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Dems: Medicaid cuts complicate health AI dreams

Dems: Medicaid cuts complicate health AI dreams

Politico2 days ago

WASHINGTON WATCH
House Republicans and Democrats clashed during a Ways and Means Health Subcommittee hearing Wednesday over how to fund and advance the use of digital health technologies.
'We live in a time where Americans have access to better technology and more health information than ever to truly be the 'CEO of their health,'' subcommittee Chair Vern Buchanan (R-Fla.) said, noting that despite high spending on health care, Americans are getting sicker.
Digital health tools and artificial intelligence are central to Health Secretary Robert F. Kennedy Jr.'s strategy to cure chronic disease and reduce costs.
But Democrats warned that the GOP's proposed Medicaid cuts in President Donald Trump's megabill could hamper the adoption of AI and other innovations in health care.
'I'm a bit in the twilight light zone. At the same time that we're here talking about this issue, my colleagues on the other side just passed a bill that would effectively take away health care for 16 million Americans,' said Rep. Steven Horsford (D-Nev.).
At the heart of the disagreement is cost.
'People cannot take advantage of technological advances in health care if they do not have health insurance coverage or face insurmountable financial barriers to health care services,' said Sabrina Corlette, co-director of the Center on Health Insurance Reforms at Georgetown University.
For health systems, that means less revenue to invest in innovative technologies, especially ones with no or low reimbursement rates.
A few ideas that were floated:
— The Centers for Medicare and Medicaid Services should set reimbursement rates for some digital technologies and raise the rates for technology that's already reimbursed.
— Congress should expand tax-advantaged health savings accounts so Americans can use them to buy health and fitness wearables like WHOOP bands and Oura Rings.
— Lawmakers should consider the impact Medicaid cuts would have on doctors' ability to implement AI.
What's next: Republicans have waffled on whether to include an expansion of health savings accounts in the 'Big Beautiful Bill' because they'll add to the budget. But Senate Republicans are feeling pressure from their House counterparts to keep them in.
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Life science company Verily is re-upping its work on the research platform that powers All of Us, a NIH-funded, big data project that seeks to understand risk factors for disease, better treatments, and how technology can help make people healthier. The contract with Vanderbilt University Medical Center, one of the NIH's key partners on the program, is for the next five years.
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CONNECTING THE DOTS
Federal agencies developed or used more than 2,000 artificial intelligence tools or programs in 2024, according to an analysis by POLITICO's Rosmery Izaguirre.
Agencies reported that, in about 16 percent of use cases, their tools or programs posed safety concerns or had the potential to infringe on users' civil rights or rights to data or privacy.
The Department of Health and Human Services reported the highest total number of AI use cases among its agencies, with four use cases presenting rights or safety concerns.
The Justice Department reported the second-highest number of AI use cases, with 124 use cases presenting concerns, and the Department of Veterans Affairs reported the third-highest number of AI use cases with 145 use cases presenting concerns.
The Trump administration is poised to expand AI use across federal agencies.
In January, President Donald Trump issued an executive order rescinding Biden-era legislation that promoted a more cautious approach to developing and testing use cases for AI.
In an April memo, the Trump administration set its own disclosure requirements for agencies using AI, repealing the previous administration's conditions. Several rules were rescinded, including those related to rights and safety reporting, but the requirement for agencies to track and report their use of AI was maintained.
What's next for HHS: AI is used widely across HHS, from analyzing big public health datasets and detecting health trends to more rote tasks like summarizing documents.
But not all of the departments' AI efforts are rolling out smoothly. Earlier this year, the Food and Drug Administration deployed a general-use chatbot to shorten reviews throughout the agency. But two current and two former agency employees granted anonymity to discuss sensitive internal matters told POLITICO that the bot isn't capable of meaningfully reducing review time.

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