artificial intelligence
It’s Time to Take On the New Cold Warriors of Silicon Valley
We can’t afford to let the people and companies that will profit most from AI’s unbridled military application have the upper hand in making the rules for how it should be used.
Venture capital and military startup firms in Silicon Valley have begun aggressively selling a version of automated warfare that will deeply incorporate artificial intelligence. Those companies and their CEOs are now pressing full speed ahead with that emerging technology, largely dismissing the risk of malfunctions that could lead to the future slaughter of civilians, not to speak of the possibility of dangerous scenarios of escalation between major military powers. The reasons for this headlong rush include a misplaced faith in “miracle weapons,” but above all else, this surge of support for emerging military technologies is driven by the ultimate rationale of the military-industrial complex: vast sums of money to be made.
The New Techno-Enthusiasts
While some in the military and the Pentagon are indeed concerned about the future risk of AI weaponry, the leadership of the Defense Department is on board fully. Its energetic commitment to emerging technology was first broadcast to the world in an August 2023 speech delivered by Deputy Secretary of Defense Kathleen Hicks to the National Defense Industrial Association, the largest arms industry trade group in the country. She used the occasion to announce what she termed “the Replicator Initiative,” an umbrella effort to help create “a new state of the art—just as America has before—leveraging attritable, autonomous systems in all domains—which are less expensive, put fewer people in the line of fire, and can be changed, updated, or improved with substantially shorter lead times.”
Hicks was anything but shy about pointing to the primary rationale for such a rush toward robotic warfare: outpacing and intimidating China. “We must,” she said, “ensure the PRC [People’s Republic of China] leadership wakes up every day, considers the risks of aggression, and concludes, ‘Today is not the day’—and not just today, but every day, between now and 2027, now and 2035, now and 2049, and beyond.”
Hick’s supreme confidence in the ability of the Pentagon and American arms makers to wage future techno-wars has been reinforced by a group of new-age militarists in Silicon Valley and beyond, spearheaded by corporate leaders like Peter Thiel of Palantir, Palmer Luckey of Anduril, and venture capitalists like Marc Andreessen of Andreessen Horowitz.
Patriots or Profiteers?
These corporate promoters of a new way of war also view themselves as a new breed of patriots, ready and able to successfully confront the military challenges of the future.
A case in point is “Rebooting the Arsenal of Democracy,” a lengthy manifesto on Anduril’s blog. It touts the superiority of Silicon Valley startups over old-school military-industrial behemoths like Lockheed Martin in supplying the technology needed to win the wars of the future:
The largest defense contractors are staffed with patriots who, nevertheless, do not have the software expertise or business model to build the technology we need… These companies built the tools that kept us safe in the past, but they are not the future of defense.
In contrast to the industrial-age approach it critiques, Luckey and his compatriots at Anduril seek an entirely new way of developing and selling weapons:
Software will change how war is waged. The battlefield of the future will teem with artificially intelligent, unmanned systems, which fight, gather reconnaissance data, and communicate at breathtaking speeds.
At first glance, Luckey seems a distinctly unlikely candidate to have risen so far in the ranks of arms industry executives. He made his initial fortune by creating the Oculus virtual reality device, a novelty item that users can strap to their heads to experience a variety of 3-D scenes (with the sensation that they’re embedded in them). His sartorial tastes run toward sandals and Hawaiian shirts, but he has now fully shifted into military work. In 2017, he founded Anduril, in part with support from Peter Thiel and his investment firm, Founders Fund. Anduril currently makes autonomous drones, automated command and control systems, and other devices meant to accelerate the speed at which military personnel can identify and destroy targets.
Thiel, a mentor to Palmer Luckey, offers an example of how the leaders of the new weapons startup firms differ from the titans of the Cold War era. As a start, he’s all in for Donald Trump. Once upon a time, the heads of major weapons makers like Lockheed Martin tried to keep good ties with both Democrats and Republicans, making substantial campaign contributions to both parties and their candidates and hiring lobbyists with connections on both sides of the aisle. The logic for doing so couldn’t have seemed clearer then. They wanted to cement a bipartisan consensus for spending ever more on the Pentagon, one of the few things most key members of both parties agreed upon. And they also wanted to have particularly good relations with whichever party controlled the White House and/or the Congress at any moment.
