The article discusses a growing conflict between President Donald Trump and several U.S. states over how health insurers should be allowed to use artificial intelligence (AI). At the center of the dispute is a Trump administration executive order aimed at limiting state regulation of AI, including its use in processing insurance claims, as part of a broader push to promote technological innovation nationwide. Some state governments, however, have passed their own bills to increase oversight of AI applications in insurance, leading to legal and political tensions.
Under the Trump executive order, many state-level restrictions on AI are challenged or preempted on the grounds that they could impede U.S. competitiveness in a “technological revolution.” Meanwhile, states like Arizona, Maryland, Nebraska, and Texas have already enacted laws placing limits on insurers’ AI use in decision-making, and other states such as Rhode Island and North Carolina have been debating similar measures. These laws often call for safeguards like requiring human review of AI-generated coverage decisions to protect patients and ensure fairness.
Republican Florida Gov. Ron DeSantis has proposed an “AI Bill of Rights” with restrictions on AI’s role in insurance processing and has backed state regulatory authority, illustrating that opposition to the Trump federal policy is not strictly partisan. At the same time, some people in the health care field — including physicians and advocacy groups — support stronger state oversight, arguing that opaque algorithms make it hard for patients to understand why claims are denied or delayed.
The insurance industry has resisted the wave of state AI regulations, saying that a patchwork of differing state rules will harm innovation and administrative efficiency. Groups representing insurers favor a coherent federal framework instead of varied state laws. In California, Gov. Gavin Newsom has signed limited AI-related consumer protections but vetoed broader regulations that would require more extensive disclosures or controls. This ongoing clash highlights a broader national debate about the balance between encouraging technological advancement and protecting consumers’ rights and health care outcomes.
