As the number of powerful narrative-impacting tools increases, the number of potential issues the DM has to account for increases, and the difficulty of balancing encounters and apportioning loot increases. In my own experience and in the experience of other DMs I've talked to, this is a serious factor in preparing notes and a pretty common cause for not being able to get things together for a session.
It's not the only reason a session falls apart, but at least IME I still play with everyone I ran my first 5e campaign with. They're all still in the area and still playing and they all still get along with me. But we're on our third campaign together because the earlier campaigns had gotten too exhausting for me so I gave them a proper ending.
I mostly just feel like the skill system isn't balanced enough to be used for a 'powers' system like this. Other than maybe having proficiency being a prereq for taking a power.