The Silicon Valley upstarts and their representatives are also much more vocal in their criticisms of China. They are the coldest (or do I mean hottest?) of the new cold warriors in Washington, employing harsher rhetoric than either the Pentagon or the big contractors. By contrast, the big contractors generally launder their critiques of China and support for wars around the world that have helped pad their bottom lines through think tanks, which they’ve funded to the tune of tens of millions of dollars annually.
The approach advocated by Brose and his acolytes is going to make war more likely as technological hubris instills a belief that the United States can indeed “beat” a rival nuclear-armed power like China in a conflict, if only we invest in a nimble new high-tech force.
Thiel’s main company, Palantir, has also been criticized for providing systems that have enabled harsh border crackdowns by U.S. Immigration and Customs Enforcement (ICE) as well as “predictive policing.” That (you won’t be surprised to learn) involves the collection of vast amounts of personal data without a warrant, relying on algorithms with built-in racial biases that lead to the systematic unfair targeting and treatment of people of color.
To fully grasp how the Silicon Valley militarists view next-generation warfare, you need to check out the work of Christian Brose, Palantir’s chief strategy officer. He was a long-time military reformer and former aide to the late Sen. John McCain (R-Ariz.). His book Kill Chainserves as a bible of sorts for advocates of automated warfare. Its key observation: that the winner in combat is the side that can most effectively shorten the “kill chain” (the time between when a target is identified and destroyed). His book assumes that the most likely adversary in the next tech war will indeed be China, and he proceeds to exaggerate Beijing’s military capabilities, while overstating its military ambitions and insisting that outpacing that country in developing emerging military technologies is the only path to future victory.
And mind you, Brose’s vision of shortening that kill chain poses immense risks. As the time to decide what actions to take diminishes, the temptation to take humans “out of the loop” will only grow, leaving life-and-death decisions to machines with no moral compass and vulnerable to catastrophic malfunctions of a sort inherent in any complex software system.
Much of Brose’s critique of the current military-industrial complex rings true. A few big firms are getting rich making ever more vulnerable huge weapons platforms like aircraft carriers and tanks, while the Pentagon spends billions on a vast, costly global basing network that could be replaced with a far smaller, more dispersed military footprint. Sadly, though, his alternative vision poses more problems than it solves.
First, there’s no guarantee that the software-driven systems promoted by Silicon Valley will work as advertised. After all, there’s a long history of “miracle weapons” that failed, from the electronic battlefield in Vietnam to President Ronald Reagan’s disastrous Star Wars missile shield. Even when the ability to find and destroy targets more quickly did indeed improve, wars like those in Iraq and Afghanistan, fought using those very technologies, were dismal failures.
A recent Wall Street Journalinvestigation suggests that the new generation of military tech is being oversold as well. The Journal found that small top-of-the-line new U.S. drones supplied to Ukraine for its defensive war against Russia have proved far too “glitchy and expensive,” so much so that, irony of ironies, the Ukrainians have opted to buy cheaper, more reliable Chinese drones instead.
Finally, the approach advocated by Brose and his acolytes is going to make war more likely as technological hubris instills a belief that the United States can indeed “beat” a rival nuclear-armed power like China in a conflict, if only we invest in a nimble new high-tech force.
The result, as my colleague Michael Brenes and I pointed out recently, is the untold billions of dollars of private money now pouring into firms seeking to expand the frontiers of techno-war. Estimates range from $6 billion to $33 billion annually and, according to TheNew York Times, $125 billion over the past four years. Whatever the numbers, the tech sector and its financial backers sense that there are massive amounts of money to be made in next-generation weaponry and aren’t about to let anyone stand in their way.
