Prior Authorization Ranked Top Barrier to Health Care Access After Cost

The findings underscore growing public frustration with insurance-driven obstacles.

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While the cost of health care remains the dominant worry among Americans, the process of obtaining prior authorization from insurers has become the most burdensome noncost barrier for insured adults trying to access care, according to a new KFF Health Tracking Poll released today.1 The findings underscore growing public frustration with insurance-driven obstacles that can delay, alter, or even block necessary medical services, treatments, and medications.

Prior authorizations are requirements set by health plans that patients or their providers must secure approval from an insurer before certain procedures, tests, drugs, or treatments are covered. Though intended to control costs and ensure appropriate use of care, the process has been widely criticized, the report noted, by patients and clinicians for adding complexity and delaying access to needed services.

High Burden and Broad Impact

About 7 in 10 insured adults (69%) describe prior authorization requirements as either a major or minor burden when getting health care, according to the poll results. Roughly 1 in 3 (34%) identify prior authorizations as the single biggest noncost barrier they face—outpacing other common challenges such as understanding medical bills (17%), finding in-network providers (15%), and securing timely appointments (19%).

The poll was conducted January 13-20, 2026, among a nationally representative sample of 1426 US adults via online and telephone interviews in English and Spanish.

Among adults with chronic conditions, who typically require frequent and ongoing care, the burden is even more pronounced. Nearly 4 in 10 (39%) of this group cite prior authorizations as their top obstacle, more than twice the share citing other issues.

The poll also finds that prior authorization ranks as the biggest challenge across different insurance types and political affiliations, including those with Medicaid, employer coverage, and individual market plans, suggesting widespread frustration that transcends demographic and partisan lines.

Delays, Denials, and Health Consequences

The analysis highlights that the prior authorization process often results not just in paperwork hassles but also in delays or denials of care. Roughly two-thirds of adults describe delays and denials by health insurance companies as a major problem, while an additional 24% see them as a minor problem. Only about 1 in 10 say these issues are not a problem in the current health system.

In the past 2 years, nearly half (47%) of insured adults report having a health service, treatment, or medication either delayed or denied by their insurer. That share climbs to 57% among those with chronic conditions.

The impacts extend beyond administrative annoyance, KFF emphasized. Among those who experienced denial or delay, about 1 in 3 say the insurer’s action had a major negative effect on their mental health and emotional well-being and on their finances. One in 4 reports a major negative impact on their physical health.

Expert and Policy Context

The KFF findings add to a growing body of evidence documenting widespread dissatisfaction with prior authorizations. Health providers, including physicians surveyed by the American Medical Association, have previously noted the process can delay care and contribute to burnout.

A commentary published in The American Journal of Managed Care® stated that “something has to give” in US health insurance and that “as cash-only practices continue to grow in popularity and number, if insurance companies aren’t careful, in the not too distant future, they could find themselves on the outside looking in.”2

“Social media platforms including TikTok are full of physicians and patients telling their stories of how vital medical interventions for conditions such as diabetes or cancer were delayed for weeks or months by their insurance providers through [prior authorizations],” they wrote. “As insurance premiums and deductibles rise each year, it feels as if the insurance companies are paying for less, leaving patients to pay more out of pocket or to forgo treatment altogether. This feels especially sinister when these health insurance companies made more than $41 billion in profit in 2022 and have made more than $371 billion in profit since the Affordable Care Act was passed. Consumers don’t appreciate paying high out-of-pocket costs for things like health insurance while feeling like they get nothing of value in return.”

The issue has also drawn attention at the policy level. The KFF analysis highlighted that insurers in Medicare Advantage plans processed nearly 53 million prior authorization decisions in 2024, illustrating the sheer volume of these requirements in practice.1

Advocates for patients and providers have called for reforms to streamline and standardize the prior authorization process to reduce administrative burdens, expedite care, and limit unnecessary delays. These new results underscore the urgency of those calls by showing that the public increasingly views prior authorization as a significant access barrier after costs.

References

1. Kirzinger A, Montalvo III J, Hamel L. KFF Health Tracking Poll: Prior Authorizations Rank as Public’s Biggest Burden When Getting Health Care. Kaiser Family Foundation. Published February 2, 2026. Accessed February 2, 2026. https://www.kff.org/public-opinion/kff-health-tracking-poll-prior-authorizations-rank-as-publics-biggest-burden-when-getting-health-care/
2. Pickern J. Prior authorizations and the adverse impact on continuity of care. Am J Manag Care. 2025;31(5):163-165. doi:10.37765/ajmc.2025.89721