Insurers Vowed To Fix Prior Authorization. One Patient Paid the Price

Margaret Hvatum, a retired community college instructor in Missouri, relies on immunoglobulin infusions to bolster a weakened immune system. When her Medicare Advantage plan from Humana got tangled in the preapproval process, her treatment stalled and she landed in the hospital, KFF Health News reports.

The case is striking because it followed high-profile promises. In June, dozens of insurers, including Humana, UnitedHealthcare, Cigna, Aetna, and Elevance, pledged through trade group AHIP to reduce the volume of services requiring prior authorization, honor existing approvals during plan transitions, and speed electronic decisions by 2026 and 2027. Those commitments are voluntary and largely unenforceable.

For patients, the gap between pledge and practice is the whole story. Prior authorization remains a leading source of care delays, and the burden falls hardest on people managing chronic and rare conditions who depend on costly, ongoing drugs. Regulators and lawmakers are watching whether insurers deliver, or whether binding rules become necessary.