Providing for Congressional Disapproval Under Chapter 8 of Title United States Code, of the Rule Submitted By the Centers for Medicare Medicaid Services of the Department of Health and Human Services Relating to ``Medicare Program; Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services

Floor Speech

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Mrs. MURRAY. Madam President, I wanted to talk today about not just how Republicans are making healthcare more expensive but also how they are making it just plain worse for seniors.

President Trump came into office saying he would not cut Medicare, but that was clearly a lie because right now his administration is trying to privatize Medicare; in part, by putting AI between Medicare beneficiaries and their healthcare.

In January of this year, under Secretary Kennedy and Dr. Oz's leadership, CMS began this pilot program that uses AI to require prior authorization in traditional Medicare for the first time ever, and it is set to run for 6 years. They call it the Wasteful and Inappropriate Service Reduction Model. Well, they got the wasteful and inappropriate part right.

The WISeR Model uses AI to deny vulnerable seniors the care they need and that their doctors recommend.

Not only that, but the for-profit contractors that conduct this prior authorization are paid a percentage of the cost of care that they deny. They are literally incentivized to rip healthcare away from seniors because that is best for their bottom line. When your business model relies on denials, denials are what seniors are going to get, and that is perverse.

WISeR was rolled out in the beginning of this year in my home State of Washington and five other States without safeguards and without any transparency and without the best interests of Medicare beneficiaries at the heart of this program.

President Trump is saying: Forget the doctors who went to medical school and took an oath to do no harm. AI knows better when it comes to healthcare decisions for our seniors.

The consequences of that poor judgment are real, and they are life- threatening. I hear from Medicare patients in Washington State all the time. They are suffering debilitating pain for weeks because they are not getting the care they need, thanks to this harmful model--patients like Joanne. She is a Medicare beneficiary from Quilcene, WA.

She went to her doctor for severe pain. An MRI showed that a herniated disk was pressing on her sciatic nerve. Joanne's doctor prescribed an epidural injection to help ease that pain. This was standard, routine care--care that, before this year, she would have been able to get quickly after it had been recommended by her doctor. But because of this WISeR Model, she had to wait 6 weeks to get approval. That means, thanks to WISeR, Joanne had to deal with unnecessary, unrelated pain for 6 weeks. Because of this nonsense delay, her day-to-day life was disrupted and the burden fell on her then to fight for the care she needed.

This is simply outrageous, but that is also WISeR working by design, and that is a direct impact of the Trump administration's actions.

We have seen way too many stories like Joanne's from States that have been selected for this pilot program. No way should an algorithm decide if seniors should get the care they need. That is exactly why I join my colleagues here in introducing a resolution to overturn this model. And I want all of my colleagues to join me in voting for it so we can make sure seniors in my State and all over the country can, once again, receive their healthcare on time and without interruption.

Let's just use our common sense. It is clear as day that some AI models should never be at the wheel making healthcare decisions left and right. And it is not just patients I have heard from. I have met with healthcare providers all over my State. Whether it is a rural hospital or a doctor in Seattle, no one--no one--has had anything good to tell me about prior authorization in traditional Medicare.

Now, I ran for office because I believe regular people deserve a say in how their government is run, and that is especially true when it comes to the government deploying AI technology. I don't know any senior--Republican or Democrat--who asked President Trump to let AI decide if their doctor-recommended treatment was necessary. Of course, AI can help make things more efficient or do good things. That is not what the WISeR Model is doing.

So let's get to the crux of it. As a country, we make a promise to American seniors: If they paid their taxes throughout their careers, they earned their Medicare coverage. Full stop. WISeR breaks that promise to seniors with these senseless AI-driven prior authorizations that deny and delay care.

Let me be clear, many seniors choose traditional Medicare over other options because traditional Medicare rarely requires prior authorizations. People choose traditional Medicare because they want to make their healthcare decisions with their doctor, not with a private company that is out to make a profit.

Simply put, the WISeR Model--which, again, delays and denies necessary care to Medicare patients--is reckless, and it is irresponsible.

I want my Republican colleagues to join us in voting to get rid of WISeR once and for all because this should not be a partisan issue. We all have seniors in our States that deserve the highest level of care without having to deal with redtape and delay. Thanks to Trump, AI is getting in between our seniors and their healthcare in Arizona, in New Jersey, in Ohio, in Oklahoma, in Texas, and in my State of Washington. We have an opportunity to stop this harmful experimental pilot program before more seniors are harmed. No senior in America should have to appeal their pain and suffering to a machine.

To my colleagues, if it were your spouse or parent who needed care, whom would you want to decide if they get their treatment, their doctor or a for-profit algorithm? Would you want them to suffer in pain for weeks for care that they are entitled to? I know what my answer is.

Let's maintain the promise of Medicare. Let's pass this resolution.

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Mrs. MURRAY. Thank you. Thank you.

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