Meanwhile, an investigation by Eric Lipton of TheNew York Times found that venture capitalists and startup firms already pushing the pace on AI-driven warfare are also busily hiring ex-military and Pentagon officials to do their bidding. High on that list is former Trump Secretary of Defense Mark Esper. Such connections may be driven by patriotic fervor, but a more likely motivation is simply the desire to get rich. As Ellen Lord, former head of acquisition at the Pentagon, noted, “There’s panache now with the ties between the defense community and private equity. But they are also hoping they can cash in big-time and make a ton of money.”
The Philosopher King
Another central figure in the move toward building a high-tech war machine is former Google CEO Eric Schmidt. His interests go far beyond the military sphere. He’s become a virtual philosopher king when it comes to how new technology will reshape society and, indeed, what it means to be human. He’s been thinking about such issues for some time and laid out his views in a 2021 book modestly entitled The Age of AI and Our Human Future, coauthored with none other than the late Henry Kissinger. Schmidt is aware of the potential perils of AI, but he’s also at the center of efforts to promote its military applications. Though he forgoes the messianic approach of some up-and-coming Silicon Valley figures, whether his seemingly more thoughtful approach will contribute to the development of a safer, more sensible world of AI weaponry is open to debate.
Let’s start with the most basic thing of all: the degree to which Schmidt thinks that AI will change life as we know it is extraordinary. In that book of his and Kissinger’s, they asserted that it would spark “the alteration of human identity and the human experience at levels not seen since the dawn of the modern age,” arguing that AI’s “functioning portends progress toward the essence of things, progress that philosophers, theologians, and scientists have sought, with partial success, for millennia.”
On the other hand, the government panel on artificial intelligence on which Schmidt served fully acknowledged the risks posed by the military uses of AI. The question remains: Will he, at least, support strong safeguards against its misuse? During his tenure as head of the Pentagon’s Defense Innovation Board from 2017 to 2020, he did help set the stage for Pentagon guidelines on the use of AI that promised humans would always “be in the loop” in launching next-gen weapons. But as a tech industry critic noted, once the rhetoric is stripped away, the guidelines “don’t really prevent you from doing anything.”
In fact, Sen. Elizabeth Warren (D-Mass.) and other good government advocates questioned whether Schmidt’s role as head of the Defense Innovation Unit didn’t represent a potential conflict of interest. After all, while he was helping shape its guidelines on the military applications of AI, he was also investing in firms that stood to profit from its development and use. His investment entity, America’s Frontier Fund, regularly puts money in military tech startups, and a nonprofit he founded, the Special Competitive Studies Project, describes its mission as to “strengthen America’s long-term competitiveness as artificial intelligence (AI) [reshapes] our national security, economy, and society.” The group is connected to a who’s who of leaders in the military and the tech industry and is pushing, among other things, for less regulation over military-tech development. In 2023, Schmidt even founded a military drone company, White Stork, which, according to Forbes, has been secretly testing its systems in the Silicon Valley suburb of Menlo Park.
The question now is whether Schmidt can be persuaded to use his considerable influence to rein in the most dangerous uses of AI. Unfortunately, his enthusiasm for using it to enhance warfighting capabilities suggests otherwise:
Every once in a while, a new weapon, a new technology comes along that changes things. Einstein wrote a letter to Roosevelt in the 1930s saying that there is this new technology—nuclear weapons—that could change war, which it clearly did. I would argue that [AI-powered] autonomy and decentralized, distributed systems are that powerful.
Given the risks already cited, comparing militarized AI to the development of nuclear weapons shouldn’t exactly be reassuring. The combination of the two—nuclear weapons controlled by automatic systems with no human intervention—has so far been ruled out, but don’t count on that lasting. It’s still a possibility, absent strong, enforceable safeguards on when and how AI can be used.
AI is coming, and its impact on our lives, whether in war or peace, is likely to stagger the imagination. In that context, one thing is clear: We can’t afford to let the people and companies that will profit most from its unbridled application have the upper hand in making the rules for how it should be used.
Isn’t it time to take on the new-age warriors?
