In American health care, the first opinion that matters often isnt the doctors, its the insurers. That may be changing.
At a press conference in Washington on Monday, Health and Human Services Secretary Robert F. Kennedy Jr. and Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz announced a new voluntary agreement among major health insurers to overhaul the prior authorization process, an often criticized practice requiring provider approval for certain medical treatments and medications.
Together, Kennedy and Oz outlined what they described as a “first and very important step” toward administrative simplification in American health care. “This is a blueprint for the industry,” Kennedy said. “We have standards this time. We have deliverables.”
The pledge, signed by insurers representing 75% of covered Americans, aims to streamline approval timelines, reduce red tape, and enhance transparency. It stops short of regulation but comes with a warning. “This is not a mandate,” Oz said, “but we are prepared to issue regulations if necessary,” providing both a carrot and a stick to insurers.
“Transparency comes with accountability” stressed Kennedy and Oz.”Well track real world performance to ensure that what’s been promised is actually being done,” Oz explained. Through these reforms, patients will have access to common data standards and public dashboards to see whether companies are following through on their promises.
Oz and Kennedy emphasized the inefficiencies of the current system. Oz noted that up to 3.2 million claims were partially or fully denied last year and that health care professionals spend an average of 12 hours per week on prior authorization paperwork. “Thats time not spent with patients,” Oz said, adding that the current structure is “filled with bureaucratic hurdles” that delay necessary care.
Kennedy shared survey data that 85% of Americans say theyve experienced care delays because of prior authorization. He told the story of a New Jersey man with heart failure who couldnt get timely approval for treatment. “Health care is too often delayed,” Kennedy said. “This is about putting patients over paperwork.”
When asked by RCP what specific metric would be used to ensure that insurers met their promises, Chris Klomp, administrator of Medicaid for CMS, said that the administration had set a January 2027 target for at least 80% of all preauthorization requirements to be adjudicated in real time at the point of care. This will allow doctors to provide treatment in the moment without waiting for insurers to review claims.
Currently, the rate of same day adjudication is in the “low single digits” according to Klomp. Furthermore, “more than 50% of all prior authorizations are still paper based using phones and faxes.” The administration hopes to move this process online, saving time for doctors, allowing patients to receive care sooner, and lowering administrative costs.
The event also included emotional testimony from Eric Dane, a longtime actor and patient living with ALS. “The worst thing we can do is add more uncertainty for patients and their loved ones with prior authorization,” Dane said.
Lawmakers present echoed the sentiment. Kansas Sen. Roger Marshall called prior authorization the “#1 bureaucratic nightmare,” saying it often puts “corporate profits over patients health.” North Carolina Rep. Greg Murphy, a practicing physician, called for more peer-to-peer interaction between providers and insurers. “Get out of the space between the doctor and the patient,” said Rep. Greg Murphy. “This is a day too long in coming. Were going to hold [insurers] to the fire.”
Insurers have committed to expanding real-time responses, streamlining and digitizing the system, and significantly reducing the number of procedures that require prior authorization. If successful, proponents say the reforms could save “tens of billions” in administrative costs while reducing patient wait times and improving care.
Oz mentioned further ideas for streamlining the authorization process such as issuing “gold cards” to doctors with strong track records that allow them to issue treatment without pre-approval, further lowering administrative costs. While this reform is not yet being implemented, it is being explored by the Trump administration and insurance companies.
Secretary Kennedy also thanked President Trump for his leadership in reforming the health care system, and for other dedicated politicians such as Rep. Murphy who have been tireless advocates for reform. “This is everyone getting together on a pain point … a thorn in everyones side,” Administrator Oz added.
“Make this system functional … rationalize it,” Secretary Kennedy emphasized. “Make it work to make our country healthy again.”
Madelynn McLaughlin is an intern at RealClearPolitics. She graduated from Liberty University in 2025 with a degree in Government: Politics and Policy.
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Adair Teuton is a 2025 intern with RealClearPolitics.
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James Eustis is an intern at RealClearPolitics. He studies politics at Washington & Lee University.
