HRES704119th CongressWALLET

Expressing the sense of the House of Representatives that the Wasteful and Inappropriate Service Reduction Model undermines beneficiary access to health care and should not be implemented.

Sponsored By: Representative Pocan

Introduced

Summary

Opposes expanding private-style prior authorization into traditional Medicare. The resolution warns the Wasteful and Inappropriate Services Reduction (WISeR) Model would begin January 1, 2026, raise the number of services requiring prior authorization in traditional Medicare by 30%, and hire private companies that use artificial intelligence and machine learning to process those requests. It cites concerns that prior authorization delays care and burdens clinicians, noting American Medical Association data that 89% of physicians link prior authorization to burnout, that 81.7% of Medicare Advantage denials are overturned on appeal, and reporting of high error rates in insurer AI tools. The resolution expresses disapproval and requests that the Centers for Medicare and Medicaid Services terminate the WISeR Model.

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Bill Overview

Analyzed Economic Effects

2 provisions identified: 1 benefits, 1 costs, 0 mixed.

House asks CMS to stop WISeR

If adopted, this resolution would strongly request that CMS terminate the WISeR Model. The request would be non-binding and would not itself change law. If CMS stops the model, traditional Medicare beneficiaries would avoid expanded prior authorization, extra contractors, and more automated decisions.

More prior authorization in Medicare

If adopted, this resolution would note a proposed WISeR model starting January 1, 2026. The proposal would increase services needing prior authorization by 30%. It would use private contractors and artificial intelligence to process authorizations. If put in place, Medicare patients and their doctors could face more paperwork and possible delays.

Sponsors & CoSponsors

Sponsor

Pocan

WI • D

Cosponsors

  • Schakowsky

    IL • D

    Sponsored 9/11/2025

  • Doggett

    TX • D

    Sponsored 9/11/2025

  • Ocasio-Cortez

    NY • D

    Sponsored 9/11/2025

  • Tlaib

    MI • D

    Sponsored 9/11/2025

  • Watson Coleman

    NJ • D

    Sponsored 9/11/2025

  • Landsman

    OH • D

    Sponsored 9/11/2025

  • Goodlander

    NH • D

    Sponsored 9/11/2025

  • McBride

    DE • D

    Sponsored 9/15/2025

  • Del. Norton, Eleanor Holmes [D-DC-At Large]

    DC • D

    Sponsored 9/15/2025

  • Frankel, Lois

    FL • D

    Sponsored 9/15/2025

  • Khanna

    CA • D

    Sponsored 9/15/2025

  • Omar

    MN • D

    Sponsored 9/16/2025

  • McDonald Rivet

    MI • D

    Sponsored 9/16/2025

  • DelBene

    WA • D

    Sponsored 9/17/2025

  • Smith (WA)

    WA • D

    Sponsored 9/18/2025

  • McIver

    NJ • D

    Sponsored 10/6/2025

  • Strickland

    WA • D

    Sponsored 10/6/2025

  • Jayapal

    WA • D

    Sponsored 10/14/2025

  • Dingell

    MI • D

    Sponsored 10/14/2025

Roll Call Votes

No roll call votes available for this bill.

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