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healthcare
Senate Urged to Reject Trump Plot to Unleash AI for Medicare Service Denials
"The bottom line is this: Seniors who choose traditional Medicare should not have their care blocked by AI," said one campaigner.
Jul 15, 2026
Advocates for seniors on Wednesday urged US senators to vote for a resolution that, if passed, would block a new Trump administration pilot program under which claims by patients seeking certain healthcare services through traditional Medicare would be reviewed by private companies using artificial intelligence to deny care.
Upper chamber lawmakers are set to vote Thursday on a resolution introduced by Sen. Ron Wyden (D-Ore.) and supported by 20 Democratic colleagues and Sen. Bernie Sanders (I-Vt.) to stop the US Centers for Medicare and Medicaid Services' so-called Wasteful and Inappropriate Service Reduction (WISeR) Model.
CMS claims WISeR "helps protect American taxpayers by leveraging enhanced technologies, such as artificial intelligence (AI) and machine learning, along with human clinical review, to ensure timely and appropriate Medicare payment for select items and services."
What CMS doesn't mention—and what alarms a growing number of physicians and advocates—about the voluntary model is that AI-assisted reviews could contribute to inappropriate care denials, despite the required human review. Private Medicare Advantage healthcare profiteers have been using AI to deny care for years.
Critics argue that, even if a human must sign off, AI will effectively drive many of the recommendations, making it easier and faster to deny or delay care. They also warn of inevitable financial incentives tied to reducing Medicare spending, raising concerns that AI would likely be used as a cost-cutting tool.
"WISeR is not wise at all. It is a dangerous, profit-motivated experiment that allows private third parties to use artificial intelligence to delay and deny seniors’ medical care," Social Security Works executive director Alex Lawson said Wednesday. "Under the WISeR pilot program, which went live in January 2026, reports already show Medicare beneficiaries are waiting 2 to 4 times longer to access certain care."
"This is just one more example of the harm that Republicans’ disastrous healthcare agenda has already waged on American patients," he continued. "Last year, Republicans slashed $1 trillion in Medicaid and Affordable Care Act spending to line their cronies’ pockets. Now, they are importing the worst parts of Medicare Advantage—automated care denials—into traditional Medicare."
"The bottom line is this: Seniors who choose traditional Medicare should not have their care blocked by AI," Lawson added.
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Medicaid Cuts Put All Children's Health at Risk—I Would Know
Cuts to Medicaid don’t only hurt the poor, disabled, or seniors—as my family and I learned, they hurt all of us.
Jul 12, 2026
I was 13 years old. We’d just returned from Christmas vacation, and I was asleep in my room.
My mother tells me she heard a noise and found me in my bed, twisted up like a clam, frothing at the mouth. She was in shock. The paramedics came and took me to the ER. I don’t remember anything about it.
That night, I had a CT scan and an MRI. They found an abnormality in my brain called a cavernoma, and I needed surgery right away to correct it. Because it was a delicate operation, I needed not only a pediatric surgeon but a sub-specialist—a pediatric neurologist.
Little did my family know, there is a nationwide shortage of pediatric sub-specialists.
Medicaid and CHIP must be protected. Congress must invest in pediatric care so that no other children are told to wait months for necessary care.
The surgeon on-call that night assured us that I could be cured with surgery, but we needed to get it done as soon as possible to avoid another seizure and more damage. But when my mom called the hospital, they said the next available appointment was more than three months away due to a lack of pediatric neurosurgeons.
I was already isolating myself. Scared, missing school, I withdrew from sports and hid from my friends. At 13, you don’t want to be different, and you definitely don’t want anyone to know there’s something wrong with your brain. The depression and anxiety deepened. And I would have to go on like this for months?
My family was financially comfortable, we had private insurance, and we lived in Manhattan. Yet even someone as fortunate as I was had to wait because there’s a severe shortage of pediatric specialists.
What if it happens to a girl from a poor or middle class family without good insurance, or who lives farther away from good care? How long would her wait be? Would her family be able to afford it all?
Thankfully, I was lucky. I was able to get the surgery sooner before three months passed, and I’m cured now. But having gone through this experience, my mom and I wanted to find out the cause of the deficit in pediatric care—and how it can be fixed.
With the help of a bipartisan advocacy organization that works on these issues, First Focus On Children, we found out that most pediatric specialties are reimbursed largely through Medicaid and its state-tailored companion program, the Children’s Health Insurance Program (CHIP).
