The Freedom Agenda: Goldwater’s State Policy Handbook

ISSUE OVERVIEW

At both the state and local levels, overbroad statutes and vague regulations have empowered a sprawling administrative state to issue commands that carry the force of law, but without the democratic accountability of being specifically debated by elected legislators. The consequences are visible nationwide: overregulation, economic stagnation, and a growing sense that opportunity is reserved for those who can afford the expense and time needed to navigate or influence the system. Americans should not have to fight against state and local agencies in their everyday pursuit of happiness.

This imbalance is reinforced by judicial deference, a doctrine that requires courts to favor an agency’s interpretations of law, even if that interpretation conflicts with prior rulings or judicial precedent. By tipping the scales in favor of the government, deference further subverts the separation of powers by amplifying the lawmaking authority that Congress has granted to the executive branch.

In 2024, the U.S. Supreme Court finally rejected this doctrine at the federal level in Loper Bright v. Raimondo, affirming that courts, not agencies, must interpret the law. Yet many state courts continue to defer to state agencies, perpetuating a system that erodes individual liberty and democratic accountability.

POLICY RECOMMENDATION

The Goldwater Institute is leading efforts to restore constitutional order by challenging judicial deference. Goldwater argues that reform must come from legislatures, not judges, and is championing the Judicial Deference Reform Act to ensure fair treatment when citizens challenge state regulators.

This reform levels the playing field by requiring administrative law judges and courts to review state agency actions without deference and interpret the relevant legal texts de novo. Making this change would give Americans a fair shot in court against government agencies and ensure that judicial officers are not biased in favor of administrative power.

STORIES OF SUCCESS

In 2018, Arizona became the first state to eliminate judicial deference by statute. “In a proceeding brought by or against the regulated party,” the Arizona law declared, “the court shall decide all questions of law, including the interpretation of a constitutional or statutory provision or a rule adopted by an agency, without deference to any previous determination that may have been made on the question by the agency.” With a single sentence, Arizona restored its citizens’ equal standing in court and stripped interpretive power from unelected bureaucrats. The effect was immediate: one of the nation’s fastest-growing regions gained even more economic momentum.

Other states soon followed. Ten states have passed similar laws, and Florida enshrined the reform in its constitution. What began as a doctrine of federal administrative law has become a national movement, with legislatures reclaiming their authority and rebalancing the scales of justice in favor of the governed.

VIEW MODEL LEGISLATION.

ISSUE OVERVIEW

Americans have always been builders. We cleared land, raised homes, and launched businesses armed with little more than grit and purpose. But today, that instinct runs headlong into red tape. Before building anything, one must apply, wait, and hope for permission. Likewise, nearly one third of all occupations now require a license. A nation of doers is becoming a nation of petitioners.

Permitting regimes across the country are plagued by ambiguity and delay. Vague legal terms like “public interest,” “aesthetically pleasing,” or “appropriate to the neighborhood” give sweeping power to unelected officials. That discretion is often wielded to stall or reshape projects based on the personal preferences of bureaucrats rather than the law.

The consequences go far beyond economic stagnation. Americans are forced to spend hundreds of dollars and an average of nine months pursuing government permission to work. Property owners must surrender land, cash, or rights to secure development permits. What began as narrow exceptions to prevent harm has metastasized into a sprawling bureaucracy that trades liberty for control.

POLICY RECOMMENDATION

The Permit Freedom Act implements three commonsense reforms to protect individuals whenever a city or county requires them to get a permit. It requires cities and counties to:

• Provide clear and unambiguous criteria for what is required to obtain a permit. No denials for “good cause,” “appropriate for the location,” or “must be aesthetically pleasing.”
• Adhere to an explicit deadline for permit decisions. Currently, municipalities can indefinitely delay action on applications, leaving applicants in limbo. Under this legislation, if the municipality fails to respond within the deadline, the permit is automatically approved.
• Provide a meaningful, unbiased hearing when the applicant thinks the permit was wrongly denied.

