Insurers ease up on prior authorization

Summary

Marketplace Morning Report Podcast Summary

Episode Title: Insurers ease up on prior authorization
Release Date: May 6, 2026
Host: Sabri Ben Assure
Reporters & Guests: Samantha Fields, Amy Killalay (Georgetown University Center on Health Insurance Reforms), Kay Pastena (KFF), Javad Salehi Isfahani (Virginia Tech)

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Episode Overview

This episode addresses two major news items:

• Health insurance changes: A significant shift in insurer practices regarding prior authorization, a major administrative requirement for doctors and patients seeking approval before certain medical services.
• Iran’s economic situation: Context on ongoing US-Iran nuclear negotiations and an in-depth look at Iran’s war-impacted economy with economist Javad Salehi Isfahani.

The episode presents these stories with brisk reporting and expert commentary, keeping listeners informed about both national health policy changes and international economic issues.

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Key Discussion Points & Insights

1. Insurers Easing Prior Authorization Demands

Reporter: Sabri Ben Assure, Samantha Fields
Experts: Amy Killalay (Georgetown University), Kay Pastena (KFF)

• Background: UnitedHealthcare, the nation's largest health insurer, announced a 30% reduction in requirements for prior authorization—a process that requires patients to obtain insurer approval before receiving certain medical care. Other insurers are following suit.
  • “Prior authorization is where your doctor orders a medical procedure or a test or a drug, but you can't get it until your insurance company approves it.” (Sabri Ben Assure, 00:54)
• Context & Frustrations:
  • Patients with chronic conditions, such as diabetes, are frequently required to go through prior authorization for devices like continuous glucose monitors, insulin pumps, and durable medical equipment.
    • “Continuous glucose monitors are often, if not predominantly covered with prior authorization attached to them.” (Amy Killalay, 01:52)
  • This extends to a range of services and medications, causing delays and administrative headaches for patients and providers.
    • “After cost, they say that prior authorization is the biggest administrative hassle they have.” (Kay Pastena, 02:19)
• Growing Pressure for Change:
  • As costs rise and more people sign up for insurance, frustration with prior authorization is spreading beyond chronic patients.
    • “It's also increasingly an issue even for people who don't have a chronic illness.” (Samantha Fields, 02:25)
  • The increased burden and outcry are prompting insurers to scale back the practice.
    • “It's coming at a time where costs are going up, people are signing up for coverage and then realizing that that’s something that they need.” (Kay Pastena, 02:33)
• Notable Policy Shifts:
  • UnitedHealthcare will no longer require prior authorization for certain outpatient surgeries and therapies, including some diagnostic tests (like echocardiograms) and chiropractic care.
    • “UnitedHealthcare says it will no longer require prior authorization for certain outpatient surgeries and therapies, such as some diagnostic tests like echocardiograms and chiropractic care.” (Samantha Fields, 02:43)
• Importance: Easing prior authorization could improve healthcare access and reduce administrative bottlenecks for millions of patients and providers.

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2. Iran’s Economy Under Pressure Amid US Negotiations

Host: Sabri Ben Assure
Guest: Javad Salehi Isfahani (Virginia Tech)

• Breaking News: The US and Iran are reportedly discussing a deal involving a moratorium on nuclear enrichment and an end to sanctions. (Sabri Ben Assure, 04:08)
• Current State of Iran’s Economy:
  • Iran is described as an economy “at war,” suffering severe destruction of property and factories due to strikes and ongoing conflict.
    • “There has been considerable destruction of property and factories. Prices are rising very fast because supplies are limited. Inflation last month was over 100%.” (Javad Salehi Isfahani, 04:44)
  • Huge inflation and shortages mean “nobody is making any plans about the future.”
    • “I think the most important characteristic of the economy is that it is waiting for something to happen.” (Javad Salehi Isfahani, 05:05)
• Impact of Blockades and Sanctions:
  • The closure of maritime routes isn’t the most critical problem; Iran can get food via land if it can afford to pay. However, industrial infrastructure damage has downstream effects, causing cascading job losses.
    • “Jobs are being lost at the rate of maybe 100,000 a month. Those are the people that are in huge stress because they're not able to live without the wage and salary and have to depend on cash transfers...” (Javad Salehi Isfahani, 06:12)
• Government Aid and Economic Resilience:
  • Iran is providing cash transfers to citizens, but the sustainability relies on access to foreign currency, potential credit from allies, and there may be support from Russia and China.
    • “The main constraint is cash, because once the food supplies, the inventories run down, they have to buy new supplies... It's possible that they can buy stuff on credit, especially if the Russians are willing to lend them. Chinese may be able to. In fact, they may be interested in helping Iran survive this.” (Javad Salehi Isfahani, 06:47)
  • Salehi Isfahani pushes back against narratives predicting immediate economic collapse.
    • “On the Iran side, it isn't as deterministic as people imagine sometimes that they are doing so badly that in a couple of months this spirals. I don't see that.” (Javad Salehi Isfahani, 07:14)
• Closing: For a deeper dive, listeners are directed to marketplace.org for the extended interview.