Why the 2024 Election Could Be Our Last If We Don’t Get Our Act Together
The biggest challenge to our democracy may lie in the absence of any long-term focus on the need for fundamental structural changes in how our elections are run.
Officials and election experts are now struggling in a big-time way. How, they wonder, can they effectively address mounting threats—of violence, election denialism, foreign influence, and voter discrimination? Do they run the risk of alarming the public to the point of reducing voter turnout? Are there reasons to assuage fears about either election disinformation or possible election interference in 2024? Standing in Pointe du Hoc, France, to mark the anniversary of D-Day, U.S. President Joe Biden told the world that those who fought in that pivotal battle are “asking us to do our job: to protect freedom in our time, to defend democracy.” Election security would be a good place to start.
Perhaps one way to assess the question of election stability and security in 2024 is to ask: How different is this election from earlier tumultuous ones in American history?
What, if any, lessons can we draw from the past? Or are we in genuinely uncharted territory today?
In truth, when it comes to presidential elections, this country has faced some frightening moments in its history, ones that touch on a number of the fears that confront us today. We may never have faced the likes of Donald Trump, but we have experienced disputed vote tallies, Supreme Court interference, threats of violence, voting rights restrictions, and a lack of confidence in the process itself.
Contested Elections
Donald Trump has made no bones about it. Should he lose the coming election, he reserves the “right” to refuse to accept the results. In 2020, his denial of the results led to a violent attempt to block Congress from certifying the vote on the following January 6. To date, any accountability for his past actions has been minimal. Found guilty last month of falsifying business records to conceal election law violations in 2016, he has yet to be sentenced and may well appeal all the way up to a sympathetic Supreme Court. Moreover, he hasn’t been tried yet in Georgia and in federal court in Washington, D.C., on significantly more serious criminal charges about ways he and his followers tried to subvert the results of the 2020 election—and he’s unlikely to be before the November elections.
Most Republicans have remained at his side. Indeed, election denialism has become a rallying point rather than a mark of shame. As a result, the former president continues to engage in implied threats to the democratic political process with unwavering partisan support. And were he to disappear from the political scene thanks to a decisive defeat in 2024, others could follow him in exploiting the democratic system for political gain.
While there have been a handful of disputed presidential election results since the country’s founding, two stand out. In the election of 1876, Republican Rutherford B. Hayes lost the popular and electoral vote to Samuel Tilden. The Republicans protested that, in three states, the results were uncertain. To resolve the issue, Congress created a bipartisan panel, including House and Senate representatives and five Supreme Court justices. That panel then granted Hayes all 20 disputed electoral votes, giving him a one-point electoral margin over Tilden, and so making him president. Ultimately, the country found a way forward.
Along with the knowledge that uncertainty can accompany election results, Americans sense as well that violence could indeed loom in as yet unknown ways, thanks to Election 2024.
More than a century later, in the 2000 election between Republican George W. Bush and Democrat Al Gore, the results again lay in dispute. Gore had won the popular vote, but the electoral vote was too close to call. All eyes focused on Florida where the results would determine the outcome. Although the Florida Supreme Court ordered a statewide recount, the Supreme Court stopped it and, in doing so, made Bush president.
In neither post-election resolution did the losing candidate contest the results, though Tilden waited four months before conceding. The day after the Supreme Court’s decision, Gore conceded, saying, “I accept the finality of this outcome”—a stark contrast to Donald Trump who still refuses to concede that the 2020 election result was legitimate.
It’s worth mentioning that both elections had major consequences. Hayes’s win, the result of a brokered deal, also ended the post-Civil War Reconstruction era and led to the withdrawal of U.S. troops from the South. That election would prove an integral part of efforts to undo the biggest push the nation ever had to achieve racial justice.
The Bush administration, in turn, failed to prevent the attacks of September 11, 2001, and then launched a multidecade-long “war on terror” that would destabilize parts of the globe from South Asia to the Middle East and Africa, while, according to the Costs of War Project, leading to the deaths of more than 7,000 American service members and more than 177,000 allied military and police in conflicts ranging from Afghanistan and Pakistan to Iraq and Syria, not to mention the deaths of more than 430,000 civilians.
