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 <a href="https://kffhealthnews.org/news/article/ai-medicare-prior-authorization-trump-pilot-program-wiser/" target="_blank" rel="noopener">testing AI’s usefulness</a> in managing the prior authorization process for the Medicare program, as well as seeking to override AI regulation by states.</p> <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" target="_blank" rel="noopener">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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