The Dictatorship
Dr. Oz’s plan to impose AI on Medicare patients is a recipe for disaster
When Daniel was consumed with severe and inexplicable pain for months, his physician prescribed an MRI. However, his health insurer required that it approve the test as well before he could undergo the procedure. When the insurer denied the prior authorization, that began his long journey to diagnose and treat his syringomyelia, or a cyst in his spinal column. For Daniel, it meant over a year of debilitating pain, weight loss, suicidal depression and dependence on opioids amid delayed diagnosis and treatment. And his repeated appeals of the denied authorization drained what little energy he had.
While writing my forthcoming book (on health insurance coverage delays and denials), I found that Daniel’s tragic experience is all too common. Of the 1,340 people I surveyed, 36% experienced at least one instance of coverage denial, often through prior authorization, that kept medical care out of reach. Prior authorization has been typically deployed by private health insurers, infuriating doctors and patients. Now, though, thanks to the Trump administration, Medicare beneficiaries will begin facing these obstacles to care as well.
Private insurers usually deploy prior authorization to limit low-value care and contain health care costs.
Starting next year, through its implementation of the Wasteful and Inappropriate Service Reduction (WISeR) Modelthe Centers for Medicare and Medicaid Services (CMS) will begin a pilot program that will import the prior authorization process to traditional Medicare plans in six states. The program will even employ artificial intelligence tools to decide whether those Medicare beneficiaries will receive the care physicians say they need.
Private insurers usually deploy prior authorization to limit low-value care and contain health care costs. Though the tactic was used sparingly in its early days, it is now applied to most higher-cost drugs and nearly all surgeries and procedures. While most prior authorizations are ultimately approved, they are a source of headaches and frustration among patients and physicians alike, sowing distrust in the health care system. Prior authorization creates delays and denials of health coverage — and the process of challenging denials is highly burdensome, especially for people who are already struggling with severe or even life-threatening health conditions.
Appealing a coverage denial demands a high degree of health insurance literacy and fortitude that most of us lack, especially in a health crisis. Coordinating between one’s physician and insurer, all while potentially going untreated, can lead patients such as Daniel to experience a sense of overwhelm and a loss of autonomy amid this navigation anxiety. It is little wonder why so few patients ultimately opt to appeal. In fact, among the 3.2 million denials of prior authorization rendered by Medicare Advantage plans in 2023, just 11.7% were appealed despite most appeals resulting in a reversal of the initial denial.
Thus, health care becomes rationed not through a final denial of coverage, but rather through accumulations of inconveniences as patients — especially those from marginalized backgrounds — struggle to navigate America’s labyrinthine health insurance bureaucracy. Perhaps not surprisingly, the use of prior authorization has effects that are not only pervasive, but also inequitable. My research has found that less affluent patients are less likely to appeal, and sicker patients and Black and Hispanic Medicaid patients are less likely to appeal successfully.
The roughly 33 million Americans in Medicare’s traditional fee-for-service plans have largely been able to evade these administrative burdens, as these plans use prior authorization very rarely, such as for durable medical equipment. On the other hand, 99% of Medicare Advantage beneficiaries have prior authorization requirements in their plans. But with the proposed changes under the Trump administration, the enrollees relying on traditional Medicare will get ensnared in red tape as well, likely leading to delayed or forgone care.
Health insurers’ reliance on AI to process claims has already faced legal challenges.
And remember, most of Medicare’s beneficiaries are 65 or older. Older adults tend to have lower health insurance literacyare more likely to have significant health challenges and more frequently suffer from cognitive decline, which makes navigating the complexities of these health insurance processes particularly onerous, if not infeasible.
CMS Director Dr. Mehmet Oz asserts that this pilot program is aimed at “crushing fraud, waste, and abuse.” But it will inevitably drive delays in care — and burdens of appealing — for seniors across the country. It will likewise exacerbate administrative burden for physicians, who must submit prior authorization documentation, conduct “peer to peer” reviews of denials, and craft appeal letters on behalf of their patients. In fact, quite apart from simply combating overprescribing, prior authorization-related burdens can actually lead to underprescribing to avoid subsequent delays or rejections of coverage.
What’s more, health insurers’ reliance on AI to process claims (including from Medicare Advantage beneficiaries) has already faced legal challenges. Lawsuits filed against UnitedHealthCignaand Humana challenge the deployment of AI programs to decide the amount of coverage that patients required, regardless of the recommendations of the treating physician. Despite the scrutiny in court, only a small minority of patients (usually more advantaged patients) appeal these prior authorization denials. In other words, the high rate at which these denials are reversed — as high as 90 percentaccording to the lawsuits — can be an acceptable cost to insurers if the process is so burdensome that few ever challenge the decisions in the first place.