STORIES OF SUCCESS

Permitting delays, vague rules, and bureaucratic hurdles have created a crisis in homebuilding, and affordable housing has become an impossible dream for many. A national study found that regulations add $100,000 to the price of a new home, a cost that falls hardest on young families and first-time buyers already grappling with high interest rates and limited inventory.

In 2023, Arizona took a different path when it enacted the Permit Freedom Act, a Goldwater Institute reform that succeeded where planners and politicians failed. The law imposed firm deadlines, objective standards, and automatic approvals when cities failed to act. Permitting moved faster, housing supply increased, and economic gains came into bloom.

A 2025 report by the Common Sense Institute found that statewide permitting timelines dropped from 200 to 126 days. Delays fell by more than 12% in Phoenix, 49% in Chandler, and 64% in Mesa. The reform is projected to produce 3,800 more homes annually by 2035, reduce home prices by 5%, and inject $6.4 billion into Arizona’s economy—creating nearly 34,000 jobs.

Faced with a shortfall of 50,000 homes and permitting delays exceeding 300 days, Arizona chose action over inertia. The Permit Freedom Act shows that clear rules and timely decisions don’t just speed up housing, they drive affordability and growth—enabling builders and doers to get back to pursuing their dreams and driving progress.

VIEW MODEL LEGISLATION.

ISSUE OVERVIEW

The ability to earn a living through honest work has long stood at the heart of the American Dream. Yet today, it’s one of our least protected rights. Across the country, would-be entrepreneurs and tradesmen face a tangle of rules imposed by unelected boards invoking vague notions of professionalism or public order.

Occupational licensing is often framed as a matter of safety or standards. In practice, it serves as a barrier to entry, one constructed by unelected bureaucrats and rarely scrutinized in public by our elected representatives. To work, nearly a third of Americans must first navigate a maze of forms, fees, and delays for jobs they are already qualified to perform. It’s a system where regulators assume the authority of legislators, while workers must prove to the unelected that they deserve a chance to earn a living.

POLICY RECOMMENDATION 

The Right to Earn a Living Act requires state regulatory agencies to demonstrate that an occupational regulation addresses a legitimate public harm before that regulation can prevent someone from working in a given profession. The reform has two unique components. First, it requires each agency to conduct a comprehensive review within one year of all occupational regulations within its jurisdiction, and articulate:

• The public health, safety, or welfare objective(s) served by the regulation, and;
• The reason(s) why the regulation is necessary to serve the specified objective(s).

If an agency finds any occupational regulation that is not necessary to serve one of these objectives, the agency is required to repeal or modify the regulation or make a recommendation to the legislature on how to repeal or modify the regulation to ensure it meets the standard above.

Second, the Act ensures that workers have a fair pathway to challenge agency rules. If a regulation violates the law, workers can petition the agency to repeal or modify the restriction. If the agency decides not to change or repeal the regulation, workers may challenge the agency’s decision in court. To ensure legislative intent is preserved, the courts must rule in favor of the challenger if:

• The challenged regulation burdens entry into or participation in an occupation or particular profession; or
• The regulation is not “demonstrated to be necessary to specifically fulfill a public health, safety, or welfare concern.”

STORIES OF SUCCESS

A growing number of states have pushed back against the administrative state’s intrusion on economic liberty by passing the Right to Earn a Living Act. Four other states have adopted a simple but profound principle: In a free society, liberty—rather than regulation—is the default. The result has been unmistakable as agency overreach has been checked, arbitrary rules dismantled, and opportunity restored.

VIEW MODEL LEGISLATION.

ISSUE OVERVIEW

In a country founded on freedom of movement and the promise of economic self-determination, state licensing and local red tape have become barriers to work. Nearly a third of American workers must hold a government-issued license to do their job. For those who relocate, a license often becomes an obstacle, not a credential.

