Congress·In Committee·H.R. 1227

Alternatives to PAIN Act

Congress Targets Lower Medicare Part D Costs and Fewer Barriers for Certain Non-Opioid Pain Drugs

Feb 12, 2025·View on Congress.gov·Read full text

Part of: Congress Proposes Expanded Medicare Access to Non-Opioid Pain Medications

This bill is one vehicle in a longer effort. See the full story across every version.View effort →

StalledNext up: A house committeeNo action in 17 months

This bill is currently sitting in the House committees on Energy and Commerce and Ways and Means. It has not moved forward since February 2025, and no action has been taken on it for 16 months. The bill is stalled because the committees have not scheduled any votes or hearings to discuss it.

Legislative Progress

House

No action since February 2025

Senate

President

Law

How we got here

This bill’s path across every version that has carried it.

Reintroduced
Reintroduced from H.R. 7142 (118th), which died when its Congress ended.
H.R. 7142 (118th) →

Key Points

Starting in 2026, Medicare Part D plans would have to cover certain non-opioid pain drugs with no deductible and the lowest cost-sharing tier.
The bill targets drugs used for post-surgery or other acute pain that do not work on opioid receptors, aiming to make non-opioid options easier to get.
It mainly applies to newer drugs with no therapeutically equivalent version sold in the U.S., and only if the monthly price stays under Medicare’s specialty-tier threshold.
Part D plans could not require “step therapy” that makes a patient try an opioid first before getting the non-opioid drug.
Part D plans also could not require prior authorization for these qualifying non-opioid pain drugs, which could speed up access at the pharmacy.

HealthcareMedicare MedicaidPrescription DrugsDrug Policy

Impact Analysis

Personal Impact

How this policy affects specific groups of people

Mixed Impacts(1)

Mental Health

Neutral

Positive Impacts(2)

Medicare

Helps

Chronic Illness

Helps

Milestones

2 milestones2 actions

Feb 12, 2025House

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.

Sent to a congressional committee for expert review. The committee decides whether this bill moves forward.

Feb 12, 2025

Introduced in House

The bill was officially filed and given a number. It now enters the legislative queue.

Related News

1 article

GlobeNewswire·Oct 8, 2025

Lexicon Pharmaceuticals Convenes Roundtable to Address Public Policy Gaps for People with Chronic Pain

Company roundtable discusses the Alternatives to PAIN Act’s Medicare Part D access provisions for non-opioid pain treatments and argues the bill should be expanded beyond acute/post-surgical pain to include chronic pain.

No votes recorded for this bill yet.

Source Information

Document Type

Congressional Bill

Official Title

Alternatives to PAIN Act

Bill NumberHR 1227

Congress119th Congress

ChamberHouse of Representatives

Latest ActionReferred 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.