of their denial of care decisions upon appeal, but count on few enrollees filing those appeals. The privatized Medicare plans aggressively and mechanically deny requests for prior authorization because they know they can get away with it. The Stop Deadly Denials Act would finally put a stop to these practices and prevent perverse experiments that threaten to bring further prior authorization into Traditional Medicare,” said Lisa Gilbert, Co-President of Public Citizen. 

The Stop Deadly Denial Act: 

  • Eliminates prior authorization for all Medicare Advantage Part A and Part B services unless required in traditional Medicare. 
  • Blocks WISeR and any substantially similar prior authorization model in Traditional Medicare.
  • Prohibits CMMI from testing any prior authorization model that imposes prior authorization for Part A/B services, uses AI or algorithm-driven denials without physician review, or outsources prior authorization determinations outside Medicare Administrative Contractors (MACs).
  • Requires CMS to use full notice-and-comment rulemaking for all future models starting in 2027. 

Read the full text of the legislation here.

Cosponsors: Representative Steve Cohen (D-TN), Representative Debby Dingell (D-MI), Representative Jonathan Jackson (D-IL), Representative Eleanor Holmes Norton (D-DC), and Representative Mark Pocan (D-WI) 

The full list of organizations that have endorsed the Stop Deadly Denials Act of 2026 include: National Nurses United (NNU), Centers for Health and Democracy, Public Citizen, Just Care USA, Social Security Works, the Labor Campaign for Single Payer, and Puget Sound Advocates for Retirement Action.

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