In many states, even seasoned professionals with years of training and unblemished records are required to repeat coursework, pass new exams, and pay additional fees just to continue their careers in a new location. Occupational licensing laws—once meant to ensure public safety—have become protectionist barriers, denying qualified workers a fair chance to contribute to their new communities.

States should welcome those ready to contribute. It’s time lawmakers stop treating regulatory agencies as neutral overseers of safety and start treating them as active impediments to opportunity. Bureaucratic inertia designed for another era should not determine whether a nurse can treat patients or whether an electrician can wire a home. Reforming the rules that govern entry into a profession is not simply a matter of efficiency. It is a test of whether a state values work, experience, and the people who come to build a better life for themselves and their families.

POLICY RECOMMENDATION

The Breaking Down Barriers to Work Act is a straightforward reform that protects the public without punishing skilled workers for moving to a new state. By recognizing out-of-state licenses, states can welcome experienced professionals who are ready to work on day one. The policy ensures that relocation does not mean starting over. This Act universally recognizes out-of-state occupational licenses based on the training or testing requirements that a person has already completed.

STORIES OF SUCCESS

Arizona became the first state in the nation to adopt universal license recognition in 2019, and the results have been transformative. In the years since, more than 10,000 workers across dozens of professions—from nurses and engineers to barbers and contractors—have used the law to get to work without unnecessary delay, and Arizona has become one of the fastest-growing states in the country. That success has inspired others. Since 2019, more than half the states have adopted forms of universal recognition.

FISCAL CONSIDERATIONS

Unlike many regulatory reforms, the Breaking Down Barriers to Work Act costs states nothing. Fiscal notes from early adopting states consistently show a net cost of zero to the government, while the benefits for individual workers are significant. Depending on the profession, a streamlined licensing process can save applicants thousands of dollars in unnecessary coursework and fees. At scale, the policy helps reduce unemployment, fill critical workforce gaps, and lower barriers for small businesses and entrepreneurs without burdening taxpayers.

VIEW MODEL LEGISLATION

ISSUE OVERVIEW

From online artisans to CPAs, the modern economy is increasingly powered by Americans working from their own homes. What was once a matter of necessity—starting small, saving costs, and building gradually—has become a hallmark of entrepreneurial independence. While technology has made home-based businesses more viable than ever, outdated local ordinances have failed to keep pace. In cities across the country, zoning codes and licensing schemes treat home-based businesses as potential dangers, criminalizing quiet, productive home-based businesses that cause no harm to neighbors.

Some local governments have gone as far as levying fines or threatening jail time simply because someone earns a living in their home. These are not regulations designed to prevent harm or mitigate nuisances; they’re signs of an administrative state that has grown out of control.

POLICY RECOMMENDATION

The Home-Based Business Fairness Act restores balance by drawing a clear line between legitimate local interests and regulatory overreach. This legislation allows local officials to target nuisances, ensure that buildings are safe, and prevent noise and traffic problems—but protects home-based workers against lengthy, uncertain, and expensive licensing and permitting processes. If a mother can teach her daughter to play the violin in her living room, it makes no sense for the government to penalize her for teaching someone else’s daughter in the same living room for money.

EXAMPLES OF ABUSE

Abuses of home-business restrictions are not theoretical. In Springfield, Virginia, a woman who ran an online clothing store from her home was forced to shut down, not because of neighbor complaints or safety issues, but because her locality prohibits “retail” activity in residential areas, even when all sales occur online. In Chandler, Arizona, Kim O’Neil ran a quiet, unobtrusive medical billing company from her home because it enabled her to care for her sick father. But the city shut her down because her business had employees—even though they did not work out of the house.

These examples are not rare and reflect a deeper problem: The instinct of the administrative state is to regulate first and justify later.

VIEW MODEL LEGISLATION.

ISSUE OVERVIEW

Under our Constitution, lawmaking power rests with the people and their elected representatives—not unelected bureaucrats. Yet state agencies routinely overstep their role by creating sweeping new regulations under vague statutory language. This practice removes lawmaking power from the legislature and places it in administrative agencies, blurring the separation of powers and undermining democratic accountability.