Daniel ultimately received his spinal cord stimulator, but through his long-term suffering, he was left wondering what might have been absent his supportive family and team of physicians advocating for his access to care at each turn in the health insurance maze. Applying the tools of managed health care to seniors, who may face cognitive decline and worsened physical health, is a recipe for disaster in which, for far too many, health benefits will feel illusory. In a nation as wealthy as the United States, seniors’ epitaphs should not be at risk of reading, “Died of red tape.”
Miranda Yaver
Miranda Yaver is an assistant professor of health policy and management at the University of Pittsburgh and a health care fellow at the Roosevelt Institute.
The Senate Judiciary Committee postponed a vote on acting Attorney General Todd Blanche’s nomination, a spokesperson said late Wednesday, as two retiring Republicans on the panel dug in over President Donald Trump’s personal “anti-weaponization” deal with the government he runs.
Sen. Chuck Grassley’s decision to delay the committee vote that had been set for Thursday marks a setback for one of Trump’s highest-profile Cabinet nominees, at the hands of Texas Sen. John Cornyn and Sen. Thom Tillis of North Carolina, a pair of Republicans set to leave the chamber next year.
“Chairman Grassley works to set President Trump’s nominees up for success in committee, not failure. Senators Cornyn and Tillis want written assurances from the Department of Justice regarding the Trump-IRS settlement,” the committee spokesperson said.
Blanche’s nomination to permanently head the Department of Justice needs the support of either Cornyn or Tillis to make it out of the committee to a vote by the full Senate, assuming all Democrats remain opposed.
“Why don’t you call over the Department of Justice and tell them they have one hour and 50 minutes to get me what I asked for,” Cornyn told reporters Wednesday afternoon amid the hardening standoff over his demand that Blanche and the DOJ put in writing a commitment never to pursue the president’s prized “anti-weaponization” fund, and to clarify the terms of Trump’s personal deal with the Internal Revenue Service.
Tillis told MS NOW that the conversations were complicated by the need for the Justice Department to get “several parties” to agree on the language of the statement Cornyn and Tillis are seeking.
“What I’ve advised the chair, and I would assume Senator Cornyn said something similar, is that we’re not prepared to vote yes yet,” he added.
“The Department has been in regular communication with Committee members for weeks, and we look forward to continuing to work productively with Senators to address any concerns,” a Justice Department spokesperson said in response to the decision to postpone the committee vote.
Cornyn was set to meet with Blanche on Wednesday morning, but the meeting was called off after Blanche failed to meet the senator’s demand for written proposals to modify the controversial settlement agreement he brokered between Trump and the IRS. The Republican senator is set to leave Congress when his term ends in January after a bruising May primary loss to Texas Attorney General Ken Paxton, Trump’s chosen candidate.
“Maybe John Cornyn’s upset with me because I didn’t endorse him,” Trump told reporters Wednesday afternoon in the Oval Office. “I don’t know what it is, but I haven’t heard that there’s a problem. I heard (Blanche) is going through quite nicely.”
Cornyn made clear to Blanche during his confirmation hearing that he will not get his support until he agrees to reopen and modify the settlement. Due to the committee’s narrow Republican majority, one GOP “no” vote is enough to sink Blanche’s nomination.
The senator has asked Blanche to provide proof that the proposed nearly $1.8 billion “anti-weaponization” fund established as part of the deal between Trump and the IRS is formally dead, and he has also demanded Blanche narrow the tax audit immunity provisions the settlement afforded to Trump and his family.
Blanche has publicly stated that his department has dropped the fund, but he and the DOJ have dodged requests from Cornyn and a federal judge to put that in writing.
After announcing his meeting with Blanche would not take place Wednesday morning, Cornyn told reporters that changes from Blanche “in a modified release form” would be acceptable, but that “for some reason … they simply refuse to do it,” referring to the DOJ.
Shortly after the meeting was called off, a Justice Department official told MS NOW that the department “provided a written proposal to Senator Cornyn’s staff yesterday following ongoing discussion with both the Committee and the Senator’s office.”
Cornyn said that proposal was “not responsive” to his demands because it did not address the tax audit immunity provisions in the settlement, one of his key demands.
In May, Blanche signed an addendum as part of the deal that granted Trump, his family and his businesses immunity from pending IRS tax audits. That agreement, which has been decried by former IRS officials and legal experts as unlawful self-dealing, is being contested in federal court.
Cornyn noted that Blanche testified under oath that he could meet the request during his confirmation hearing.
“Maybe they think I’m just going to give up or you know, go along, but they’re mistaken,” Cornyn said when asked why he thinks the DOJ could be slow-walking his request.
Kevin Frey contributed to this report.
