Patients cite prior authorization as top healthcare burden, KFF finds
In a new poll from KFF, patients reported that navigating the U.S. healthcare system is burdensome, but the biggest headache of all is prior authorization.
According to the latest Healthcare Tracking report from the nonprofit, surveys conducted in January 2026 found that 70% of insured adults feel prior authorizations are to some degree a burden, with 32% of all those surveyed ranking the approval process as a “major” hurdle.
Less than one-third (31%) responded saying that prior authorization, including “having to get insurance approval before you can get certain tests, treatments or medications” was “not a burden,” meaning the process was not seen as particularly difficult.
Regardless, of the issues patients struggle with, prior authorization was named more often than any other single source of vexation. By comparison, 23% of respondents said understanding their medical bills is a major burden, and 20% listed finding an appointment when you need it as an equal hassle.
Rounding out the bottom was finding a provider who accepts your insurance, something only 17% of those surveyed ranked as a major burden—though overall, 53% measured the issue as cumbersome on some level.
Zooming out, a sense of anxiety and strain over the American healthcare system was something most respondents shared. None of the four categories saw “not a burden” rated any higher than 47%, signaling a general dissatisfaction with the administrative aspects of patient care.
“The complexity of the health system drives patients crazy, can have real consequences, and disproportionately affects people who are sick,” KFF President and CEO Drew Altman said in a statement. “Prior authorization review is the poster child for that complexity.”
Chronically ill, consistently burdened
Of respondents, those dealing with chronic conditions were asked to rank their single biggest pain point when it comes to getting healthcare. Once again, prior authorizations topped the list, with 39% ranking it as their No. 1 burden.
That’s a 5% rise when compared to the full cohort of respondents.
Second on the list was getting appointments when you need them, which 19% of those with chronic conditions said was the single biggest burden, followed by understanding your bill (15%). Rounding out the bottom was finding a provider who accepts your insurance, with only 14% rating that as their primary concern.
Notably, 14% of those with chronic conditions rated "none" of the four categories as their single biggest burden, as did 15% of all respondents. Meaning, something else about the U.S. healthcare system is deemed a bigger hassle, but there is no elaboration on what that could be.
Delayed, denied and altered
KFF added that nearly half of all insured adults (47%)—and an even larger 57% of those with chronic conditions—said they’ve experienced an incident where patient care or medications have been “denied, delayed or altered” in the past two years as a result of their payer plan.
“Among those who report such denials, delays, or alterations, about a third say it had a ‘major negative impact’ on their mental health and emotional well-being (34%) and finances (33%), and a quarter say it had a “major negative impact” on their physical health (26%),” KFF wrote.
“This translates to about 1 in 5 of all adults with insurance saying that their mental or physical health, or finances, have been majorly impacted,” the group added.
Results of the Healthcare Tracking Poll are based on a survey of 1,426 people, conducted Jan. 13 to 20.
Chad is an award-winning writer and editor with over 15 years of experience working in media. He has a decade-long professional background in healthcare, working as a writer and in public relations.