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Notable Quotes & Memorable Moments

• “Prior authorization is where your doctor orders a medical procedure or a test or a drug, but you can't get it until your insurance company approves it.”
  – Sabri Ben Assure, 00:54

• “Continuous glucose monitors are often, if not predominantly covered with prior authorization attached to them.”
  – Amy Killalay (Georgetown University), 01:52

• “After cost, they say that prior authorization is the biggest administrative hassle they have.”
  – Kay Pastena (KFF), 02:19

• “There has been considerable destruction of property and factories. Prices are rising very fast because supplies are limited. Inflation last month was over 100%.”
  – Javad Salehi Isfahani, 04:44

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Timestamps for Key Segments

• 00:54 – 03:14: Insurers pull back on prior authorization (policy change details, expert commentary)
• 04:08 – 07:47: Iran’s economy under wartime pressure (blockade, inflation, supply routes, government response)
• 07:47: Directions to hear the full Iran interview at marketplace.org

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Tone and Language

The episode maintains Marketplace’s hallmark direct and informative reporting style. Insights are concise, clear, and stay focused on key economic and policy implications, making the episode ideal for listeners who want to quickly get up to speed on complex issues impacting business and society.

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This summary distills the major news and analysis points of the episode, providing valuable context for listeners seeking to understand recent healthcare administrative reforms and the economic situation in Iran, without the time investment of listening to the original broadcast.

Transcript

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[Sabri Ben Assure]

insurers are easing up on prior authorization From Marketplace, I'm Sabri Ben Assure in New York. UnitedHealthcare, the nation's biggest insurer, announced that it's cutting back on its requirements for prior authorization by 30%. Prior authorization is where your doctor orders a medical procedure or a test or a drug, but you can't get it until your insurance company approves it. From the insurer's perspective, it's a way to cut costs and prevent people from getting expensive or unnecessary care. For doctors and patients, it has been a source of massive frustration. UnitedHealth isn't the only one to cut back on the requirement, though, and other insurers have been doing this in the past year as well. Marketplace's Samantha Fields has more if you

[Samantha Fields]

have a chronic health condition, you're probably quite familiar with prior authorization. Amy Killalay at Georgetown's center on Health Insurance Reforms has done a lot of research on coverage for diabetes, and I

[Amy Killalay / Kay Pastena (Health Experts)]

will say continuous glucose monitors are often, if not predominantly covered with prior authorization attached to them.

[Samantha Fields]

Lots of other durable medical equipment prescribed by a doctor often requires insurer approval, too, like insulin pumps and wheelchairs. So do certain surgeries, imaging tests like MRIs, and many prescription drugs and therapies. Kay Pastena at the health policy nonprofit KFF says in polling people with chronic

[Amy Killalay / Kay Pastena (Health Experts)]

illnesses after cost, they say that prior authorization is the biggest administrative hassle they have.

[Samantha Fields]

It's also increasingly an issue even for people who don't have a chronic illness. Pestena says that's likely why there's growing pressure for something to change.

[Amy Killalay / Kay Pastena (Health Experts)]

It's coming at a time where costs are going up, people are signing up for coverage and then realizing that that's something that they need.

[Freedom From Religion Foundation Sponsor]

The care they need is not being covered soon.