Sydney Carruth is a breaking news reporter covering national politics and policy for MS NOW. You can send her tips from a non-work device on Signal at SydneyCarruth.46 or follow her work on X and Bluesky.
Mychael Schnell is a reporter for MS NOW.
Ebony Davis is a breaking news reporter for MS NOW based in Washington, D.C. She previously worked at BLN as a campaign reporter covering elections and politics.
When Israeli Prime Minister Benjamin Netanyahu arrived this week for his tour of Washington, he may have had a mission in mind.
Netanyahu needed to overcome his newly diminished stature and waning influence over his once close friend President Donald Trump as both leaders grapple with the unpopularity of a war they started together and is escaping their control.
His meeting at the White House with Trump on Tuesday, which was closed to the press, was the first face-to-face encounter between the two allies since the U.S. and Israel launched a joint attack against Iran on Feb. 28.
Trump gave him a muted welcome and afterwards simply described the meeting as “very good.” “Obviously, many important subjects were discussed,” the president wrote on Truth Social.
Rather than an intimate one-on-one setting, the Oval Office was full of top U.S. officials — Vice President JD Vance, Secretary of State Marco Rubio, Treasury Secretary Scott Bessent, Secretary of Defense Pete Hegseth, Chairman of the Joint Chiefs of Staff Gen. Dan Caine, and special envoy Steve Witkoff.
But Netanyahu continued the full court press on the Trump administration.
Over the course of two days, in addition to seeing Trump and attending Sen. Lindsey Graham’s funeral at the Capitol, Netanyahu also met separately with Vance, Hegseth, and Rubio, White House and Israeli officials confirmed to MS NOW.
The Israeli prime minister’s slate of meetings with key U.S. national security officials comes at a pivotal moment in the Iran conflict as tensions escalate in the region and Americans increasingly sour on the war. A recent Quinnipiac poll shows 60% of American voters opposing U.S. military action against Iran and 74% against sending U.S. ground troops into Iran.
Not only does Trump face pressure as Republicans face an uphill battle to retain congressional control in this fall’s midterms, Netanyahu’s fate as prime minister is at stake in Israel’s upcoming September elections – and he can’t afford to lose Trump’s favor.
The talks largely focused on what to do next as Iran continues to menace shipping in the Strait of Hormuz and retaliate against American bases in the region and launch attacks on Gulf allies.
According to a senior Israeli official who was granted anonymity to describe the closed-door meeting, President Trump and Israeli Prime Minister Netanyahu did not come to a final decision after discussing three paths forward: get a “good deal” focused on Iran’s nuclear program and enriched material, have no deal and instead continue the blockade and economic pressure, or take escalated military action.
But Netanyahu did not tell Trump what he should do – nor did he express a preference.
The senior Israeli official noted Netanyahu has not ruled out diplomacy – as long as it is coupled with “very strong pressures,” calling the push to dismantle Iran’s nuclear program “a contest of will and a contest of force.”
“There are ways of squeezing them and squeezing them and squeezing them and negotiating at the same time,” the official said.
Netanyahu did not present President Trump with new intelligence regarding the underground Iranian nuclear facility Pickaxe Mountain, per the senior Israeli official, noting the U.S. and Israel already are constantly sharing intelligence – and know where Iran’s highly enriched material is. “We don’t think it’s moved, and I think we have a pretty good grasp on that,” the official said.
During their meeting on Tuesday, Trump and Netanyahu discussed ways Israel and the U.S. can work together to stop Iran’s nuclear program and get the Strait of Hormuz open to maritime trade, the senior Israeli official said.
The two leaders also discussed a third goal: to continue to undermine the Iranian regime and “possibly create future conditions for a change in that area.” U.S. officials have backed away from pursuing paths that would overthrow the current leadership, but Netanyahu still believes that could happen.
“The chasm that has been created between the people and the regime is not about to be closed,” the senior Israeli official said of Netanyahu’s thinking.
Netanyahu advised Trump in February that Israeli intelligence indicated launching strikes against Iran would lead to the toppling of the Islamic Republic’s regime – and five months later, the slain ayatollah’s son retains power with a close circle of hardliners, calling into question the accuracy of Israel’s intelligence apparatus.
But the senior Israeli official said at the time, Netanyahu did not promise the Iranian people would take fate into their own hands following a coordinated attack. Rather, he chose his words carefully and said that an attack could create conditions to “advance the probability or the possibility that that would happen.”
The conditions needed for the Iranian regime to fall, “did not materialize,” the official told MS NOW, adding, “not for lack of insight, but for either operational failure or decisions that were made.”
