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Senators have introduced the “Seniors Deserve SMARTER Care Act”, to prohibit the Trump administration’s “Wasteful and Inappropriate Service Reduction (WISeR)” model. The WISeR model, set to start in 2026, would allow private companies using AI to approve or deny certain medical procedures for patients on traditional Medicare, potentially delaying or outright denying care. Critics argue this plan could negatively impact seniors by adding burdensome requirements and red tape for healthcare providers, while rewarding third-party AI companies based on the volume or cost of care they deny to seniors.
Senators Introduce Legislation to Block AI Experiment in Medicare
U.S. Senators, led by Patty Murray, Ron Wyden, and Kirsten Gillibrand, have introduced a new legislation titled the Seniors Deserve SMARTER (Streamlined Medical Approvals for Timely, Efficient Recovery) Care Act. This legislation aims to prevent the implementation of the Wasteful and Inappropriate Service Reduction (WISeR) model, which is slated to commence on January 1, 2026, and run for six years.
The WISeR model, proposed by the Trump administration, plans to incorporate prior authorization requirements into Traditional Medicare for the first time. It would allow private firms to leverage artificial intelligence (AI) to decide whether to approve or deny specific medical operations for seniors on Traditional Medicare. This model is set to increase the administrative load for healthcare providers, particularly those operating in small or resource-constrained environments, and could create barriers for patients. One of the most alarming aspects of this program is that AI, not doctors, will be deciding what care patients receive. Furthermore, the third-party AI firms participating in the program will be compensated based on the amount of “averted expenditures” – effectively encouraging firms to deny care to seniors.
The Trump administration has chosen six states, including Washington State, to pilot the WISeR model for six years beginning January 1, 2026. Approximately 1.6 million individuals in Washington State are enrolled in Medicare, and over half of them are enrolled in Traditional Medicare. Despite being described as a voluntary model, healthcare providers and patients with Traditional Medicare in the selected states will effectively be required to participate.
The Senators’ proposed legislation, the Seniors Deserve SMARTER Care Act, is a response to these alarming developments. It states that “The Secretary of Health and Human Services shall not implement the innovative payment and service delivery model described in the notice titled “Medicare Program; Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model” (90 Fed. Reg. 28749 (July 1, 2025)), or any substantially similar model.” The proposed Act not only seeks to halt the implementation of the WISeR model but also addresses broader concerns about the undue influence of AI in healthcare decision-making.
Several Senators, including Tammy Baldwin, Richard Blumenthal, Cory Booker, Maria Cantwell, Tammy Duckworth, Ruben Gallego, Andy Kim, Ben Ray Luján, Ed Markey, Jeff Merkley, Lisa Blunt Rochester, Bernie Sanders, Tina Smith, Elizabeth Warren, and Peter Welch, have co-sponsored the Seniors Deserve SMARTER Care Act. The Act has also garnered endorsements from several organizations, including Washington State Hospital Association, Washington State Medical Association, Puget Sound Advocates for Retirement Action, Physicians for a National Health Program, the Center for Health and Democracy, among others.
Text of the legislation is available HERE.
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