The AI lab had argued multiple violations of its rights, but a divided panel of judges sided with the Trump administration.

Six months ago, first lady Melania Trump walked into a White House education summit next to a faceless robot powered by artificial intelligence, which she said could one day give children personalized instruction.

“Imagine a humanoid educator named ‘Plato,’” she said. “Access to the classical studies is now instantaneous…humanity’s entire corpus of information is available in the comfort of your home.” 

Weeks earlier, her guest at the State of the Union had been a 10-year-old from Alpha School, a fast-growing private school network where children learn reading and math from AI software for two hours a day, and spend the rest of their time on workshops and projects overseen by adults the school calls “guides” rather than teachers.

The Trump administration had chosen AI as the future of American schooling, and wanted everyone to know it. But they picked a bad year to ask Americans to trust the technology with their kids.

Earlier this month, top leaders at Anthropic, OpenAI, and Google DeepMind publicly urged for an AI development slowdown, warning that companies racing to build ever more powerful systems could lose control of them, threatening not only large swaths of infrastructure but even humanity itself. Trump responded by calling the panic a “hoax” and said the US would not “hinder or stifle” the industry, because “whoever wins AI wins.” This “let them cook” mantra has met nearly every AI fear this year, from job loss to data center construction.

Yet the public is not convinced, and parents perhaps least of all. Efforts to bring AI into classrooms have run into organized opposition, and much of it is coming from inside Trump’s own coalition, setting up a fight between the administration’s pro-tech allies and conservatives who think screens have already done enough damage to kids.

In the nation’s two largest school districts, New York City has recently pulled student-facing generative AI from classrooms through eighth grade and Los Angeles blocked it on all student devices. But it’s not just Democratic-run cities that are pushing back. Earlier this year Utah barred students from using generative AI on assignments without a teacher’s say-so, and required schools to notify parents when it’s used in class. Oklahoma followed suit with a law, passed without a single “no” vote, that requires districts to tell parents which AI tools they use and what data they collect, and lets families opt out. Florida went further last week, when its Board of Education adopted rules for parents to opt their children in before they use AI at school, guaranteeing non-AI alternatives, and banning “companion” chatbots outright. 

Even at the Heritage Foundation, a conservative think tank with close ties to Trump, leaders are warning about the risks of AI in the classroom. In a March report, Heritage officials cautioned that AI tools built with addictive design features can harm children’s attention, mental health, and learning, and said schools should set limits rather than assume the technology will regulate itself. In July, the Manhattan Institute, another conservative think tank, recommended New York State bar students from using AI until third grade and keep it out of tests at every grade.

All the while, the Trump administration continues to push in the opposite direction, casting the wider AI race as one the US cannot afford to lose to China. Last year, Trump signed an executive order creating a White House task force to bring AI into K-12 classrooms, train teachers to use it, and build an “AI-ready workforce” to keep America as the global leader.

Polling data released in August found voters across the political spectrum concerned about AI in classrooms, with 85 percent worried about students using it to finish assignments without learning anything. Republicans were, if anything, slightly more eager than Democrats for government guardrails, 80 percent to 76 percent. Put differently, Republican voters appear closer to the Heritage Foundation than to the White House, which points to a coming clash inside the GOP over parental rights, innovation, and whether schools that take public money should have to prove their tactics work.

Up to this point much of the AI backlash has focused on regulating the tech in public schools, while some of its most ambitious boosters have concentrated on building private schools and developing new tools. A state can cap screen time in its elementary classrooms and let another family down the road pay thousands of dollars for Alpha, and everyone can call it a win for parent choice.

That peace may start to fray though as more public money comes on the table. Texas recently expanded vouchers to Alpha network schools and the company has also sought to open publicly funded charter schools. Other states are likely to confront these issues as well, meaning the AI education fight on the right may soon be unavoidable — and would land before an electorate whose patience for the tech, in schools and increasingly everywhere else, has been running thin all year. 

The Trump administration’s AI bet

The AI-in-schools executive order came just three months into Trump’s second term, and called for AI education to begin as early as kindergarten. Within five months, Education Secretary Linda McMahon was touring Alpha School’s Austin campus, describing it as “the most exciting thing” she’d seen in education in a long time. 