Despite Netanyahu insisting Israel and the U.S. are on the same page, differences still remain: the sale of F-35 fighter jets to Turkey and the Saudi nuclear arrangement did not come up during Wednesday’s White House meeting, according to a second Israeli official granted anonymity to describe sensitive discussions.
Meanwhile, the conflict continues to spread, with an Iranian drone attacking a U.S. gas storage tanker off the coast of Egypt on Wednesday.
Trump indicated he would not let Iran’s latest action slide, telling reporters on Wednesday that the U.S. would retaliate against Iran even as he leaves room for diplomatic talks to resume.
“It’s our turn, and we’ll see if we get there with an agreement at some point,” Trump said. “But we’re going to hit them very hard.”
As for what it would take for Israel to join the U.S. strikes, the senior Israeli official said that if Israel is attacked by Iran, “We will respond very, very forcefully and very quickly. And I think Iran would make a great mistake.”
Julia Jester covers politics for MS NOW and is based in Washington, D.C.
International rage over FIFA’s close ties to President Donald Trump has reached a fever pitch after soccer’s governing body announced a plan to sell a significant stake to an investor group led by Joshua Kushner, the brother of Trump’s son-in-law.
The president and his family have all but turned the White House into their personal piggy bank. And FIFA — which has its own sordid history of corruption — seems to have made itself a party to Trump’s self-enrichment under Gianni Infantino’s leadership, such as by paying for space inside Trump Tower in New York. (The organization has defended the office rental as a World Cup outpost.)
Soccer is seen by many as a unifying game. But Trump’s incorporation of FIFA into his political dynasty is threatening that idea.
FIFA has announced plans to sell a large minority stake in a new company that will run its main events, including the World Cup and Club World Cup, as part of a plan to triple the amount of development money it dishes out to its 211 member associations.
Under the proposals — which are subject to approval by a majority of those national associations and FIFA’s 37-member council — a new entity called FIFA Forward Enterprises (FFE) will take over all commercial operations, while FIFA remains the game’s global governing body and retains a majority stake in FFE.
A press release from FIFA confirmed the plans and said Thrive Eternal, which was launched by Joshua Kushner, is expected to lead the investment group that would control FIFA Forward Enterprise. FIFA did not clarify why Thrive Eternal was selected, and Kushner was already dabbling in sports.
But Trump basically has already given son-in-law Jared Kushner carte blanche to dictate U.S. foreign policy in the Middle East while simultaneously hatching business plans in the region. (Jared Kushner has denied any conflicts of interest.)
Joshua Kushner reportedly has been a major donor to Democrats. But, predictably, the idea of another Kushner becoming financially entwined with the World Cup — the world’s most popular sporting event — and basically being dropped into a position of global significance isn’t going over well. Several other soccer governing bodies have expressed concerns, including Europe’s UEFA.
“This crosses a line that football’s governing institutions should never cross,” UEFA said in a statement about The Athletic’s report, adding: “The soul and governance of football are not assets to trade — especially with zero transparency as to who gains financially. None of us are the owners of football. It is not FIFA’s to sell.”
Democrats on the House Judiciary Committee also rebuked the plan, writing on X: “Apparently the fake Peace Prize and giant lease with Trump Tower weren’t enough — now Infantino performs a kickback hat trick by pursuing a multibillion-dollar deal with Jared Kushner’s brother to sell ownership stakes in the World Cup to private investors.”
FIFA, Donald Trump’s favorite corrupt racketeering enterprise in world sports, is now going directly into business with the Trump family!
Apparently the fake Peace Prize and giant lease with Trump Tower weren’t enough—now Infantino performs a kickback hat trick by pursuing a… https://t.co/knSZibuMea
— House Judiciary Dems (@HouseJudiciary) July 28, 2026
Rep. Jamie Raskin, D-Md., has already launched an investigation into the FIFA leader’s relationship with the Trump administration, while dozens of European lawmakers — citing concerns about “potential breaches of political neutrality” — have called for the FIFA Ethics Committee to investigate Infantino. This new proposal seems unlikely to assuage those concerns.
But what it does seem likely to do is fuel global anger toward the U.S. — the kind that has been growing since Trump retook office.
And when you consider that, it’s truly remarkable how the same MAGA movement whose members whined for years about politics mixing with sports is now in lockstep with a president who seems dead-set on casting his shadow over every sports event he can.
This post on X basically sums up the foul stench around FIFA’s latest proposal.
Sepp Blatter was Infantino’s predecessor as FIFA president and oversaw the organization amid some of its many scandals. When heof all people, is warning about how Trump and Infantino’s relationship is “deeply damaging” soccer, it’s a sign of how far FIFA has descended into the gutter.
Ja’han Jones is an MS NOW opinion blogger. He previously wrote The ReidOut Blog.
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