Along with the knowledge that uncertainty can accompany election results, Americans sense as well that violence could indeed loom in as yet unknown ways, thanks to Election 2024.
Violence Before, During, and After an Election
It’s not that Americans have never experienced the threat of violence around elections. The Civil War years saw numerous outbreaks of violence. In 1861, a mob of Confederate supporters tried to gather to storm Congress to stop the certification of Abraham Lincoln as president. There was no violence only because General Winfield Scott, a southerner, made sure the Capitol was protected.
So, too, in 1868, in the runup to the first election of the Reconstruction era between Ulysses S. Grant and Horatio Seymour, Ku Klux Klan violence led to thousands of murders in Georgia, Kansas, and Louisiana, and threats of violence kept voters away from the polls in droves. In the 1876 Tilden-Hayes election in which four states submitted multiple slates of electors to Congress, one popular slogan was “Tilden or Blood.” Expecting violence, President Grant secured the Capitol with troops and prepared to deploy them elsewhere as well.
And then (as now), race and violence were a distinct issue. In 1873, white mobs assaulted a courthouse in Colfax, Louisiana, to remove pro-Reconstruction Republican officials. In 1898, a horde of white North Carolinians conducted a coup against the fusionist government of the city of Wilmington to empower reactionary southern Democrats.
The embrace of such anti-democratic sentiment by such a potentially powerful figure and his party at a time when global anti-democratic forces are on the rise has already created an historically rare level of instability in this country.
During the last part of the 19th and early 20th centuries, southern Jim Crow laws imposed in response to Reconstruction produced literacy tests and poll taxes that disenfranchised Black voters. And in the 20th century, racially motivated violence aimed at suppressing the vote became a regular part of election politics.
During “Freedom Summer” in 1964, three civil rights workers—James Chaney, Andrew Goodman, and Mickey Schwerner—were killed by white terrorists for participating in Black voter registration initiatives in Mississippi. When demonstrators were assaulted by police and white mobs on the Edmund Pettus Bridge in Alabama during a nonviolent march on March 7, 1965, in support of voting rights legislation, the nation witnessed just how much brutality then existed when it came to those seeking to fulfill the nation’s democratic promise.
21st Century Challenges
Experts anticipate a surge of violence at the polls in 2024. A Brennan Center survey found that, since 2020, “38% of local election officials experienced threats, harassment, or abuse for doing their jobs.” To counter this, the federal government and individual states have already mounted efforts intended to protect both voters and officials. Since 2020, in fact, the Department of Justice, the Department of Homeland Security, and Congress have ponied up an extra $205 million for election protection. And yet, as the Brennan Center points out, a growing fear of violence and harassment has led to “an exodus from the field” of election work. Not surprisingly, a recent Ipsos/Reuters poll reported that two out of three Americans are concerned about the prospect of election violence in 2024 and fear the possibility of a worse version of the January 6 insurrection at the Capitol.
Violence at the polls has, in fact, plagued elections throughout the nation’s history, as Steven Hahn recounts in his new book, Illiberal America, while the Voting Rights Act of 1965 proved to be fragile indeed, as red states continued to put voting restrictions in place based on false allegations of voter fraud.
Worse yet are the threats already emanating from former president Trump and Republicans close to him. The embrace of such anti-democratic sentiment by such a potentially powerful figure and his party at a time when global anti-democratic forces are on the rise has already created an historically rare level of instability in this country.
Past negative experiences have, in our moment, been twisted into newly dangerous configurations.
And keep in mind that not all the dangers of this moment have a footprint in the American past. There are new challenges that face the nation today. Disinformation is a case in point. While false information has always been a part of politics—smears against alleged communists were, for instance, a staple of the early Cold War years—the Internet has proven a game-changer when it comes to facilitating false narratives that could lead to both voter suppression and a deep mistrust of election results.