Regulatory overreach doesn’t just offend constitutional principles, it also hurts people.

• Higher costs for families and businesses: Citizens, employees, entrepreneurs, and consumers all pay more when agencies pile on red tape without legislative approval.
• Unfair advantages for big corporations: Large businesses often have the resources to influence agencies and comply with complex regulations, leaving small businesses struggling to keep up.

Courts have long recognized that agencies cannot regulate without guidance from the legislature, under the so-called “non-delegation” doctrine. But in practice, courts do not meaningfully enforce this restriction, allowing agencies to claim sweeping powers from the thinnest statutory authority. This intrusion on the lawmaking authority of the legislature has enabled regulators to push major policy changes without meaningful checks.

POLICY RECOMMENDATION

The Agency Accountability Act restores accountability by ensuring agencies can only act when the legislature clearly authorizes them to do so.  Specifically, it would:

• Require every regulation to be based on a specific grant of authority from the legislature.
• Clarify that agencies cannot rely on broad grants of authority to make policy decisions in areas where the legislature did not authorize them to do so.  

This reform rebalances the separation of powers, protects democratic accountability, and ensures that only elected lawmakers—not unelected regulators—make important policy decisions that affect citizens’ lives and the prosperity of businesses and entrepreneurs.  

VIEW MODEL LEGISLATION.

ISSUE OVERVIEW

Property ownership is mentioned more times in the U.S. Constitution than any other right, and for good reason: It secures autonomy, anchors prosperity, and shields the individual from state overreach. But that right has been eroded as state laws often allow local bureaucracies to regulate away property rights under the broad and ill-defined banner of public health and safety.

Across the country, governments have discovered that they can sidestep the constitutional requirement to compensate property owners by regulating rather than seizing land. Citing vague laws, cities and agencies can impose restrictions that render homes undevelopable, land unusable, and investments worthless.

POLICY RECOMMENDATION

The Property Ownership Fairness Act (POFA) restores balance to the relationship between government and landowners. It does not prevent the state from regulating dangerous uses of property, such as polluting, maintaining unsafe conditions, or using land in a way that violates the rights of neighboring landowners.

Instead, it draws a constitutional line: When regulation strips a property of its value or utility—and the government cannot justify that intrusion on genuine health or safety grounds—it must either pay for what it has taken or refrain from applying the regulation to an owner’s land.

Under POFA, governments must compensate property owners if a restriction does all of the following:

• Limits existing rights to use the property (the regulation was enacted after the owner acquired the land);
• Directly regulates the owner’s land;
• Reduces the property’s fair market value; and
• Is not a legitimate use of the government’s authority to protect public health and safety.

STORIES OF SUCCESS

Arizona’s POFA law has already proven its worth. In 2021, the City of Flagstaff enacted a sweeping land-use mandate—the High Occupancy Housing (HOH) Plan—restricting property improvements by capping bedroom counts, dictating parking configurations, and tightly regulating density. While marketed as city planning, the policy effectively stripped hundreds of property owners of their development rights, forcing them to seek costly permits or abandon their plans altogether.

Armed with POFA, those owners filed claims totaling tens of millions of dollars. Rather than face legal defeat or cover the cost, Flagstaff officials reversed course, restoring property rights. It was a victory not just for those claimants, but for the principle that government must answer for the burdens it imposes.

VIEW MODEL LEGISLATION.

ISSUE OVERVIEW

For those living and working in a lawless square mile where Phoenix officials had designated over a thousand homeless individuals, many being severe substance abusers. For property owners in “The Zone,” tolerating violent crime and threats to their life came hand in hand with repairing fences, picking used drug needles off your stoop, or cleaning human waste. Property owners begged their local city officials for help.

