Published 1:30 am Friday, October 2, 2026
When the Health Human Services Secretary sat before me during a Ways and Means Committee hearing in April, I shared the story of a Washington senior on Medicare who had been lingering in crippling pain for weeks while waiting for approval for a common pain treatment. Her delay was the direct result of the Trump administration's new AI experiment, which began earlier this year. This program, known as the Wasteful and Inappropriate Service Reduction (WISeR) program, pays private companies to use AI to review Medicare claims.
Joannes severe pain forced her to use crutches and a wheelchair to get around, leading to multiple falls that compounded her injuries. The Secretary called this a terrible outcome, yet defended the program, saying it was running as planned. Conveniently, Joannes treatment was approved quickly after the hearing. If her doctor had ordered the procedure last year, it would have been approved without friction. Instead, her nightmare is emblematic of this chaotic rollout.
When WISeR was first announced, I cautioned the administration that quickly rolling out a program that uses the same problematic delay tactics that private Medicare Advantage plans use would leave patients frustrated and in pain. Sure enough, I began hearing about issues with WISeR from health care providers and patients almost as soon as it launched in January in Washington and five other test states.
For months, the administration operated in the dark, releasing no meaningful data. Even Congress couldnt see under the hood until the Electronic Frontier Foundation filed a Freedom of Information Act (FOIA) lawsuit against the administration and finally received almost 1,000 pages of internal documents. What I called a Trojan horse to privatize Medicare earlier this year is now more alarming than ever.
So far, this pilot program only applies to certain procedures, like the pain treatment that Joanne was waiting for. My concern from the start was that once the administration started doing this, it was only a matter of time before it was scaled up to more procedures and more states. The new documents confirm exactly that, outlining the administrations next targets: cancer treatments, cardiology procedures, and even air ambulances. To state the obvious, none of these treatments can wait weeks for approval.
Washington seniors have borne the brunt of this experimental programs malfunctions. From January to March, over half of the claims submitted in Washington were denied and far exceeded the 72-hour decision deadline. This triggered an internal CMS audit and corrective action plan. This shouldnt come as a surprise because the program pays these private companies for every claim they deny, which incentivizes them to reject more care.
The audit and corrective action plan have never been released, which would further help inform lawmakers, health care providers, and patients about how WISeR is failing to function. This stonewalling must end. Thats why I am filing a new FOIA request for these specific documents in addition to the audits and corrective action plans of any other private company participating in WISeR.
Congress holds a constitutional mandate to oversee the executive branch, yet the Republican-led House has been notably restrained in exercising this authority since President Trump assumed office. A recent illustration came when a proposal to unlock additional WISeR program documents, originally put forward by DelBene, failed to gain majority support among Ways and Means Republicans. Though five members shifted their positions following informal guidance from party leadership during deliberations, the measure still fell short.
The initiative sought greater transparency around WISeR, a federal initiative piloted in select states that applies AI tools to streamline benefits administration. Even representatives without districts directly involved in the current phase acknowledged broader implications, noting that nationwide expansion could affect millions of beneficiaries nationwide.
Earlier reporting noted that the program’s rollout has drawn scrutiny after cases surfaced of older adults encountering delays or errors in benefit processing linked to AI-driven decisions. Advocates argue a more thorough review is warranted before broader implementation proceeds. DelBene emphasized that when Democrats assume House leadership this November, they intend to launch a comprehensive examination of WISeR to safeguard beneficiaries, particularly seniors like Joanne, from unintended consequences tied to the program’s rapid technological integration.