The scale and scope of disinformation in the modern age has no precedent. Without editorial control and given the ease of disseminating misinformation, guardrails have crumbled. Experts warn that the massive communications infrastructure that transmits bad information could undermine confidence in election results in ways never before seen. Worse yet, Artificial Intelligence is likely to prove a particularly dangerous mechanism for producing electoral deepfakes.
Additionally, foreign interference seems now to have become a permanent feature of American elections, although to what end remains in question. As the 2019 report issued by Special Counsel Robert Mueller demonstrated, Russia’s attempts to interfere with the 2016 election, including conducting “information warfare” and attacking voter databases, proved “sweeping and systematic.”
Where Are We Today?
When it comes to elections, despite Donald Trump, it’s not been all downhill. In 2021, the Department of Justice launched an Election Threat Task Force aimed at individuals who posed threats to election workers. To date, 17 people have indeed been prosecuted. Significantly, in 2022, Congress passed the Electoral Count Reform Act, an attempt to update the Electoral Count Act of 1887 and improve the process of certifying the vote, ensuring that the transition period between election day and inauguration day goes smoothly. In addition, in 2022, Congress passed legislation to establish a Foreign Malign Influence Center to counter disinformation from overseas generally, not just in elections.
The federal courts have also proven to be barriers against electoral subversion. In the wake of the 2020 election, they repeatedly denied Donald Trump success in his efforts to overturn the results. Yet even this source of democratic protection has been limited, while the present all too conservative Supreme Court, which in 2013 gutted the Voting Rights Act, has continued to weaken voter protections.
The question then remains: What do the lessons of history—and recent reforms—tell us about our current moment? On the one hand, history suggests that election dysfunction has been overcome time and again. Whether we’re talking about contested results, challenges to voter suppression, outbreaks of violence, or presidents elected without national majorities, such situations have been resolved reasonably successfully in the past. Meanwhile, new measures have been put in place for the security of election workers, the certification of the vote, and the deterrence of voter suppression in new ways. In other words, American democracy has continued, despite deeply rooted problems.
Rather than facing a continual nip and tuck of problems as they appear, what we really need is a commission that will offer a full-scale rethinking of election security in the 21st century, while focusing on getting Congress to move toward developing a comprehensive new strategy to deal with it.
And yet, it’s also clear that past negative experiences have, in our moment, been twisted into newly dangerous configurations. In place of contested elections, there is now outright election denialism. In addition to racially motivated violence, there’s growing extremist violence aimed at the institution of voting itself. In place of partisan campaign rhetoric, we’re experiencing the spread of hate speech based on race, ethnicity, gender, or simply opposition to democracy itself. Instead of support for the outlawing of post-election violence, we now live with references to the imprisoned offenders of January 6, 2021, as “hostages.” And just because this country has survived challenging times in the past doesn’t mean it will do so again, particularly as pressure against democratic norms ramps up globally.
Many would blame such election instability on Donald Trump alone and there’s no question that he does have a profound knack for manipulating public discourse and threatening to upend election laws, not to speak of the rules, norms, and processes that underlie election legitimacy. However significant, though, he’s not the only factor that warrants attention in this election year.
The largest threats to our elections now come not from weaponized technology, or a tone-deaf Congress or Supreme Court, or even perhaps from Donald Trump himself (though dangerous he may be). The biggest challenge may lie in the absence of any long-term focus on the need for fundamental structural changes in how our elections are run. For centuries, we as a nation have made incremental changes in response to moments of election-related crisis. But far more is needed if we are to escape a future in which questions about whether the electoral process itself is legitimate and whether the results will be accepted become part of every election season.
Our democratic system seems increasingly frail. To face the future with confidence in the most elemental building block of our democracy, we need a longer-term perspective. The elimination of the Electoral College, greater accountability for violence in and around elections, tools for curbing disinformation and improving election administration, a vast increase in funding for public education about polling sites and candidate platforms, strict accountability for attempted voter suppression, and heightened efforts to secure voting rights for all are badly needed. In other words, rather than facing a continual nip and tuck of problems as they appear, what we really need is a commission that will offer a full-scale rethinking of election security in the 21st century, while focusing on getting Congress to move toward developing a comprehensive new strategy to deal with it. Even if we get through the 2024 election cycle intact and violence-free, the task of election reform remains both essential and, sadly, all too ignored.
