“Stop Profit-Driven AI From Denying Medicaid Care”

I am writing to demand urgent legislative action to protect Medicaid beneficiaries from harmful and unethical practices involving third-party artificial intelligence systems being used to determine eligibility and claims. Across the country, states and managed care organizations are outsourcing Medicaid decision-making to private contractors that rely on AI-driven systems. These systems are not accountable to the public and have already been shown to issue wrongful denials and terminations of care. Even more disturbing, some contracts financially reward these vendors for denying services, creating a direct conflict of interest that prioritizes profit over the health and safety of vulnerable people. Medicaid is a lifeline for millions of Americans, including children, older adults, and people with disabilities. Eligibility and claims decisions must be made transparently and based on law, medical necessity, and human review—not by opaque algorithms designed to cut costs. Denials issued by profit-incentivized AI vendors are not only unjust, they violate the principles of due process and threaten the health of those who can least afford to fight back. I urge you to take immediate steps to: • Prohibit the use of AI or algorithmic systems as the final arbiter in Medicaid eligibility or claims determinations. • Ban any financial incentives that reward contractors for denying coverage or care. • Require human review, accountability, and full transparency in all Medicaid decision-making. • Ensure that beneficiaries have clear avenues to appeal denials and receive timely remedies. Medicaid was designed to serve people, not corporations. Allowing third-party AI vendors to profit from denying care undermines trust in the program and endangers lives. Please act now to safeguard Medicaid and ensure decisions are made fairly, ethically, and with human accountability. Thank you for your leadership and for standing up for the rights of your constituents who depend on Medicaid