Alpha is hardly the first education company to promise a shiny new school model, but it has quickly become an influential player in the growing national debate around AI in schools. Its story so far reflects many of the big questions around AI in the classroom, including how to determine if the tech is helping or hurting kids, who is profiting, and what role governments should play in facilitating its adoption.

Alpha had been a small operation for most of its existence. MacKenzie Price, a Stanford graduate, co-founded it in 2014 after her second-grade daughter complained that school was boring. The tech billionaire Joe Liemandt became Price’s partner and the school’s principal financial backer. As recently as 2024 it served about 300 students across three campuses. 

Growth exploded in summer 2025, when Alpha took over campuses from a shuttered Montessori chain and announced plans for 10 new schools. This August it announced plans for 27 more.

Behind the school’s growth is its claim that students enrolled can cover a full day’s worth of academics in just two hours with AI, learning twice as fast as they would at a traditional school. Alpha can “enable the increase in human intelligence,” Price declared on a panel in Washington, DC, earlier this month, because “our academics can be delivered so much more efficiently and effectively.” 

Alpha says results from MAP tests, a widely used measure of academic growth, show its students learning 2.6 times faster on average than similar students at other schools. But no outside researcher has audited or independently verified those results.

That may soon change. MIT’s Blueprint Labs, the group behind some of the most rigorous charter school research in the country, told Vox it is designing pilot studies to measure the effects of the school’s programs on achievement and engagement, using experimental designs. Alpha is paying for the research; the lab says its own researchers will set the questions and methods. Harvard’s Human Flourishing Program is separately planning to study students’ life skills and well-being via a longitudinal study during the next academic year, Christina Hinton, who is involved with the research, told me. For now, Alpha’s academic claims remain its own.

Meanwhile, scrutiny of Alpha has grown. A Wired investigation last year described the school’s surveillance system as capable of recording students’ screens, keystrokes, and mouse activity and potentially tracking their eye movements. A 404 Media report published this winter claimed Alpha’s own internal documents said its AI-generated lessons sometimes did “more harm than good.” Alpha has disputed both reports, saying they relied on cherry-picked examples and accounts from fired employees, and provided me with an open letter it says every current family at the Brownsville campus signed, stating that the school Wired described doesn’t resemble theirs.

But education officials are still wary. This month, ProPublica and the Texas Tribune reported that at least nine states, Texas among them, had turned down Alpha’s bids to open publicly funded charter schools, with officials repeatedly pointing out that the model had only been tested on affluent students. (Tuition varies based on location, ranging from $10,000 a year at its Brownsville campus to $75,000 at its most expensive California schools.) Where Alpha had worked with lower-income students, ProPublica and the Texas Tribune found, it either hadn’t released enough data to back its claims of student growth or state test scores fell well short of what its leaders had predicted. 

After the Texas State Board of Education rejected Alpha’s charter bid in the summer of 2025, Alpha didn’t reapply. While policy advocacy was “frustratingly slow,” Price wrote, Alpha’s goal was “for students everywhere at every income level to be able to use this model of learning.” They turned instead to Texas’s new voucher program, which lets families spend public money at private schools. Unlike a charter, a private school in the program doesn’t have to give state tests or show anyone how its students perform. The comptroller, which runs the Texas Education Freedom Accounts (TEFA), approved most of Alpha’s Texas schools, which, counting virtual programs and specialty academies, now number more than 30.

None of the concerns that Texas’s State Board of Education had raised about Alpha’s test scores, missing data, or AI applied. “That wasn’t relevant,” Travis Pillow, a spokesperson for the TEFA voucher program, told ProPublica. “Our role is to make sure that a school meets the requirements in the law.” 

The five most expensive Alpha schools in Texas opted to leave the voucher program earlier this month, but many Alpha network schools are still participating, including Texas Sports Academy, Montessorium, NextGen Academy, Nova Academy, and Waypoint Academy. TEFA confirmed to me that students are attending Alpha affiliates via vouchers this year. 

