The trend: Over half of US adults with health insurance (51%) said they needed a prior authorization for a medical service or treatment in the past two years, according to a July 2025 KFF study. For context, prior authorization is a cost-control tactic used by insurers to determine whether they’ll pay for a prescribed medication or service.

Why it matters: Prior authorizations can lead to delayed—or even denied—care.

• Physicians and their staff spend 13 hours per week completing prior authorizations, per a February 2025 study from the AMA. That’s because insurers typically ask doctors for specific clinical information to determine if the service or treatment is medically necessary to pay for.
• Nearly one-quarter (24%) of people with insurance report that a prior authorization delayed their ability to get service or treatment that their doctor requested.
• 22% with health insurance said a prior authorization led to an outright denial of coverage.