[Samantha Fields]

UnitedHealthcare says it will no longer require prior authorization for certain outpatient surgeries and therapies, such as some diagnostic tests like echocardiograms and chiropractic care. I'm Samantha Fields for Marketplace.

[Freedom From Religion Foundation Sponsor]

This Marketplace podcast is supported by the Freedom From Religion Foundation. America is an idea, but progress isn't guaranteed. Those founding principles are being challenged by efforts to mix religion and government. The Freedom From Religion foundation is working to protect the Constitution and keep power where it belongs with we the people. Visit FFRF US America or text America to 511-511-text America to 511-511 and keep state and church separate. Text fees may apply.

[Marketplace Announcer]

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[Sabri Ben Assure]

as we mentioned, the US and Iran are reportedly back to negotiating and are close to a deal. Axios is reporting the deal would involve a moratorium on nuclear enrichment and an end to sanctions. To CNBC is reporting Iran's currently considering the proposal. Meanwhile, inside of Iran, the economy is suffering with more than a million people out of work, food prices spiking, businesses closing, all while the US Naval blockade is shrinking Iranian oil exports. For more, we're joined by Javad Salehi Isfahani. He's professor of economics at Virginia Tech. Good morning.

[Javad Salehi Isfahani]

Good morning.

[Sabri Ben Assure]

What is Iran's economy like right now?

[Javad Salehi Isfahani]

Well, it's very much an economy at war. There has been considerable destruction of property and factories. Prices are rising very fast because supplies are limited. Inflation last month was over 100%. So nobody is making any plans about the future because of this waiting nature. I think the most important characteristic of the economy is that it is waiting for something to happen.

[Sabri Ben Assure]

How much of this uncertainty that you are describing, how much of it is the actual bombardment of infrastructure? How much of it is the closure of the strait?

[Javad Salehi Isfahani]

Well, the closure of the strait isn't all that important at this time because I think the critical supplies those of food. And Iran has other ways of getting food. The land routes has, you know, half a dozen countries border it that can supply Iran with food if it has money. So I don't know how much foreign reserves they have, but as long as they have dollars, they can get their food. The other important thing in Iran is that a lot of industrial establishments were bombed, especially of heavy industries like steel, petrochemicals, although they did not employ many people, but they have a huge downstream effect. A lot of other factories will not be able to operate. So jobs are being lost at the rate of maybe 100,000amonth. Those are the people that are in huge stress because they're not able to live without the wage and salary and have to depend on cash transfers that the government deposits, which is barely enough to buy daily food.

[Sabri Ben Assure]

So the government actually has a cash program where it provides people with a certain amount of money, and they've been doing this for a while. How long can efforts like that go on?

[Javad Salehi Isfahani]

The main constraint, in a way is cash, because once the food supplies, the inventories run down, they have to buy new supplies, which can come through Pakistan, through Turkmenistan, Iraq and Azerbaijan. It's possible that they can buy stuff on credit, especially if the Russians are willing to lend them. Chinese may be able to. In fact, they may be interested in helping Iran survive this because if Iran falls, both China and Russia stand to lose. So I think on the Iran side, it isn't as deterministic as people imagine sometimes that they are doing so badly that in a couple of months this spirals. I don't see that. I think that's the kind of exaggerations about Iran that has got us into this difficult situation now.

[Sabri Ben Assure]

Javad Salehi Isfahani, professor of economics at Virginia Tech, thank you so much.

[Javad Salehi Isfahani]

Thank you.

[Sabri Ben Assure]

There's a lot more to that interview and the state of Iran's economy, as well as how the Iranian people are responding to that economic pressure. You can find [e-mail] or or on our podcast in New York. I'm Sabri Ben Assure with the Marketplace Morning Report. From APM American Public Media.

[Amy Killalay / Kay Pastena (Health Experts)]

Anxiety, depression, bipolar disorder. At least half of us will experience a mental illness in our lifetime. In a new series of special reports from Call to Mind, we hear about the mental health impact of stress, climate change, immigration and more. Tune in for conversations with people managing hardship and experts seeking solutions. Listen to Call to Mind from American Public Media.