Insurer Denials High In Medicare Advantage, Medicaid And Obamacare, Report Says

Healthcare Insurer Denials High In Medicare Advantage, Medicaid And Obamacare, Report Says By Bruce Japsen ,

Forbes contributors publish independent expert analyses and insights. Bruce Japsen writes about healthcare business and policy. Follow Author Aug 13, 2026, 11:50am EDT Aug 13, 2026, 01:17pm EDT --:-- / --:-- This voice experience is generated by AI. Learn more . This voice experience is generated by AI. Learn more . Summary A new KFF analysis reveals health insurers denied at least one in eight standard prior authorization requests last year across major government-subsidized plans, including Medicare Advantage, Medicaid, and ACA Marketplace. Denial rates ranged from 12% for Medicare Advantage to 18% for ACA plans, with significant variation among individual insurers. This report emerges as insurer business practices face intense scrutiny from patients, physicians, and regulators. While many insurers have since committed to reforms or eliminated prior authorization, the analysis also revealed that a substantial portion of denials, between 43% and 67%, are overturned when appealed, despite appeals being rare. This underscores persistent concerns regarding access to necessary medical treatments.