Ruben Gallego Demands Medicare AI Program Be Overturned

Senator Ruben Gallego (D-AZ) is demanding the overturning of an experimental pilot artificial intelligence (AI) program being implemented through Traditional Medicare.

Traditional Medicare, or Original Medicare, is provided to seniors 65 and older and provides Medicare Parts A (hospital insurance) and B (medical insurance).

The Trump Administration is running a pilot program called the Wasteful and Inappropriate Service Reduction (WISeR) Model, which uses AI and human oversight to reduce waste, fraud, and abuse in the Medicare system. This pilot program is being conducted in Arizona, New Jersey, Texas, Washington, Ohio, and Oklahoma from January 1, 2026, to December 31, 2031.

Sen. Gallego is leading the opposition to the WISeR program for several reasons, claiming that the model is "opaque" and that patients must obtain prior authorization for treatments or procedures, which may be denied for unexplained reasons, thereby slowing the whole process.

On top of that, the WISeR model is mediated through for-profit companies contracted by the Centers for Medicare and Medicaid Services (CMS) that are compensated for averted expenditures, meaning they make money by denying services.

And finally, the Government Accountability Office (GAO) ruled that the WISeR system is subject to the Congressional Review Act, and Democrats have a 60-day period to force a vote on a resolution of disapproval to end the program.

"Health care providers know what treatments are in the best interest of their patients," said Sen. Gallego in his press release, adding, "No Arizona senior should have to worry that their doctor will get overruled by an AI bot. I have opposed the WISeR model since the beginning and will continue doing all I can to push back on this dangerous program."

The Arizona Senator has been a vocal opponent of the Trump Administration's healthcare reforms, previously demanding answers from pharmaceutical companies on the nature of deals they have made with the Trump White House to lower drug prices equivalent to the lowest paid in other developed countries ("most favored nation") through the TrumpRx system.