Perhaps, however, there could be a silver lining in our unnerving moment if our ongoing election troubles lead us to conclude that the time for keeping our fingers crossed should end and the time for wholesale reform begin.
Alarms Raised Over For-Profit Medicare Advantage Using AI to Deny Care to Seniors
"Insurers using AI to deny needed care to seniors and people with disabilities means sacrificing patient needs on the altar of corporate greed," said one campaigner.
Dozens of Democratic U.S. lawmakers joined consumer and patient advocates on Tuesday in sounding the alarm over the use of artificial intelligence by companies providing Medicare Advantage plans to deny healthcare to their senior customers.
Fifty-one Democratic members of Congress and Independent Sen. Bernie Sanders of Vermont wrote to Centers for Medicare and Medicaid Services (CMS) Administrator Chiquita Books LaSure on Tuesday expressing their concern over Medicare Advantage (MA) providers' increasing use of algorithmic systems to deny patient care.
"Plans continue to use AI tool to erroneously deny care and contradict provider assessment findings," the letter notes. "Last year, a class action lawsuit was filed alleging that UnitedHealth Group unlawfully used an AI algorithm, nH Predict, to deny rehabilitative care to sick Medicare Advantage patients."
"The lawsuit cites an investigation suggesting that UnitedHealth Group pressured employees to use the algorithm to issue payment denials to Medicare Advantage beneficiaries and set a goal for employees to keep patient rehabilitation stays within 1% of the length of stay predicted by nH Predict," the lawmakers continued.
MA plans are not part of Medicare. They are a private health insurance "scam" created by a Republican-controlled Congress and signed into law by then-President George W. Bush "as a way of routing hundreds of billions of taxpayer dollars into the pockets of for-profit insurance companies," according to frequent Common Dreams opinion contributor Thom Hartmann.
Advocates have warned about the use of AI in MA denials since at least last year, while imploring congressional and regulator action to protect seniors and people with disabilities from being preyed upon by what critics have called "Medicare disadvantage" companies.
In February, CMS "clarified that Medicare Advantage organizations may use algorithms, artificial intelligence, and related technologies to assist in making coverage determinations, but these technologies may not override standards related to medical necessity and other applicable rules for how coverage determinations by Medicare Advantage organizations are made."
Rights groups echoed the lawmakers' concerns about the use of AI for MA denials.
"Medicare Advantage insurers using AI to deny needed care to seniors and people with disabilities means sacrificing patient needs on the altar of corporate greed," Public Citizen executive vice president Lisa Gilbert said. "CMS must expand upon the steps it has already taken to improve oversight of companies using AI to deny care that would be covered by traditional Medicare."
"It is time to protect enrollees by cracking down on Medicare Advantage insurers using AI to deny needed care through additional reporting requirements and increased enforcement actions against bad actors," Gilbert added.
David Lipschutz, associate director of the Center for Medicare Advocacy, said in a statement that "in our experience, MA plans' use of AI or algorithmic software has led to more inappropriate denials and premature terminations of care—this must end."
A report published earlier this month revealed that MA plans have overcharged the federal government by $612 billion since 2007—and $82 billion last year alone. Another report published last year by Physicians for a National Health Program found that MA plans are also overcharging U.S. taxpayers by up to $140 billion per year, enough to erase all Medicare Part B premiums or fully fund Medicare's prescription drug program.
A 2022 U.S. Senate Finance Committee investigation found that insurance companies and other brokers are "running amok" with "fraudsters and scam artists" making false or misleading claims to dupe seniors into buying MA plans. In February 2023, Reps. Mark Pocan (D-Wis.), Ro Khanna (D-Calif.), and Jan Schakowsky (D-Ill.) reintroduced legislation to change the official name of MA to "alternative private health plan" to make clear that such coverage is offered by for-profit companies.