Preemption at the Intersection of Health Care and Artificial Intelligence

Document Type

Article

Publication Date

2-11-2026

ISSN

0098-7484

Publisher

JAMA Network

Language

en-US

Abstract

Medical artificial intelligence (AI) is increasingly embedded in clinical practice in the US, with roughly two-thirds of physicians reporting using it in a 2023 survey. Yet, federal agencies only review a fraction of the medical AI that affects clinical care.1 States have begun to step into the gap with their own regulations addressing whether and how medical AI may be used in their jurisdictions; every state introduced AI-related legislation in 2025.2 On December 11, 2025, President Trump signed an AI executive order (EO)3 that purports to undo most state legislation and discourage further state actions, drawing on a legal doctrine called preemption that blocks state authority when it conflicts with federal law. The EO followed Congress’ failed attempts to preempt state AI laws, including a 10-year moratorium on state AI laws in the One Big Beautiful Bill Act and AI preemption language in the National Defense Authorization Act, both of which were stripped from the bills before they became law.4

In this Viewpoint, we describe what the EO means for medical AI regulation, highlight the legal questions it raises, and consider the merits of state-level experimentation in health care regulation.

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