Goodsurance

Medicare Advantage

Seven in Ten Insured Adults Call Prior Authorization Their Biggest Health Care Obstacle, KFF Poll Finds

A January 2026 national survey found prior authorization requirements ranked above billing confusion, appointment wait times, and network access as the top health care burden, with the pressure especially high among people managing chronic conditions.

By the Goodsurance editorial teamAugust 4, 2026

Prior authorization, the insurer approval step required before certain tests, procedures, or prescriptions can be filled, has become the most widely cited source of frustration in American health care, according to a KFF Health Tracking Poll conducted in January 2026 among 1,426 insured adults.

Nearly seven in ten respondents (69 percent) described prior authorization as a burden. When asked to name their single biggest obstacle to getting care, 34 percent chose prior authorization requirements, placing the issue ahead of understanding medical bills (23 percent), getting timely appointments (20 percent), and finding providers who accept their insurance (17 percent).

Prior authorization tops billing confusion, appointment wait times, and network limits as the biggest obstacle insured adults face when seeking care, a KFF poll finds.

For people managing chronic conditions, a group that makes up roughly half of all insured adults, the share citing prior authorization as their top barrier rises to 39 percent, about twice the share who pointed to any other obstacle.

The findings carry particular weight for Medicare because beneficiaries tend to be older and carry higher rates of chronic illness. Prior authorization is also more common in Medicare Advantage than in Original Medicare. Medicare Advantage insurers made roughly 53 million prior authorization determinations in 2024, and about 7.7 percent were denied. Most denials were reversed when enrollees appealed, but each appeal adds time and effort for patients and their care teams.

Congress is weighing legislation that would require Medicare Advantage plans to answer standard prior authorization requests within 72 hours and urgent requests within 24 hours, and to limit which types of care can be subject to the requirement. The poll results link the policy debate directly to the patient experience.

In plain words

Before an insurance plan pays for certain tests or drugs, a doctor sometimes must ask the plan for permission first. This process is called prior authorization. A January 2026 survey of about 1,400 insured adults found that more people name this as their biggest health care problem than any other issue. Seven in ten called it a burden. Among people with long-lasting health conditions, nearly four in ten said it was their single biggest barrier to getting care. In Medicare Advantage plans, this approval step is used more often than in regular Medicare. Congress is working on bills that would require plans to respond faster and limit when they can require the approval step.

Understand the basics first

Source: KFF
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