Washington state congressional leaders made the right move this week when they urged appropriators to block funding for AI in traditional Medicare. We want to thank Reps. DelBene, Schrier, Larsen, Jayapal, Randall, Strickland and Smith for signing on.
In their recent letter tied to the fiscal year 2027 appropriations process, House lawmakers urged appropriators to block funding for the Centers for Medicare & Medicaid Services’ Wasteful and Inappropriate Service Reduction (WISeR) model.
The WISeR model would allow private contractors to use artificial intelligence and large language models to review and potentially deny coverage for a broad range of services. This poses the very real risk of AI restricting medically necessary care.
WSHA has long cautioned that prior authorization, particularly when paired with automated decision making, increases administrative burden for providers and delays or limits patient access to critical, sometimes lifesaving care. Prior authorization also has a documented history of inappropriate denials that are later overturned on appeal, especially within Medicare Advantage.
WSHA believes traditional Medicare works because medical decisions are made by clinicians in partnership with patients — not algorithms or profit-driven contractors.
We are deeply appreciative of congressional leaders who are standing up for seniors and people with disabilities by pushing back against models that introduce perverse incentives and unnecessary barriers to care.
Sincerely,
Jacqueline Barton True
WSHA President & CEO
[email protected]