The city government did nothing about it. In fact, officials made it worse by deliberately refusing to enforce the law as a matter of policy. By 2024, Phoenix had become a cautionary tale for urban America. In the previous five years, the city spent over $180 million to “address” the homelessness crisis—only for the number of homeless people to increase by 92 percent. The city-sanctioned encampment harbored over 1,000 people living in conditions resembling a failed state.

While some offered sympathy without action—and government demanded more spending without a real strategy—Goldwater developed an answer rooted in a deeply American principle: When government deliberately fails to protect property by refusing to enforce the law, the state should forfeit its claim to tax that property. That concept became the core of The Safe Neighborhoods Act, a reform that empowered property owners to claim refunds of documented mitigation expenses if their city refuses to enforce public nuisance laws.

POLICY RECOMMENDATION

The Safe Neighborhoods Act offers a solution rooted in a timeless American principle: If the government refuses to protect your property, it forfeits the right to tax it. Under this framework—pioneered by the Goldwater Institute through Arizona’s groundbreaking Proposition 312—property owners may file compensation claims if local governments refuse to enforce public nuisance or homelessness-related laws. If a property’s value declines or an owner must pay for private security, sanitation, or legal services due to government inaction, the Act gives them legal standing to recoup those costs.

The Safe Neighborhoods Act holds officials accountable when they fail to meet their obligations, and it arms citizens with a tool to protect themselves, their property, and their communities.

STORIES OF SUCCESS

The Safe Neighborhoods Act was passed in Arizona with over 58% of the statewide vote. The measure united rural, urban, and suburban Arizonans behind a single sentiment: Enough is enough. In the wake of its passage, cities across the Phoenix metro area—Mesa, Tempe, Scottsdale, Goodyear, Surprise, and Phoenix itself—rapidly enacted or began enforcing ordinances banning camping in public spaces.

Property owners in Arizona now have a real, enforceable means to seek redress when their government chooses to look the other way. Goldwater’s outreach efforts have ensured that citizens know how to file claims and how to protect their rights.

VIEW MODEL LEGISLATION.

ISSUE OVERVIEW

For millions of American families, the promise of quality public schools has manifested only a rigid system of uniformity where the needs of gifted children, students with disabilities, and those with nontraditional learning styles are left unmet. Parents who sense that their child is falling through the cracks often find themselves trapped—forced to fund a failing model with their tax dollars, even as they remain unable to afford better alternatives.

This crisis is most acute in high-poverty and rural communities, where public schools may be the only formal option. In such districts, the inability of government-run systems to provide a quality education becomes a de facto denial of opportunity. As inflation and public-school costs rise, the need for affordable, adaptable, parent-led alternatives grows more urgent by the day.

POLICY RECOMMENDATION

Lawmakers should implement, expand, and expedite access to Education Savings Accounts (ESAs), which place education funding directly into the hands of parents. Under this reform, a portion of the dollars earmarked for a child’s public schooling is deposited instead into a flexible spending account. Parents can then use these funds to customize their child’s learning experience. Instead of being forced to funnel their tax dollars into a failed system, they can spend their money on private school tuition, tutoring, special education therapies, textbooks, online courses, and home-based curricula.

ESAs return power to families while preserving fiscal discipline. In states that already offer ESAs, lawmakers should eliminate red tape and streamline application processing, so no family is held hostage by delays or arbitrary deadlines when seeking the education their child deserves.

STORIES OF SUCCESS

Nearly half of all states have now implemented ESA-style programs, including fourteen with universal student access. In Arizona—the national leader—more than 90,000 students now use ESAs to access high-quality alternatives.

ESA dollars have made private education accessible to the middle and working classes. According to Goldwater Institute research, the median ESA amount in Arizona ($7,400) is enough to almost fully cover tuition at most of the state’s private K–8 schools.  

FISCAL CONSIDERATIONS

Far from burdening taxpayers, ESAs generate substantial public savings. Arizona public schools spend more than $15,000 per student annually, yet the average ESA award for a non-special education student is nearly half that amount. This means taxpayers save thousands of dollars for every student who leaves the traditional system for an ESA-funded education.

