Prior Authorization Is Source of Greatest Patient Burdens in the Health System, Poll Finds

Getting through prior authorization (PA) creates more headaches for patients navigating the health care system than finding a doctor, scheduling an appointment, or even paying for care, according to a recent KFF Health Tracking Poll.^1,2

Polls and studies of physicians have repeatedly cited PA as a drain on practices and a source of individual burnout. Studies have also documented PA as a cause of patient harms, such as blocking access to less toxic drugs or delaying access when patients have advancing disease, a particular cause of concern during cancer treatment.^3-6

The poll of US adults with insurance, published February 2, 2026, asked participants directly to compare PA with other potential sources of friction in the health system that could lead to delays or denials of care. KFF found that people cited PA over burdens by a wide margin, with 32% calling requirements a “major burden,” and 37% calling it a “minor burden,” with the rest stating it was not a burden (See Figure). Other choices included the following:

Understanding your bill or what you owe: 23% called this a “major burden,” with 37% finding it a “minor burden.”

Getting appointments when you need them: 20% said this was a “major burden” and 40% a “minor burden.”

Finding providers who take your insurance: 17% said this was a “major burden,” with 36% reporting this was a “minor burden.”

However, when asked which of these 4 factors is “the single greatest burden” before accessing tests, treatments, or medications, 34% ranked PA first. Among those with a chronic condition, 39% say PA is the single greatest burden—more than twice the percentage who say it ranks the same as other barriers.

Nearly half (47%) of insured adults, and more with chronic conditions (57%), reported that their health insurer denied, delayed, or altered access to a specific health care service, treatment, or medication in the past 2 years.

According to the results, PA was cited as the single biggest burden for those with employer coverage and Medicaid, as well as those who buy their own coverage, typically through the Affordable Care Act Marketplaces.

In a statement accompanying the results, KFF President and CEO Drew Altman, PhD, said: “The complexity of the health system drives patients crazy, can have real consequences, and disproportionately affects people who are sick. Prior authorization review is the poster child for that complexity.”¹

In June 2025, Trump administration officials, including US Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr, and CMS Administrator Mehmet Oz, MD, MBA, announced a voluntary pledge by several insurance industry leaders to reduce the burden of PA.⁷ These included steps to standardize electronic PA submissions, reduce the volume of services subject to PA by January of this year, improve transparency surrounding the process, and honor existing PA agreements during transitions of care.

In January, America’s Health Insurance Plans (AHIP) announced that 2026 “will bring progress” on this issue.⁸ At press time, a progress report had not materialized. Meanwhile, a January 2026 report from KFF showed that PA determinations in Medicare for 2024 increased over 2023.⁹

The KFF poll was taken January 13 to 20, 2026, online and by telephone among a nationally representative sample of 1426 US adults, both in English (1355 participants) and Spanish (71 participants). The sample included 1028 adults (60 in Spanish) reached through the SSRS Opinion Panel either online (1003) or over the phone (25). The margin of sampling error is plus or minus 3 percentage points.²

References
1. Poll: people view prior authorization as greatest burden in navigating the health system. News release. KFF. February 2, 2026. Accessed March 15, 2026. https://www.kff.org/public-opinion/poll-people-view-prior-authorization-as-greatest-burden-in-navigating-the-health-system/
2. Kirzinger A, Montalvo J, Hamel L. KFF Health Tracking Poll: Prior authorizations rank as public’s biggest burden when getting health care. KFF. February 2, 2026. Accessed March 15, 2026. https://www.kff.org/public-opinion/kff-health-tracking-poll-prior-authorizations-rank-as-publics-biggest-burden-when-getting-health-care/
3. Kyle MA, Keating NL. Prior authorization and association with delayed or discontinued prescription fills. J Clin Oncol. 2024;42(8):951-960. doi:10.1200/JCO.23.01693
4. Wallace ZS, Harkness T, Fu X, Stone JH, Choi HK, Walensky RP. Treatment delays associated with prior authorization for infusible medications: a cohort study. Arthritis Care Res (Hoboken). 2020;72(11):1543-1549. doi:10.1002/acr.24062
5. Trapani D, Kraemer L, Rugo HS, Lin NU. Impact of prior authorization on patient access to cancer care. Am Soc Clin Oncol Educ Book. 2023;43:e100036. doi:10.1200/EDBK_100036
6. Smith AJB, Apple A, Hugo A, Haggerty A, Ko EM. Prior authorization for FDA-approved PARP inhibitors in ovarian cancer. Gynecol Oncol Rep. 2024;52:101335. doi:10.1016/j.gore.2024.101335
7. HHS Secretary Kennedy, CMS Administrator Oz secure industry pledge to fix broken prior authorization system. News release. HHS. June 23, 2025. Accessed March 18, 2026. https://www.hhs.gov/press-room/kennedy-oz-cms-secure-healthcare-industry-pledge-to-fix-prior-authorization-system.html
8. 2026 will bring progress on simplifying prior authorization. News release. AHIP. January 7, 2026. Accessed March 17, 2026. https://www.ahip.org/news/articles/2026-will-bring-progress-on-simplifying-prior-authorization
9. Medicare Advantage insurers made nearly $53 million in prior authorization determinations in 2024. KFF. January 28, 2026. Accessed March 18, 2026. https://www.kff.org/medicare/medicare-advantage-insurers-made-nearly-53-million-prior-authorization-determinations-in-2024/