Anna Davlantes, a spokesperson for Alpha, told me that in lieu of vouchers for their most expensive campuses, her network is offering families financial aid. 

The conservative revolt

Despite Alpha’s enthusiastic embrace in the White House, the introduction of AI in schools is increasingly challenged by forces on the right, from grassroots MAGA parents to social conservatives and technocrats.

The new AI rules in Florida, Oklahoma, and Utah, for example, grew out of a broader conservative push against screens in classrooms that predated the rise of chatbots and was turbocharged by parents’ frustrations with virtual learning during the pandemic.

Earlier this year Iowa capped elementary school screen time at an hour a day in a bill Gov. Kim Reynolds signed with Health and Human Services Secretary Robert F. Kennedy Jr. at her side. Tennessee passed a weakened version of a bill that would have banned devices in elementary schools outright, while similar bills in Missouri and Kansas died after school districts and teachers unions objected.

Uniting these efforts is a growing conviction that the last 15 years of education technology has failed most kids. The sponsor of Kansas’s bill used to sit on his state’s board of education and remembers thinking that ed tech held such promise. “What we found out is that not only is it not the education of the future, but it is destroying the education of the past,” he told Education Week. A growing number of lawmakers and parents have been citing The Digital Delusion, a book self-published in 2025 by neuroscientist Jared Cooney Horvath, that blames the proliferation of screens for declining student achievement. In January Sen. Ted Cruz (R-TX), who is otherwise one of the Senate’s leading opponents of AI regulation, invited Horvath to testify about the harms of AI on student learning and mental health.

The screen skeptics overlap with a more traditionalist wing of the GOP that objects to classroom technology on principle. Missouri’s original bill would have required cursive and kept 70 percent of student work on paper. The classical education movement, which holds up teachers as a moral example, has grown fast on the right. (Of the 895 identified classical schools nationwide, roughly one-third opened or converted to the model between 2020 and 2024, according to a Heritage Foundation tracker.)

The strand of conservatism that cuts closest to Alpha School comes from a third group, the school choice advocates. On paper, Alpha sounds like what the school reformers have wanted for years: It can offer an alternative to underperforming local public schools, its AI programs can theoretically compensate for inconsistent teacher quality, it provides personalized instruction, and it checks mastery on every lesson, so families can easily know whether their child is learning. Those are problems the education reform movement was launched to solve, and Alpha claims to fix them all.

The reformers, though, want proof. Mike Petrilli, who runs the conservative Thomas B. Fordham Institute think tank and has spent decades advocating for charter schools, wrote recently on his Substack that parents who want to pay for Alpha out-of-pocket should be able to, but “that doesn’t mean the rest of us shouldn’t be skeptical, or that we shouldn’t worry about fraud, or that we should allow public funding to flow to these school.”

This split was on display in DC this month at the education conference where Price appeared. Molly Hart, who runs Utah’s public schools and calls herself a school choice supporter, argued that once a school takes taxpayer money, “the game changes,” and parents can’t make a real choice without data about how it performs. Erika Donalds, who chairs the education center at the America First Policy Institute and is one of the Trump administration’s closest allies on schools, said parents, not the government, should decide which results matter. Donalds compared the choice to picking a restaurant on Yelp. 

The evidence has started to catch up with parental concern. In a randomized trial involving nearly 1,000 students at a Turkish high school, those given access to a GPT-based math tutor that readily supplied answers scored 17 percent lower on a subsequent exam taken without it. A version designed to withhold answers eliminated that penalty but produced no statistically significant learning gain. A newer working paper tracking nearly 27,000 Chinese students found that adopting AI raised homework scores by 18 percent but lowered monthly exam scores by 20 percent within six months.

Alpha School is working to add more detail to that pile, and other studies will surely follow. It’s at least possible that some aspects of AI in education prove more promising with further study. But public skepticism will remain a major barrier, either way. On an issue where parties are still sorting themselves out, the White House and its allies are swimming against a growing anti-tech tide that extends far beyond just AI or even schools. That’s unlikely to change before 2028, and whoever wants the Republican nomination will have to say which parents they’re listening to.

