Trump administration AI pilot denies Medicare care, EFF documents show

September 25, 2026 at 04:00 PM2 min

This digest was compiled by AI from multiple sources — links to the originals are below.

The Trump administration's WISeR pilot program is using artificial intelligence to authorize or deny Medicare services in six states. The Electronic Frontier Foundation released federal documents showing rushed implementation and provider reports of patients crying in pain while awaiting care. Lawmakers are seeking to halt the program even as the Government Accountability Office found officials failed to follow proper procedure.

Key Facts

WISeR launched in January in New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington and is set to run until the end of 2031.
The program requires prior authorization for about a dozen services, including epidural steroid injections, cervical fusions, and skin substitutes.
The Government Accountability Office determined in May that Trump officials did not follow proper procedure in setting up WISeR.
Rep. Suzan DelBene (D-Wash.) called a committee vote last week to force release of WISeR documents, but Republicans voted it down.

Program Rollout

WISeR, which stands for Wasteful and Inappropriate Service Reduction, uses AI and machine learning to ensure appropriate Medicare payment for select services. The pilot launched in January in six states: New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington. It requires prior authorization for around a dozen medical services, including nerve stimulation, epidural steroid injections for pain, cervical fusions, skin substitutes for wounds, and treatments for incontinence and impotence. The program is scheduled to run until the end of 2031.

Provider Complaints

The Electronic Frontier Foundation released federal documents obtained through litigation that included feedback from healthcare providers. One provider called the program "a disgrace to the human race" and reported seeing patients crying in pain as they waited for care. The documents show the program's implementation was rushed and the technology was not ready. Media outlets reported technical difficulties, long delays in decisions and care, puzzling denials, and frustrated doctors.

Congressional Response

Rep. Suzan DelBene (D-Wash.) called a committee vote last week to compel the Trump administration to release more WISeR documents. Republicans voted the effort down. DelBene said the administration is concealing documents because Americans would be outraged by WISeR's impact on care and Medicare privatization. The Government Accountability Office determined in May that Trump officials did not follow proper procedure in setting up the program.