Half of the nation’s children receive health coverage through Medicaid or CHIP, and even children with private insurance rely on Medicaid when they need specialized care. So most pediatric specialists and sub-specialists have to rely on these government programs for reimbursement.
But unlike Medicare and private insurance, which reimburse adult and senior care specialists at much higher levels, Medicaid reimbursements are significantly smaller for pediatric care—though the doctors go through the same expensive training and have the same qualifications. Because of this, far fewer medical specialists go into pediatric care because it’s financially untenable.
As a result, there is a crisis in pediatric care. To make it worse, Congress’s partisan “Big Beautiful Bill” slashes almost $1 trillion from Medicaid over 10 years. At a time when we desperately need more investment in Medicaid, we are going in the opposite direction.
Cuts to Medicaid don’t only hurt the poor, disabled, or seniors—as my family and I learned, they hurt all of us. Healthcare in this country isn’t sufficiently serving those in need. If things continue this way, what will pediatric care look like for my own children one day?
We must do better. Medicaid and CHIP must be protected. Congress must invest in pediatric care so that no other children are told to wait months for necessary care. It’s not only about the “haves” and the “have-nots.” It’s about all of us.
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'A Deliberate Choice' by Trump's GOP: Health Insurance Premiums Set to Rise by Double-Digits Again
"Every day the consequences of GOP healthcare cuts get worse," said one campaigner.
Jul 08, 2026
Health insurance companies that offer plans on the Affordable Care Act marketplace are proposing double-digit premium increases for 2027, signaling the second consecutive year of out-of-pocket cost hikes following President Donald Trump and congressional Republicans' refusal to extend enhanced subsidies that lapsed last December.
The health policy research group KFF and the Peterson Center on Healthcare released an analysis on Wednesday showing that ACA marketplace insurers "are proposing a median premium increase of about 14% in 2027." While that would represent a decrease compared to the median finalized premium increase of 20% for 2026, it marks "the second-highest requested rate change since 2018, as premium growth had been relatively flat in this market for several years," the analysis notes.
"If these early indications of median premium increases for 2027 hold, typical premiums for insurers participating in the ACA marketplaces will have jumped by more than one-third over a two-year period," KFF and the Peterson Center found, pointing to the significance of Trump and the GOP's deciseion to oppose an extension of enhanced ACA premiums that were established in 2021 during the Biden administration.
KFF and the Peterson Center explain:
As anticipated, many healthier enrollees left the ACA Marketplaces in 2026 as their subsidies decreased—leading to an average increase in premium payments after subsidies of 58% this year—leaving behind an enrollee base that is on average somewhat sicker and more expensive to cover. For 2026, this dynamic was estimated to drive rates an average of four percentage points higher than they otherwise would have been, and insurers are now building 2027 rates on top of that adjusted, less-healthy risk pool—compounding the effect into next year’s premiums as well.
Leslie Dach, chair of the advocacy group Protect Our Care, said in a statement Wednesday that the analysis underscores "just the latest hit on hard-working families struggling to get by after Republicans ripped away the tax credits that helped millions of Americans afford coverage."
"Every day the consequences of GOP healthcare cuts get worse," said Dach. "This was a deliberate choice by Republicans who took away affordable coverage from millions of people to help fund tax breaks for billionaires and big corporations. The damage is already being felt at kitchen tables across America, and these new premium hikes show the worst is still ahead. And Republicans will pay the political price. Healthcare is already the driving issue leading up to the elections, and as the consequences mount, it will only mobilize voters further.”
Since the start of President Donald Trump's second White House term, ACA enrollment has declined by more than 5 million people as a growing number of Americans are priced out of coverage by surging premiums.
For 2027, at least 20 insurers across states that have submitted rate filings so far have proposed premium increases exceeding 20%, according to the KFF-Peterson Center analysis.
Kendall Witmer, the Democratic National Committee's rapid response director, said in a statement Wednesday that "healthcare is unaffordable for millions of Americans because Donald Trump and Republicans sold them out to give billionaires even bigger tax cuts."
"Working families are already grappling with sky-high prices for groceries and gas, and growing medical bills are putting them over the edge," said Witmer. "Healthcare for Americans has never been more expensive—and Trump and Republicans are squarely to blame."
Leor Tal, campaign director for the advocacy group Unrig Our Ecnomy, echoed those arguments and called for GOP lawmakers, who still control the House and the Senate, to act.
“Millions have already lost access to health insurance, and these planned premium hikes will only escalate this crisis," said Tal.
"We need Republicans in Congress to restore the health care tax credits they took away from millions. Otherwise, when their premiums rise again, Americans will know who is at fault.”
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