When the AI apocalypse becomes regular dinner-table conversation, you know we’ve reached the freakout stage. Rogue AI agents are hacking into competitors. Former Big Tech employees are posting Skynet-style warnings on social media. CEOs are crying for help in ways that have made this once-wonky tech issue a frontline political fight. 

I still think many of the concerns outlined by the AI leaders themselves are massively self-serving — especially when their companies are soon to go public. But the growing list of AI scandals is real. And it tells us that the status quo for regulating this powerful new technology is not working.

The question now on everyone’s mind: Is any kind of global brake possible? What form of AI safety regime is practical, over the short term, when there is no trust between major governments? And what could possibly work when companies are loath to give up their secret sauce and are bent on domination in the global AI race?

Two major conversations are now playing out, in real time. On Wednesday, President Donald Trump welcomed Chinese President Xi Jinping to Washington for a three-day summit — part of which will be dedicated to AI risks. The same day, with the United Nations meeting for its annual General Assembly, heads of the world’s leading AI companies urged the UN to police the emerging technology, or risk potentially wiping out humanity. “We could lose control of the future to AI,” OpenAI’s boss, Sam Altman, bluntly told the UN’s Security Council.

Confronted with this collective freakout, it’s time to take a long, deep breath. 

In fact, AI safety has been on a lot of policymakers’ minds for years now, gaining momentum after ChatGPT was introduced in 2022. Governments have held hearings, convened expert groups, and drafted their own outlines of how to keep it under control. These weren’t just idle listening exercises. They aren’t all well known to the wider public, but they yielded real plans.

Barring any breakthroughs this week, we already have a quasi-planetary shield against the potentially runaway technology. That’s the good news.

The bad news is that it’s not really up and running yet. It’s also not clear whether it will actually work. So what is it — and how can we fix it so we have a global system that responds in time to deal with the incredibly fast-moving threats from AI?

What the global AI patchwork looks like now

For the last four years, the most tech-savvy nations — and would-be AI leaders — have been running serious conversations about this exact AI safety threat. Some are in Congress and the White House; some at the UN, at the G7, and in other capitals.

I’ve been covering this closely as a global technology journalist, from my current perch at a think tank. Here’s what the landscape looks like:

• There are national AI safety and security institutes, government-funded bodies whose job it is to kick the tires of AI companies’ latest products before they are let loose into the wild. 
• There are also voluntary commitments by companies, many of which have made their own pledges or developed joint standards, to protect elections from AI threats, stop the spread of AI-fueled deepfake imagery, and joint government-corporate efforts to bake safety into how the technology develops.
• At the international level, there’s a G7-led reporting mechanism — embraced by the most important Western tech nations that allows AI giants to share how they are building their latest models, as well as create standards for how to reduce catastrophic risks.
• An international scientific report provides a yearly update on risks posed by the most advanced AI systems, based on existing research, to help governments plan for the worst. 

What’s missing from all that?  What we currently lack — and what is needed between now and the end of 2026 — is a way to turn this cottage industry of AI safety mechanisms into a functioning, but crude, first-responder system when things suddenly go wrong. 

The last four years have laid out a pathway, and some of the necessary systems even exist. But there’s no way to respond globally, and in real time, when an AI crisis hits — especially if such a possibly doomsday event cuts across countries already skeptical of each other.

This week’s US-China summit may be a step in the right direction. Under proposals outlined by American officials, Washington and Beijing could set up a hotline between US Treasury Secretary Scott Bessent and Chinese Vice Premier He Lifeng in case of an AI incident affected each country’s national security. 

It’s still unclear if Trump’s meeting with Xi will lead to such progress. Chinese officials also have balked at Washington’s pleas for AI rules because, so far, Congress has failed to act, and China already has some of the world’s most stringent AI oversight.

For AI to be “safe,” this conversation will need to go beyond this week’s US-China summit. Relying just on Washington and Beijing — arguably the most important AI powers — would not solve the underlying problems, nor would it make other countries feel more comfortable.

