STAT Health Tech: Who's writing the rules as more states consider AI sandboxes

A sandbox, as any parent knows, is the fenced enclosure you put the toddlers in so they stop eating the furniture. That is roughly the regulatory innovation 'more states' are now considering for artificial intelligence, per a STAT Health Tech newsletter item headlined “Who's writing the rules as more states consider AI sandboxes”. Good question. The answer, historically, has been whoever shows up first with a lobbyist and a slide deck. It arrives as the sequel to the state-level scrum we flagged when Patty Murray convened her legendary 'handful' of officials in Olympia — Congress has folded its arms, so the states are doing the legislating, badly, in public.

STAT's beat list is the giveaway: FDA regulation of AI, Medicare health tech payment, and AI in clinical care. Two of those are about medicine; the middle one is about money, and money is the one that actually moves. Sandboxes, as a regulatory form, are where a company gets to break the rules in a designated paddling pool and then graduate to the deep end having written its own report card. Note what the excerpt does not contain: no named states, no bill numbers, no dates, no dollar figures — a scramble to shape regulations so thoroughly documented that not one scrambler has a name attached to the scramble.

The newsletter's remaining beat — AI in clinical care — is where this stops being an abstraction about paperwork and becomes a question of who gets a diagnosis and who gets the bill. A sandbox there means relaxed supervision over systems involved in clinical decisions, refereed by states that are simultaneously arguing about how to pay for any of it. “Who's writing the rules” is a decent headline; the honest answer in most sandboxes is the children, who have had a great deal of practice and are, by now, extremely well funded.