Insurers’ Delays in Approving Medical Care Persist, Despite Promises

Why It Matters

Persistent prior‑authorization bottlenecks increase costs for providers and delay critical care, threatening patient outcomes and fueling regulatory scrutiny.

Key Takeaways

• Prior authorization delays persist despite insurers' 2025 pledge.
• 33% of insured adults label it a major burden.
• Patients face weeks-long waits for essential medication refills.
• Insurers promised 90‑day continuity, yet approvals remain slow.
• Industry trade groups pledged faster reviews, but evidence lacking.

Pulse Analysis

The practice of prior authorization—requiring insurers to sign off before a doctor can prescribe a drug or order a test—has become a flashpoint in U.S. health care. In June 2025, the nation’s two largest insurance trade groups announced a voluntary overhaul, pledging to cut the number of services needing pre‑approval and to guarantee patients could stay on the same therapy for at least 90 days after a plan switch. The promise was framed as a response to mounting administrative costs and growing political pressure to streamline care.

One year later, frontline experiences tell a different story. A recent KFF poll found that 70% of insured adults consider prior authorization at least somewhat burdensome, and a full third label it a major obstacle to timely treatment. Stories like Candace Rond’s—who waited weeks for a refill of her daughter’s autoimmune medication—illustrate how delays translate into missed school days, deteriorating health, and added emotional strain. Physicians report increased chart‑review time, diverting resources from direct patient care and inflating practice overhead.

The gap between industry promises and reality is prompting renewed calls for legislative action and digital innovation. Lawmakers are drafting bipartisan bills that would set maximum review windows and require transparent denial reasons, while health‑tech firms are deploying AI‑driven prior‑auth platforms to automate data entry and accelerate decision cycles. If insurers adopt these tools and honor their 90‑day continuity pledge, the market could see reduced administrative spend and improved patient satisfaction, but without enforcement the status quo is likely to persist.