VIEW MODEL LEGISLATION.

ISSUE OVERVIEW

America’s public colleges were once guardians of academic inquiry that prepared Americans to be informed citizens while readying them for a career. Today, rather than cultivating a community of open debate and intellectual exploration, many institutions promote politicized programming. A 2024 study by Speech First found that 67% of American universities now “require students to take a DEI-related class to graduate.”[2] Without serious reform, students will continue to see their tuition siphoned to push ideological conformity via mandated courses of no academic or professional value.

POLICY RECOMMENDATION

The Goldwater Institute’s Freedom from Indoctrination Act is a legislative safeguard that reaffirms the university’s role not as a factory of docile orthodoxy, but as a place where freedom of thought can flourish. While it leaves students free to take courses rooted in DEI or Critical Race Theory (CRT), it prohibits schools from requiring this as a condition of graduation. Faculty, likewise, are shielded from mandates that embed DEI-CRT content in syllabi or performance reviews—except in academic programs expressly focused on race, gender, or ethnicity. The bill carefully defines “DEI-CRT content” and outlines its boundaries, reaffirming the primacy of academic freedom and the value of open intellectual exchange.

The Act also reorients civic education by requiring students to study America’s founding principles through engagement with primary texts such as the Constitution and The Federalist Papers. It emphasizes discussion of political ideologies not as dogma, but as subjects of critical inquiry.

Finally, the bill reforms freshman orientation programs by anchoring them in classical liberal values. These sessions are intended to elevate free expression and pluralism, prioritizing instruction on the First Amendment and offering forums for genuine viewpoint diversity. DEI- or CRT-themed modules are not prohibited, but the Act leaves participation strictly voluntary.

SUCCESS STORY

Idaho became the first state government to adopt the Freedom from Indoctrination Act in 2025, and the reform has been proposed in several other states, including Texas and Iowa.

FISCAL CONSIDERATIONS

The Goldwater Institute has found that DEI course mandates in higher education cost students and taxpayers more than $2 billion over each four-year period.[3] Eliminating mandatory DEI courses and politicized orientations would ensure students and taxpayers are no longer forced to fund ideological indoctrination on campus.

VIEW MODEL LEGISLATION.

ISSUE OVERVIEW

The rise of Diversity, Equity, and Inclusion (DEI) offices at public universities has not fostered greater understanding or academic excellence. Instead, these entities function as ideological enforcers—entrenched bureaucrats who impose a rigid orthodoxy rooted in Critical Race Theory (CRT) and identity politics. Far from welcoming diversity, DEI regimes enforce conformity under the guise of inclusion.

Recent studies highlight a tragic irony in higher education: Campuses with the largest DEI staffs tend to be those where students feel least welcome. These structures, while claiming to promote inclusion, often divide students into categories of “oppressors” and “oppressed” and reward ideological conformity over academic merit. These offices are not neutral facilitators of learning. They are political actors. In a university system built to safeguard inquiry and elevate truth, enforced orthodoxy is not just misplaced—it is a corrosive contaminant. It hollows out the academic mission and wastes taxpayers’ trust and money alike.

POLICY RECOMMENDATION

A genuine commitment to academic integrity demands the abolition of DEI. Under the proposed reform, institutions of higher education would be barred from using any form of public or private funds—including tuition, donations, grants, or endowments—to support DEI offices or staff. No public university employee should be hired or disqualified on the basis of race, gender identity, sexual orientation, or any other political or ideological litmus test.

The proposal further bans the use of mandatory DEI training and prohibits diversity statements in hiring and admissions. These practices do not measure character or competence. They screen for political orthodoxy.

SUCCESS STORIES

Eight states and counting have enacted laws restricting or banning DEI programs in public higher education, targeting DEI offices, training, and hiring practices.