What we need next, so it really saves us

I’ve been talking to AI safety experts and government officials, and it’s clear the missing piece is a way to activate this whole system in a crisis. Countries don’t all have to have the same AI safety policies, and they never will. But as with nuclear weapons — a similarly high-threat technology that the world found a way to contain — safety requires a rough global agreement on how to respond quickly when something goes terribly wrong.

What’s needed right now is a 90-day, opt-in rapid response mechanism that joins existing pieces of the AI safety puzzle together. I’ve pieced together some ideas about how it should work, and who needs to sign on. Granted, none of what I outline below is sufficient. But, together, they are more plausible than trying to negotiate a comprehensive global regime — let alone arrange another AI summit — while Washington, Beijing, and other national capitals disagree over what “AI safety” actually means.

All of these options are based on existing mechanisms, are derived from efforts that have worked in other policy areas, and provide a band-aid to the AI safety dilemma until a more durable solution can be negotiated.

• First, developers, AI safety institutes, and regulators, from across different countries, should agree that when an incident occurs, it triggers a specific Chernobyl-style protocol. That would mean submitting a confidential report within a 72-hour period to a national designated responder and a small technical secretariat. It can build on the OECD’s AI Incidents Monitor, lead to a technical, multi-stakeholder confidential investigation into what went wrong, and, subsequently, the publication of an anonymized lessons-learned note.
• Second, governments and developers can agree to publish common declarations related to safeguards, residual risks, escalation thresholds, and independent auditing before the release or upgrading of a next-generation model. It would use the G7 Hiroshima AI Process reporting framework as its base, and turn the current hodgepodge of corporate safety declarations and voluntary standards into a common minimum disclosure obligation. View it as similar to the collective bank stress tests after the 2008 global financial crisis. It can allow outsiders to truly compare models’ safety protocols without putting someone in charge of determining which company is doing it best.
• Third, create a Cold War-style US-China AI safety hotline — but see it as an initial step that can later be opened to other countries. There are good reasons, in the long term, that Washington and Beijing should not be allowed to rule artificial intelligence between them, and the rest of the world should have a real seat at the table. But for now those are the two “great powers” in the tech conversation, and we can set that philosophical argument aside to create a standing, technically-informed direct line of communication for acute AI-risk incidents. Its remit is inherently narrow: prevent dangerous misunderstandings linked to serious model incidents, AI-enabled cyberattacks and/or alleged breaches of agreed safety commitments.

There are obvious limits to what I describe above. For one, it’s an inherently Western-centric view that primarily discounts global majority countries. It also places too much sway on existing institutions like the Organization for Economic Cooperation and Development, as well as on the US-China relationship. Other countries’ officials will legitimately balk at all three options, and rightly so.

But this is not about creating a vague, unenforceable UN-led mandate for AI safety. Nor is it about corralling the geopolitical cats to hammer out a global AI treaty. The options — a collective safety protocol and incident reporting protocol; common pre-release standards; and a US-China AI safety hotline — are inherently short-term. They are also based on existing efforts and those that have worked successfully for other policy areas.

There will be time to quibble about the future of AI safety. But now is not that time. The latest AI models are moving faster than many had expected, tech bosses are worried their creations are already out of control, and the window for action may be smaller than we all think.  

What is required are practical steps to assuage people’s growing concerns amid heightened geopolitical tension, a lack of trust between governments and companies, and a need not to let the perfect get in the way of the good.

The AI freakout of the past few weeks has centered on nothing less than the risk of human extinction — on the possibility that artificial intelligence could wipe us all out. But the reality is, AI programs are already having a direct and sinister effect on people’s physical health: UnitedHealth Group, the largest health insurer in the US, has been accused of using AI programs to deny payments to people, despite their doctors saying the care was necessary, and is facing a class-action lawsuit. 

Humana and Cigna are facing their own litigation over similar allegations. Meanwhile, Medicare has launched its own AI tool that will help the government determine whether to approve prior authorizations, and doctors are sending the federal government reports of patients at their offices who are in tears because they can’t get the medicine to manage their chronic pain.   

