Trump admin using AI to deny medical care for seniors in disastrous experiment

Trump admin using AI to deny medical care for seniors in disastrous experiment
Vendors rolling out AI have an "incentive to deny as many claims as possible."

In January, the Trump administration rolled out a pilot program that uses artificial intelligence to authorize or deny certain types of care for patients with Medicare—a federal healthcare program for seniors that previously hasn’t required doctors to get any such pre-approval, called prior authorization.

Not long after, media outlets began relaying the disastrous outcomes: technical difficulties, long delays in decisions and care, puzzling denials, frustrated doctors, and patients suffering in pain. Those reports were largely confirmed earlier this month when the Electronic Frontier Foundation released a tranche of federal documents about the program, called WISeR, that the group obtained amid litigation. The documents included feedback from healthcare providers, including one who called the program “a disgrace to the human race” and reported seeing patients crying in pain as they waited for care.

Amid the worrying reports, lawmakers have been trying to get answers and shut the program down. Meanwhile, the Government Accountability Office determined in May that Trump officials did not follow proper procedure in setting up the program, calling its legality into question. Still, it appears to be moving ahead unabated, with plans to expand in the years to come.

Last week, Rep. Suzan DelBene (D-Wash.) called a committee vote to try to get the Trump administration to release more documents about WISeR, but Republicans voted the effort down.

“It’s clear why the administration is doing everything they can to conceal these documents,” DelBene said in a statement. “The more that Americans learn about WISeR, the more outraged they get at the Trump administration for jeopardizing their care and trying to privatize Medicare.”

Technical fumbles

WISeR, which stands for Wasteful and Inappropriate Service Reduction, aims to use AI and machine learning to ensure “appropriate Medicare payment” for select services while benefiting taxpayers “by decreasing fraud, waste and abuse.” It was rolled out in January in six states—New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington—and intends to run until the end of 2031.