A federal pilot is letting AI decide whether seniors get care, and the early results are ugly.
Since January, the Trump administration's WISeR pilot has used artificial intelligence to authorize or deny certain types of care for patients on Medicare, the federal insurance program for seniors that previously did not require this kind of prior approval. Doctors and patients quickly reported technical breakdowns, long delays, and denials that made little clinical sense. This month, the Electronic Frontier Foundation published federal documents, obtained through litigation, that backed up those complaints with provider feedback. One provider called the program "a disgrace to the human race" and described patients crying in pain while they waited for a decision.
Prior authorization is already the most hated phrase in American healthcare, and this program automates it for a population with little room for delay. The Government Accountability Office found in May that officials skipped required procedure when standing up WISeR, calling its legal basis into question. That's a real problem for a program that decides who gets treated and when.
Lawmakers are demanding answers and the courts are watching, but the administration's answer so far has been to keep the program running and plan to expand it.