The claims in the legal complaints are harrowing: Families are desperate for an elderly loved one who recently experienced a serious fall to be allowed to stay in a nursing home. Doctors are flummoxed when a patient who may need months of rehab is cut off by an algorithm after a couple of weeks. 

This is AI’s threat to people’s health right now. 

While the current conversation may be fixated on something more Hollywood, private insurers and the Trump administration are already deploying AI programs to vet people’s health insurance claims — and the evidence is growing that these programs are not always doing a good job and are instead putting people’s health at risk. Until these lawsuits are settled or policymakers can figure out a way to regulate how insurers use this new technology, it will be up to each of us to make sure that an AI program isn’t being used to cheat us out of insurance benefits that we’re entitled to.

“The type of care that clinicians deliver is very sensitive to the patient’s unique circumstances. That may not really show up as a number. There’s not a numeric value that tells you the completeness and connection of a patient’s social network,” said Mika Hamer, a health services researcher at the University of Maryland. “There really are a lot of factors that really can’t be quantified and so aren’t really suitable to go into these models. If we start to rely exclusively on the models, I think we run the risk of losing that human touch.”

Patients say private health insurers are using AI to deny claims

Insurers and patients fighting over medical claims is nothing new: Policyholders want the most coverage they can get and payers have a business incentive to pay as little as they can. Health insurers have also used algorithms for decades: Plug in somebody’s age, their weight, whether or not they smoke, and one of the old-fashioned algorithms could spit out a rough estimate of how much medical care they would need before they died. Simple — and comparatively transparent. 

When you submitted a claim or sought prior authorization, there was supposed to be a human doctor who could review all of the relevant information on behalf of the insurer and make the final decision, in theory with the patient’s best interests in mind. It didn’t always work that way in practice, of course, but that was the idea.

What’s different right now, according to Daniel Schwarcz, a law professor at the University of Minnesota who has looked at health insurers’ AI use, is that these newer programs can make very specific predictions about someone’s future health based on the information that’s fed into them, and those predictions are being used in the process of approving or denying medical claims. And exactly what went into making those predictions — and whether it is the AI or the human who ultimately holds the final authority — is often opaque from the outside.

“The reason we want human review is we want human substantive judgment. We want AI to be supporting that,” Schwarcz said. “But the difficulty is distinguishing between AI supporting meaningful human processing and AI basically replacing the human with the human just passively defaulting to the AI judgment. It’s just incredibly hard to distinguish between those two in practice, particularly in rules or regulations.”

And those questions are at the heart of the lawsuits brought against three major insurers in the past few years about their use of AI in processing claims.

In May 2022, Gene Lokken, then 91 years old, fell in his home. He was taken to the nearby hospital in Tomahawk, Wisconsin, and treated for a broken leg and a broken ankle. Less than a week later, he was placed in the health system’s hospice care because, according to the lawsuit filed by his family, he was “very weak, not communicative, and in constant pain.”

But a month later, after receiving skilled nursing care, Lokken started to improve. By late June, his doctor had removed his splint and placed his leg in a removable boot. In July, he started physical therapy to get up and walk again. And for a while, his Medicare Advantage plan sold by UnitedHealth covered all of the services he needed.

Until July 20. Around that time, according to the lawsuit, UnitedHealth denied any more services at the nursing facility where Lokken had been for the past two months. It insisted that he could be safely discharged and more time at the nursing care facility “was not medically necessary.”

The insurer’s decision left Lokken and his physician “dumbfounded.” The physical therapist notes from the time said Lokken was still suffering paralysis and weakness after only a couple weeks of rehab. His family appealed, but UnitedHealth continued to deny the claims, asserting that because Lokken could feed himself and did not require help to clean himself, he did not need nursing care and could go home. 

From July 2022 to July 2023, Lokken remained at the nursing home, but his family had to pay between $12,000 and $14,000 monthly to keep him there. And on July 17, 2023, Lokken died — having never left the facility.

