Twenty-one percent of privately insured U.S. working-age adults had coverage denied for themselves or a family member over the span of one year.
The Commonwealth Fund 2025 Affordability Survey, published June 4 and administered by research firm SSRS, heard from 6,353 adults between 19 and 64 years old. More than 70% of them had private coverage, and they served as the basis of the Commonwealth Fund’s analysis. The researchers also ran focus groups.
Here are six other findings to know from the survey:
1. That 21% stemmed from 13% of surveyed adults reporting prior authorization denials, 8% reporting claim denials and 1% reporting both.
2. Forty-one percent of people who faced a prior authorization denial said it prompted a delay in medical care, while 28% said a health problem worsened as a result.
3. Sixty-three percent of those with a prior authorization denial found that added worry and anxiety.
4. Almost 70% of those who received a claim denial said it cost their household more money.
5. About half of those who received a claim denial appealed, but insurers still rejected one-third of the appeals. The wait time for appealed claims was at least one month for more than 60% of people who had tried and received an answer.
6. Nearly 90% of people with a coverage denial blamed their insurance company.
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