The Trump administration has promised to reduce the burden of prior authorizations, but experts say there is no easy solution. Prior authorizations, where insurers must approve certain medical services before they are performed, have become a major bottleneck in the U.S. healthcare system. They delay care and frustrate both patients and providers.
Health and Human Services Secretary Robert F. Kennedy Jr. announced that several large insurers have pledged to overhaul the system and reduce delays.
However, some experts are cautious about whether these promises will come to fruition. “We’ll have to see to what extent they make good on their promise, because right now, it is a pledge,” said Miranda Yaver, a health policy professor at the University of Pittsburgh.
Officials seek to streamline authorizations
Prior authorization has long been unpopular, and despite years of promises from insurers, little has changed. At a recent press event, Kennedy and Centers for Medicare & Medicaid Services administrator Dr. Mehmet Oz acknowledged that this is not the first time insurers have promised to streamline the process.
The recent killing of former UnitedHealthcare CEO Brian Thompson, allegedly by a man who struggled with insurance denials and medical debt, has sparked widespread outrage and may be a catalyst for change. Federal health officials say the prior authorization process should become faster, clearer, and less frustrating by the end of the year. The proposed changes include moving the process online, reducing the number of services requiring prior approval, making approvals portable, boosting transparency, fast-tracking routine care, and requiring licensed medical professionals to review all clinical denials.
However, officials acknowledge that this will not be a simple fix, and whether these reforms lead to meaningful relief remains to be seen. The commitments from insurers are voluntary, and there is no accountability mechanism in place. While the proposed changes could help reduce administrative delays and simplify care for many Americans, it is unclear whether they will be fully adopted and lead to significant improvements in the prior authorization process.