The lawsuit alleges that the decision to stop covering Lokken’s nursing-home stay was largely made by an AI algorithm, called nH Predict, which UnitedHealth follows so unquestioningly that employees were allegedly at risk of being disciplined or fired if their claims decisions went against the AI’s projections. The complaint alleges that the AI model would typically start denying claims after two weeks of nursing home care — and the attorneys have more examples than Lokken.

Glennette Kell required emergency surgery after a fall in late August 2023 and was referred to a nursing home rehab center. By mid-September, UnitedHealth was denying her claims for nursing care, despite the fact that, according to the lawsuit, she still could not walk. Kell had to pay $10,000 of her own money to cover the rest of her bills. Darlene Buckner suffered a heart attack in October 2023 and underwent triple-bypass surgery. She was readmitted to the hospital in late November because she was experiencing complications, but less than two weeks later, UnitedHealth allegedly denied any further treatment at the hospital because it was deemed medically unnecessary. At the time, according to the class-action lawsuit, Buckner was experiencing “an open infected wound near her heart from the open-heart surgery, she was on blood thinners, and was receiving antibiotics through an IV.” 

UnitedHealth, in its responses to the plaintiffs, has asserted that federal laws and regulations already require all claims decisions ultimately be made by a human doctor, not an AI program, and raised several other technical legal objections (such as saying the plaintiffs have not fully exhausted their administrative appeal options). The plaintiffs, however, allege that UnitedHealth employees “are instructed not to deviate” from the AI model’s projections, and then tell patients the AI-generated information is proprietary when they or their doctor try to inquire about why their claims are being denied. 

And, to be clear, UnitedHealth is not the only insurer being sued for using AI programs to deny claims. Humana is facing its own lawsuit brought by other Medicare Advantage patients who allege the same nH Predict program also led to their claims being wrongfully denied. Joanne Barrows, then 86, fell in November 2021 and went to a rehab nursing facility after her hospital stay. And just two weeks later, Humana began denying her claims for further care, according to the complaint, leaving her and her doctor “bewildered” because she was under doctor’s orders not to put any weight on her leg.

And the third lawsuit, filed against Cigna, alleges the company used a different AI algorithm that allowed its doctors to deny claims in huge batches — hundreds or thousands at a time — if they did not meet certain predetermined criteria. One patient, Suzanne Kisting-Leung, had claims denied for two ultrasounds done by her doctor to check for ovarian cancer, putting her on the hook for more than $700 in medical bills because, the lawsuit alleges, Cigna’s AI program determined that the scans were not medically necessary. The plaintiffs say that their claims were instantly rejected, without their medical files ever being opened. As for the law that human doctors have to make the final call? According to the lawsuit, the algorithm “enable[s] its doctors to automatically deny payments in batches of hundreds or thousands at a time for treatments that do not match certain pre-set criteria, thereby evading the legally required individual physician review process.”

These people, many of them elderly, had no idea AI was being used to make decisions about their coverage — until it was too late.

“From their perspective, you might as well have been speaking Esperanto. They just had no idea what it was that was being said to them when they were being told. They usually heard about it for the first time when they were being told that they needed to leave,” Glenn Danas, one of the attorneys in the class-action litigation against United, Humana, and Cigna, told me. “They just had no idea what was going on or why this was being done to them.”

AI is now making decisions for traditional Medicare claims too

It’s not just private insurers either. The Trump administration is now pushing traditional Medicare and Medicaid to use AI to adjudicate insurance claims too. In June 2025, nearly two years after those lawsuits had been filed against Cigna, Humana, and UnitedHealth, the US Department of Health and Human Services announced it would deploy a new program called the WISeR (Wasteful and Inappropriate Service Reduction) model to make prior authorization decisions for about a dozen procedures for the people on traditional Medicare in six states — “leveraging enhanced technologies, such as Artificial Intelligence (AI) and Machine Learning (ML), along with human clinical review to ensure timely and appropriate Medicare payment for select items and services.” It would be a pilot program, before federal officials decide whether to take the program nationwide.

