A cadre of elite techies, financiers, and high-level Trump administration officials have spent a year quietly charting an extraordinary and rapid campaign to persuade Americans to use
to manage their healthcare and medical records.
asserted
cadre → spend → records
As that campaign has unfolded, administration officials have granted tech companies an unusual opportunity to nudge the nation's health department toward a loosely regulated future for AI health apps in which the government reimburses them for services as it does medical professionals.
asserted
it → unfold → professionals
In February, federal health officials invited those businesses — including tech giants
, , , Apple, and Google — to a listening session on conversational AI products for patients, such as chatbots.
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officials → invite → chatbots
Representatives from at least 35 industry organizations attended the meeting held by the Food and Drug Administration, which is responsible for regulating health apps as medical devices.
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which → attend → devices
Companies were prompted in advance to explain their AI products and how they access patients' sensitive medical information.
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they → prompt → information
But the meeting did not appear on the FDA's public calendar or regulatory notices, nor was the public invited.
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public → appear → calendar
Rather, the invitation for a select group to help shape federal policy governing AI in healthcare was extended in a chat room on the messaging service Slack.
asserted
invitation → help → service
"This is a great opportunity to support HHS' goals and share your state-of-the-art understanding of safe Conversational AI development and monitoring to help FDA shape future guidance," CMS senior policy adviser Morgan Taylor wrote in the Slack workspace.
asserted
Taylor → support → workspace
The Centers for Medicare & Medicaid Services has not formally announced the chat room through federal regulatory channels, though CMS officials have talked about it at industry conferences.
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officials → announce → conferences
Legal experts said the chat room resembles a federal advisory panel, which would be required to operate in public view.
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which → say → view
KFF Health News reviewed thousands of Slack messages, meeting transcripts, and video recordings that reveal how the Trump administration has granted the industry a direct line to top government officials — including former head of the Department of Government Efficiency
.The conversation took place behind the scenes as federal health officials publicly worked to integrate AI and other technology into nearly every aspect of healthcare, a plan they've branded the "Health Technology Ecosystem."
asserted
they → review → plan
"We wanted to give industry a chance to play in the sandbox of government-supported healthcare," CMS Administrator Mehmet Oz said in September at the public launch of an initiative that allows health apps to bill Medicare for AI services such as wearable device tracking.
asserted
apps → want → tracking
Last week, Health and Human Services Secretary Robert F. Kennedy Jr. delivered an enthusiastic endorsement of AI in healthcare, claiming it is "much better informed than any doctor in the country.
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it → deliver → country
Meanwhile, HHS staff even promised that a recently launched Medicare App Library would serve as a lucrative pipeline for those businesses to get new users.
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businesses → promise → users
The library's webpage currently promotes only two dozen commercial apps to millions of American seniors and those with disabilities.
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webpage → promote → disabilities
As Trump officials sell it, Americans will get easier access to their medical records so apps can swiftly provide health or wellness advice.
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apps → sell → advice
Doctors, meanwhile, are increasingly worried about how patients use and share their medical records with the nascent technology.
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patients → use → technology
"Some of these tools just aren't ready for primetime," said John Whyte, CEO of the American Medical Association.
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Whyte → say → Association
"We don't have enough data about them.
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We → have → them
We don't understand how they work, how they're using the information.
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they → understand → information
There's no liability if these tools get things wrong."
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things → be → ?
CMS officials declined to answer several questions about the Slack workspace, including about its legality.
asserted
officials → decline → legality
"CMS is focused on giving Medicare beneficiaries greater access to their health information and useful digital tools while promoting an open, interoperable healthcare system," Gleason, now chief product officer for the newly created Office of Health Technology and Products at CMS, wrote in an emailed statement.
asserted
Gleason → focus → statement
CMS will continue working with patients, providers, payers, technology organizations, and other stakeholders to make health information more accessible and useful to the Americans it serves."
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it → continue → Americans
The FDA did not respond to a request for comment.
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FDA → respond → comment
The conversation begins
The behind-the-scenes effort to funnel more Americans to AI-powered health apps began in August 2025 in the Slack workspace.
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effort → begin → workspace
"Welcome all!" Gleason wrote.
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Gleason → write → ?
"Please be sure to read the Code of Conduct and see the Channel list as well to help you find channels that are relevant to you.
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that → read → you
"
Gleason is best known for serving as the acting administrator of Elon Musk's Department of Government Efficiency, as it gained access to millions of Americans' sensitive personal and financial data, including at the Social Security Administration.
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it → know → Administration
As her work with DOGE wound down last year, Gleason welcomed a variety of tech leaders, investors, and entrepreneurs to the chat room.
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Gleason → wind → room
The Slack workspace's participants include representatives from major digital wellness companies like Oura Health, AI companies like Palantir, and investment outfits like 8VC, a venture capital firm associated with Kennedy's son Finn.
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participants → include → son
While the Slack's member count has ballooned to 1,700 over the past year, only a handful of patient advocates, doctors, and hospital representatives are in it.
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handful → balloon → it
The code of conduct Gleason shared on Slack in August 2025 documented that CMS had quietly established a technology working group.
asserted
CMS → share → group
The document also set ground rules for the Slack workspace, noting that the group does not constitute an "advisory committee," nor would it be used "to obtain advice or recommendations for HHS, CMS, or any HHS/CMS officials."
asserted
it → set → HHS
The code also advises that federal employees "are prohibited from endorsing any product, service, or enterprise."
asserted
employees → advise → product
Joseph Daval, a former FDA lawyer who is now a research specialist at Harvard Medical School, reviewed messages from the Slack workspace at the request of KFF Health News.
asserted
who → review → News
He said the chat room in some ways resembles a federal advisory committee — an independent panel that can be formally stood up by an agency head, Congress, or the president to ensure agencies act in the best interest of the public rather than industry.
asserted
agencies → say → industry
The law on advisory committees "was passed in part out of a concern about interest group capture, about anticompetitive capture of agency policymaking, about corruption," he said.
asserted
he → pass → corruption
Daval said the chat group looks like a committee, with members interacting with one another and building consensus on preferred courses of action.
asserted
members → say → action
If it were a formal advisory committee, though, Daval said, it would be subject to certain "membership requirements having to do with independence and fair balance.
asserted
it → say → independence
…and 44 more, not listed.
The Aporia
