06/06/2026
https://www.commonwealthfund.org/publications/surveys/2026/jun/how-health-insurance-coverage-denials-affect-americans-2025-affordability-survey
“One in five privately insured adults in the United States say they or a family member have been denied coverage for doctor-recommended medical care in the past year, according to a new Commonwealth Fund survey.
“The survey examines two types of denials: prior authorization denials, which occur before care is received, and claim denials, which occur after care has already been provided. The survey found that:
“More than one-quarter of people who experienced a prior authorization denial said their health problem worsened as a result.
“More than 40 percent of people with a claim denial said it led to medical debt that they are still paying off.
“Only about half of people who were denied coverage chose to appeal, even though many who challenge denials ultimately obtain coverage or have their bills reduced.”
The 2025 Commonwealth Fund Health Care Affordability Survey finds that for many Americans, having health insurance is no guarantee their care will be covered.