It was a quiet, massive change for traditional Medicare, which covers about half of the 66 million Americans on the program. (Medicare Advantage plans, in which private companies administer Medicare benefits under slightly different parameters and which were the subject of the earlier AI-related class-action litigation, cover the rest.) People on traditional Medicare had historically not been required to get prior authorization for most services; now they would be, and a novel AI program would play a significant role in which claims get approved and which ones don’t.

From the start, physician and patient advocates warned about the potentially adverse consequences of the WISeR program; the Center for Medicare Advocacy said the program would likely “complicate, delay and even outright deny necessary care.” According to media reports and internal government documents, that’s exactly what has happened since the model went live in January. 

The Washington Post first reported in March that physicians and their patients were experiencing approval delays or denials for medical services that should have been covered. One glitch led to a denial of payment for services that had been approved. Doctors noticed that certain procedures seemed to give the AI model problems — such as two competing treatments for incontinence — and were weighing whether or not to stop offering one of those services altogether. The Post reported on one Arizona patient who had been receiving steroid injections for chronic back pain before being denied multiple times after the AI program’s launch. The pain became so severe, he said, that he could not exercise at all.

Then this month, the Electronic Frontier Foundation released a trove of documents it received in response to a Freedom of Information Act lawsuit related to the WISeR model. The documents revealed aggressive denials — one company using the AI model had actually denied more prior authorization requests than it had approved — and there were delays even when the care was ultimately approved. One review took 83 days when the model was supposed to make a decision within 72 hours.

The direct feedback from doctors in the federal documents obtained by EFF was devastating.

“We have patients calling our offices crying in pain because their procedures are being delayed while awaiting approvals or guidance tied to this model,” one doctor wrote. “A 3-4 day delay for necessary pain procedures is already difficult for vulnerable patients, but when providers cannot obtain answers for weeks, the situation becomes unacceptable.”

According to the federal documents, the Trump administration was already discussing ways to expand the program. Despite the outcry from doctors and patients, and growing concern among their representatives in Congress, it doesn’t look like WISeR is going away.

How can we make sure AI doesn’t take over insurance claims?

AI is becoming a part of healthcare — it is already happening. And many of those uses could be truly beneficial. Anthropic recently announced an initiative to apply the theoretical findings of its AI models to real-life lab work that could lead to new drugs being developed in the future. In terms of scientific discovery and the potential to translate it into new treatments, the excitement among clinicians about its potential is palpable.

And nobody denies that health insurance administration is chaotic and burdensome and would benefit from being made more efficient and streamlined — tasks which AI is at least superficially well-suited for.

But as the past few years have already shown, rushed and sloppy deployment of AI to take responsibility for approving or denying payment for people’s medical care has created serious problems. The issue is that this technology is being adopted more quickly than any regulator can oversee it. We don’t really know how health insurers are using AI tools. We don’t have a good framework for what keeping a “human in the loop” of insurance decisions — which is what people want — would really mean, Schwarcz said. 

“I think everyone agrees at a high level of generality, ‘Yes, AI should be used to enhance human review and not to replace it,’ but no one actually knows how to write rules to enforce it,” he told me. “I don’t think that there’s anything I’ve seen that has effectively defined what it means for a human to be meaningfully in the loop in the sense of retaining independent judgment as opposed to just reviewing and deferring. It is incredibly hard to specify in rules or regulations a standard that is verifiable and enforceable. That is still, as far as I know, an unsolved problem.”

Some states have started adopting rules requiring transparency for AI use in insurance claims, and lawmakers in Congress have put forward proposals requiring human involvement, including the bipartisan Protecting Patients from Automated Denials Act. But these technologies are so ubiquitous and so flexible that rigorously regulating their use is going to be difficult. Meanwhile, the profit incentive for companies to adopt these tools and deploy them widely is extremely strong. We don’t even know how widespread their use really is.

Danas said he and his clients hoped their litigation would help with “putting the brakes” on AI’s use in insurance. Until we figure out what to do from a policy perspective, what can each of us do in the meantime? Hamer told me that the old advice is still the best advice: If your claim is denied, appeal it. An enormous number of denied claims end up getting overturned on appeal. 

“You do not necessarily have to accept that the first answer from your insurance company is the final determination,” she said.