Watch: As AI Makes More Health Coverage Decisions, the Risks to Patients Grow

By Darius Tahir and Hannah Norman

April 10, 2026

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<br /> <span class="byline">Darius Tahir and Hannah Norman, KFF Health News</span></p> <p>This year, executives from nearly every major health insurance company made the same declaration in calls with Wall Street analysts: Using artificial intelligence to make coverage decisions would help save them money.</p> <p>Even the Trump administration is testing AI’s usefulness in managing the prior authorization process for the Medicare program, as well as seeking to override AI regulation by states.</p> <div class="related-sec related-2"> <div class="inner block-list-small-2"> <div class="block-h heading-layout-13"><div class="heading-inner"><h4 class="heading-title none-toc"><span>Related News</span></h4></div></div> <div class="block-inner"> <div class="p-wrap p-small p-list-small-2" data-pid="3994"> <div class="feat-holder"> <div class="p-featured ratio-v1"> <a class="p-flink" href="https://lifeaurahealth.com/environmental-factor-april-2025-tiny-plastics-big-questions-in-conversation-with-dr-matthew-campen/" title="Environmental Factor – April 2025: Tiny plastics, big questions: in conversation with Dr. Matthew Campen"> <img data-lazyloaded="1" src="data:image/svg+xml;base64,PHN2ZyB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciIHdpZHRoPSIxNTAiIGhlaWdodD0iMTUwIiB2aWV3Qm94PSIwIDAgMTUwIDE1MCI+PHJlY3Qgd2lkdGg9IjEwMCUiIGhlaWdodD0iMTAwJSIgc3R5bGU9ImZpbGw6I2NmZDRkYjtmaWxsLW9wYWNpdHk6IDAuMTsiLz48L3N2Zz4=" width="150" height="150" data-src="https://lifeaurahealth.com/wp-content/uploads/2026/04/Environmental-Factor-April-2025-Tiny-plastics-big-questions-in-150x150.jpg" class="featured-img wp-post-image" alt="Environmental Factor - April 2025: Tiny plastics, big questions: in conversation with Dr. Matthew Campen" loading="lazy" /> </a> </div> </div> <div class="p-content"> <h5 class="entry-title none-toc"> <a class="p-url" href="https://lifeaurahealth.com/environmental-factor-april-2025-tiny-plastics-big-questions-in-conversation-with-dr-matthew-campen/" rel="bookmark">Environmental Factor – April 2025: Tiny plastics, big questions: in conversation with Dr. Matthew Campen</a></h5> </div> </div> <div class="p-wrap p-small p-list-small-2" data-pid="3990"> <div class="feat-holder"> <div class="p-featured ratio-v1"> <a class="p-flink" href="https://lifeaurahealth.com/rovner-recaps-medicaid-cuts-impact-on-hospitals-and-fields-caller-questions-on-affordability/" title="Rovner Recaps Medicaid Cuts’ Impact on Hospitals and Fields Caller Questions on Affordability"> <img data-lazyloaded="1" src="data:image/svg+xml;base64,PHN2ZyB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciIHdpZHRoPSIxNTAiIGhlaWdodD0iMTUwIiB2aWV3Qm94PSIwIDAgMTUwIDE1MCI+PHJlY3Qgd2lkdGg9IjEwMCUiIGhlaWdodD0iMTAwJSIgc3R5bGU9ImZpbGw6I2NmZDRkYjtmaWxsLW9wYWNpdHk6IDAuMTsiLz48L3N2Zz4=" width="150" height="150" data-src="https://lifeaurahealth.com/wp-content/uploads/2026/04/Rovner-Recaps-Medicaid-Cuts-Impact-on-Hospitals-and-Fields-Caller-150x150.jpg" class="featured-img wp-post-image" alt="Rovner Recaps Medicaid Cuts’ Impact on Hospitals and Fields Caller Questions on Affordability" loading="lazy" /> </a> </div> </div> <div class="p-content"> <h5 class="entry-title none-toc"> <a class="p-url" href="https://lifeaurahealth.com/rovner-recaps-medicaid-cuts-impact-on-hospitals-and-fields-caller-questions-on-affordability/" rel="bookmark">Rovner Recaps Medicaid Cuts’ Impact on Hospitals and Fields Caller Questions on Affordability</a></h5> </div> </div> <div class="p-wrap p-small p-list-small-2" data-pid="3987"> <div class="feat-holder"> <div class="p-featured ratio-v1"> <a class="p-flink" href="https://lifeaurahealth.com/environmental-factor-april-2025-synthetic-data-created-by-generative-ai-poses-ethical-challenges/" title="Environmental Factor – April 2025: Synthetic data created by generative AI poses ethical challenges"> <img data-lazyloaded="1" src="data:image/svg+xml;base64,PHN2ZyB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciIHdpZHRoPSIxNTAiIGhlaWdodD0iMTUwIiB2aWV3Qm94PSIwIDAgMTUwIDE1MCI+PHJlY3Qgd2lkdGg9IjEwMCUiIGhlaWdodD0iMTAwJSIgc3R5bGU9ImZpbGw6I2NmZDRkYjtmaWxsLW9wYWNpdHk6IDAuMTsiLz48L3N2Zz4=" width="150" height="150" data-src="https://lifeaurahealth.com/wp-content/uploads/2026/04/Environmental-Factor-April-2025-Synthetic-data-created-by-generative-150x150.jpg" class="featured-img wp-post-image" alt="Environmental Factor - April 2025: Synthetic data created by generative AI poses ethical challenges" loading="lazy" /> </a> </div> </div> <div class="p-content"> <h5 class="entry-title none-toc"> <a class="p-url" href="https://lifeaurahealth.com/environmental-factor-april-2025-synthetic-data-created-by-generative-ai-poses-ethical-challenges/" rel="bookmark">Environmental Factor – April 2025: Synthetic data created by generative AI poses ethical challenges</a></h5> </div> </div> </div> </div> </div> <p>But class action lawsuits have accused insurers of using AI to wrongfully withhold treatment. And <a href="https://news.stanford.edu/stories/2026/01/ai-algorithms-health-insurance-care-risks-research">new research from Stanford University</a> outlines the risks of training AI on a current system rife with wrongful denials.</p> <p>“There is a world in which using AI could make that worse, or at least replicate a bad human system, because the data that it would be training on is from that bad human system,” said Michelle Mello, a co-author of the study.</p> <p>Although, Mello said, the research team found “real positives alongside the risks.”</p> <p>In this video produced by KFF Health News’ Hannah Norman, Darius Tahir, a correspondent covering health technology, explains.</p> <p>You can read Tahir’s recent coverage of AI’s use by health insurers below:</p> <p>
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