A Democratic bill with 2 Republican cosponsors · See all 7 cosponsors
Last activity — Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Education and Workforce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
In committee
Introduced and handed to a committee in the chamber it started in.
The committee holds it, and most bills are never heard from again. A hearing or a committee vote would be news; silence is the usual outcome, and it kills the bill without anyone voting against it.
Its path through Congress
- Introduced
- In Committee
What this bill would do
This bill regulates the use of artificial intelligence in the review of health care claims by group health plans and health insurance issuers. It establishes that adverse benefit determinations involving clinical judgment cannot be issued or dictated by an artificial intelligence system. Instead, these decisions must be made solely by a licensed health care professional who uses independent clinical judgment and evaluates the individual medical circumstances of the enrollee. The legislation requires health plans to include specific disclosures in notices sent to enrollees if artificial intelligence was used in connection with a determination. Additionally, it mandates that documentation regarding the artificial intelligence system and its outputs must be maintained as part of the administrative record and made available to enrollees upon request. Finally, the bill addresses parity treatment by establishing that the use of artificial intelligence in utilization review constitutes a treatment limitation, particularly regarding mental health and substance use disorder benefits.
Yes· 3 of 9
- Scored +6
Does this make health care easier to get in general?
The bill ensures that insurance coverage decisions are made by licensed professionals rather than algorithms.
- Scored +5
Does this protect the right to fair treatment by the courts?
The bill enhances the due process rights of patients seeking medical coverage reviews.
- Scored +5
Would households on low incomes be better off under this?
Providing human clinical oversight can prevent the unfair denial of essential benefits.
The opposite
- Scored -2
Would business owners be better off under this?
Increases administrative and compliance costs for insurance providers.
Who it would affect, and how
Potential Positive Impacts for People
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Protection from Automated Denials: Under Section 2, Section 3, and Section 4 of the bill, group health plans and health insurance issuers must ensure that adverse benefit determinations involving clinical judgment are not issued or dictated by an artificial intelligence system. This provision ensures that a machine cannot simply reject a person's medical claim without human oversight.
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Requirement of Real Human Expertise: The legislation specifies in Section 2, Section 3, and Section 4 that adverse benefit determinations must be made only by a licensed health care professional who is acting within their scope of practice and has training and experience in the specific health care item or service. This means a qualified doctor or nurse will be reviewing your specific medical situation rather than an automated software program.
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Right to Transparency and Records: Sections 2, 3, and 4 require that if artificial intelligence is used in connection with a determination, the notice must state that the system was used, describe its role, and provide the name and credentials of the licensed professional who made the decision. Furthermore, health plans must maintain detailed documentation of the AI system used and its outputs as part of the administrative record, which must be made available to the enrollee or participant upon request.
Potential Negative Impacts for People
- Potential Administrative Delays: Because every adverse benefit determination involving clinical judgment must be individually evaluated and decided by a licensed health care professional without relying on artificial intelligence outputs as presumptively valid, the review process for appeals and claims could potentially take longer. This might slow down how quickly patients receive final answers on their disputed health care claims.
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Tap or hover a score for the reason it gave.
- Governance And Ideology
- Does this protect the right to fair treatment by the courts? — The bill enhances the due process rights of patients seeking medical coverage reviews. Does this make what the government does easier for the public to see? — The bill mandates transparency in how AI is used in medical insurance determinations. Does this give the federal government more power? — The bill expands federal regulatory oversight of health insurance practices involving AI.
- Healthcare
- Does this make health care easier to get in general? — The bill ensures that insurance coverage decisions are made by licensed professionals rather than algorithms. Does this make mental health care easier to get? — The bill enhances parity evaluations for mental health and substance use disorder benefits.
- Demographic And Interest Groups
- Would households on low incomes be better off under this? — Providing human clinical oversight can prevent the unfair denial of essential benefits. Would middle-income households be better off under this? — Ensures more reliable insurance coverage decisions for families. Would business owners be better off under this? — Increases administrative and compliance costs for insurance providers.
- Economy And Finance
- Does this give people more protection from unfair business practices? — The bill protects consumers by ensuring human oversight in medical insurance decisions.
- Education And Technology
- Does this put more rules on large technology companies? — The bill imposes new regulatory requirements on the use of AI in health insurance processes.
- 11/9/2026
- 1 Cosponsor added.
- 10/13/2026
- 1 Cosponsor added.
- 10/5/2026
- 1 Cosponsor added.
- 9/28/2026
- 1 Cosponsor added.
- 9/1/2026
- Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Education and Workforce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 3 Cosponsors added.
- Introduced in House
Tom BarrettRepublican · Michigan
Earl CarterRepublican · Georgia
Debbie DingellDemocrat · Michigan
Jared HuffmanDemocrat · California
April McClain DelaneyDemocrat · Maryland
Greg StantonDemocrat · Arizona
Kim SchrierDemocrat · Washington