PSARA Meets with Congressman Adam Smith to Talk About WISeR

In April, Washington Congressman Adam Smith (9th District) invited PSARA to a roundtable to discuss WISeR and its impacts on the community.  Representatives from AARP Washington and Kline Galland (a skilled nursing facility) also attended. PSARA Co-president Karen Richter and Board member Anne Watanabe told Rep. Smith about WISeR’s implementation. We described the concerns and fears we’ve heard from PSARA members and other seniors when they learn that WISeR expands the use of prior authorization in Traditional Medicare, and rewards third-party AI contractors who deny or delay care. Rep. Smith reiterated that he was with us in our fight to protect Medicare and that his office wants to hear stories about patients’ experiences. He has already signed HB 5940, the Seniors Deserve SMARTER Care Act, to halt WISeR, and signed onto a letter to the House Committee on Appropriations Subcommittee to prohibit its implementation. PSARA looks forward to his continued support.

PSARA will continue to monitor threats to Medicare. For now, here are recent developments that may be of interest to our members:

WISeR

WISeR continues to attract critical reporting and lawsuits. A Seattle Times article (March 18, 2026), "New Medicare Program Using AI Leaves WA Patients in Pain," described the real human cost of WISeR for patients waiting for or being denied needed pain treatments. The Washington Post (March 17, 2026) described the delays, confusions and frustrations by medical providers attempting to navigate "WISeR; Medicare’s AI Experiment Leads to Delayed Care for Some Seniors."

The Electronic Frontier Foundation (EFF) filed a lawsuit against the federal Centers for Medicare and Medicaid Services (CMS) in late March, based on CMS’s failure to respond to EFF’s Freedom of Information Act requests concerning its vendors and how they are using and training their AI. Two other lawsuits have been filed in Arizona (another of the impacted states) by providers and other affected parties.

Making Medicare Advantage the Default Choice

The Trump Administration has been busily implementing Project 2025, the far-right blueprint for our country. Project 2025 proclaims that Medicare and Medicaid “operate as runaway entitlements that stifle medical innovation, encourage fraud, and impede cost containment.” It includes a directive to “Make Medicare Advantage the default enrollment option” and includes “reforms” such as replacing the “bureaucrat-driven fee-for-service system with value-based payments.”

As RA readers know, with private Medicare Advantage (MA), for-profit insurance companies have taken billions of dollars in overpayments from the government-funded Medicare system, an unsustainable drain of funding.

MA plans now account for over half of the country’s Medicare plans, and, as PSARA members may have sadly experienced, MA plans can leave enrollees trapped in a shrinking network of providers and benefits, while being subjected to MA companies’ aggressive use of prior authorization. But now, the Center for Medicare Advocacy reports that CMS is actively exploring models to automatically enroll beneficiaries in MA plans, rather than Traditional Medicare. (Medicare already allows certain employers and unions to automatically place beneficiaries in MA plans). This could greatly expand the MA system and the abuses that accompany the MA system.

PSARA led passage of a bill in our Washington State legislature this year calling on Congress to “level the playing field” between MA and Traditional Medicare systems. We will continue to advocate for the right to choose Traditional Medicare over private MA plans.

Using AI to Guide Your Medicare Choices

CMS recently issued a Request for Information (RFI) asking for AI and machine-learning tools to improve navigation related to the Medicare website, the Plan Finder Tool, and the 1-800 MEDICARE call center. But in the context of WISeR and its reliance on AI, the RFI may indicate a step towards using AI “agents” to replace human advisors. Indeed, at his keynote address in March at a healthcare conference, CMS Administrator Mehmet Oz declared, “Why couldn’t we start to introduce agentic AI for every beneficiary of Medicare?” He noted that “if you can buy a mortgage with agentic AI giving you advice, you should be able to use that same technology to help you pick which [Medicare Advantage] plan to use or which doctor to go to." (At HIMSS26, Dr. Oz, "CMS Officials Push Agentic AI Adoption. Are Medicare Beneficiaries Ready?", Fierce Healthcare, March 12, 2026.)

Why not indeed…stay tuned.