FISCAL CONSIDERATIONS

Beyond their ideological overreach, DEI bureaucracies are a fiscal burden. Public universities now spend millions annually on DEI administration. These are resources that could instead support legitimate instruction, research, or tuition relief. Consider that:

• In 2023 alone, Oklahoma’s public universities spent $10.2 million on DEI.
• Mississippi spent $23.4 million over four years.
• The University of Michigan funnels over $18 million annually into DEI infrastructure.

These budgets are just the tip of the iceberg.

VIEW MODEL LEGISLATION.

ISSUE OVERVIEW

Across the country, lawmakers are hearing the same concern from constituents: Parents deserve to know what their children are being taught in school. Yet in many classrooms, foundational subjects are being replaced or distorted by political narratives that cast America as irredeemably flawed and society as reducible to identity groups. Meanwhile, parents are kept in the dark. With DEI-infused lesson plans that incorporate the seriously flawed 1619 Project, K–12 instruction too often veers into activism and away from academics—without parents ever knowing.

Even when parents have attempted to find out what their children are learning, they are met with resistance. In Rhode Island, Nicole Solas asked what her daughter would learn in kindergarten. Instead of getting answers, she was handed a $74,000 public records bill for her request to be fulfilled—on top of facing a lawsuit from the teachers’ union.

Public schools are funded by taxpayers and intended to serve the public trust. But without transparency, parents are shut out of decisions that shape their children’s civic identity and understanding.

POLICY RECOMMENDATION

The Academic Transparency Act equips parents with the tools they need to make informed choices about their children’s education, without dictating curriculum or banning content. It requires every public school to publish online a list of actual instructional materials used during the academic year, giving parents visibility into what is being taught and allowing lawmakers to promote accountability without micromanaging classrooms.

STORIES OF SUCCESS

Florida has enacted a version of the Academic Transparency Act, requiring public school districts to publicly disclose the instructional materials used in their classroom libraries.

FISCAL CONSIDERATIONS

Most teachers already submit lesson plans or instructional materials to administrators. Making that information accessible to parents simply requires modest administrative coordination rather than new spending. For lawmakers looking to respect both parental rights and district autonomy, this policy strikes the right balance.

VIEW MODEL LEGISLATION.

ISSUE OVERVIEW

Patients with rare, life-threatening, or severely debilitating conditions often face a significant hurdle in their health care journey. The current FDA regulatory framework bars most from trying treatments that are scientifically promising but have yet to gain government approval. This regulatory framework was primarily designed for mass-produced drugs intended for large populations, not for a more recent phenomenon: the rapid development of personalized therapies. For many patients, especially those with rare diseases, the traditional, lengthy FDA approval process is not a viable option.

POLICY RECOMMENDATION

The Right to Try for Individualized Treatments Act aims to close this critical gap by creating a lawful pathway for eligible patients to access these individualized, investigational treatments in consultation with their doctors, after they have considered all other approved treatment options. The Act empowers patients with life-threatening or severely debilitating illnesses to make informed decisions about their healthcare, restoring the right of patients and their physicians to pursue hope when no other options remain. The law is designed to empower the most vulnerable patients to fight to save their own lives.

STORIES OF SUCCESS

Since 2022, sixteen states have adopted the Right to Try for Individualized Treatments Act including New Hampshire, Texas, Colorado, Iowa, Louisiana, Maryland, Mississippi, Arizona, Nevada, North Carolina, Arkansas, Tennessee, South Dakota, Kansas, Indiana, and Georgia. This momentum reflects a growing bipartisan consensus on the importance of patient autonomy and timely access to innovative, personalized treatments.

FISCAL CONSIDERATIONS

The law does not mandate that insurance plans, including government programs like Medicare or Medicaid, cover the cost of these treatments. While manufacturers are permitted to charge for the direct costs of production, they are prohibited from making a profit. This policy imposes no new costs on state taxpayers.

VIEW MODEL LEGISLATION.