Prior Authorization: Top Healthcare Burden for Insured Americans – KFF Poll

Prior Authorization: Top Healthcare Burden for Insured Americans – KFF Poll

February 2, 2026 discoverhiddenusacom Health

Navigating the American healthcare system can be challenging even for those with insurance. Recent polling data reveals that prior authorization requirements are a significant source of frustration for insured adults, surpassing concerns about understanding medical bills, scheduling appointments and finding in-network providers.

The Burden of Prior Authorization

A new poll indicates that 32% of insured Americans consider prior authorization a “major burden” when accessing healthcare. This is a higher percentage than those who cite difficulty understanding their bills (23%), getting timely appointments (20%), or locating doctors who accept their insurance (17%).

Chronic Conditions Amplify the Problem

The burden of prior authorization is particularly acute for individuals managing chronic health conditions. Nearly 4 in 10 (39%) of insured adults with ongoing medical needs identify prior authorization as their “single biggest burden” when seeking care – more than double the share who point to other obstacles. Approximately half of all insured adults have a chronic condition.

Did You Know? The survey, conducted between January 13-20, 2026, included responses from 1,426 U.S. Adults, both online and by telephone, in English and Spanish.

Prior authorization isn’t just a hassle; it can directly impact access to care. The poll found that 47% of insured adults – and 57% of those with chronic conditions – have experienced denials, delays, or alterations to their healthcare services, treatments, or medications due to insurance requirements in the past two years.

Impact on Well-being

These denials and delays aren’t without consequence. Roughly a third of those affected reported a “major negative impact” on their mental health and emotional well-being (34%) and finances (33%). A quarter experienced a significant negative impact on their physical health (26%). This translates to approximately 1 in 5 insured adults reporting major impacts to their health or finances.

Expert Insight: The complexity of insurance processes, as highlighted by these findings, underscores the challenges patients face in simply accessing the care their doctors recommend. This complexity can be particularly damaging for those already dealing with the stress of managing a chronic illness.

The challenges associated with prior authorization appear consistent across different types of insurance coverage. It ranks as the single biggest burden for individuals with employer-sponsored plans, Medicaid, and those who purchased coverage through the Affordable Care Act’s marketplaces.

Frequently Asked Questions

What is prior authorization?

Prior authorization is a process where health insurers require doctors to obtain approval before certain tests, treatments, or medications are covered.

Who is most affected by prior authorization requirements?

Individuals with chronic conditions requiring ongoing medical treatment are disproportionately affected, with 39% identifying it as their single biggest burden.

What are the potential consequences of prior authorization delays or denials?

Delays or denials can have a major negative impact on a patient’s mental health, emotional well-being, physical health, and finances, affecting as many as 1 in 5 insured adults.

As health insurance policies and regulations evolve, it’s possible that policymakers may consider changes to prior authorization processes. These could include streamlining the process, reducing the number of services requiring prior authorization, or increasing transparency regarding denial rates. However, any such changes would require careful consideration of potential trade-offs and impacts on healthcare costs.

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