From the Moonshot Press Team
January 2026
Dear Fellow Citizen,
We’re writing to you about a rare opportunity—one that happens quietly, without fanfare, but with real consequences for how healthcare will work in the age of artificial intelligence.
Right now, the Department of Health and Human Services is asking a question: How should AI be used in American healthcare? They’ve opened a 60-day public comment period. The deadline is February 23, 2026. Your response becomes part of the legal record that shapes policy.
This isn’t a petition. It’s not a poll. Under the Administrative Procedure Act, federal agencies must consider what you say. If you participate, you don’t just express an opinion—you exercise democratic power.
Most people will never hear about this opportunity. That’s exactly why we’re reaching out.
The Question We’re Really Answering
HHS asks how to “accelerate AI adoption,” “reduce regulatory uncertainty,” and “deflate healthcare costs.” Those are important questions. But they’re not the most important question.
At Moonshot Press and through Project 2026, we believe the central question is this:
How do we build a healthcare system where everyone can get the care they need to live healthy, flourishing lives?
That question changes everything. Because if the goal is human flourishing, then AI becomes a tool to support that goal—not an end in itself.
It means asking whether AI will help prevent disease, or just process it more efficiently. Whether it will expand access to care, or concentrate it further. Whether it will make healthcare more comprehensible to families navigating confusing systems, or add another layer of opacity.
It means starting with what creates and maintains health—what researchers call the “salutogenic” approach—rather than just what treats disease after it appears.
And it means recognizing that the people best positioned to answer these questions are not algorithms, administrators, or even experts. It’s you. It’s all of us. It’s citizens.
Why AI Matters for Your Health
Artificial intelligence is already reshaping healthcare in ways most people don’t see:
Algorithms help decide which patients get flagged as high-risk
AI systems review insurance claims and recommend approvals or denials
Predictive models identify which communities need preventive resources
Machine learning tools analyze medical images and suggest diagnoses
Some of these applications are genuinely helpful. Others create new problems—bias in risk scoring, unexplained denials, decisions no one can challenge because “the algorithm said so.”
But here’s what matters: AI could be so much more than a back-office efficiency tool.
Imagine AI systems that help new parents understand their baby’s development and connect them to support before problems become crises. Tools that translate complex medical information into plain language so people can make informed decisions about their own care. Systems that identify social and environmental factors making people sick and help communities address them before disease takes hold.
Imagine AI designed not to optimize hospital billing, but to help families stay healthy in the first place.
That’s possible. But only if citizens demand it.
What Moonshot Press Is Doing
We’re submitting a comprehensive response to the HHS Request for Information. Our submission will argue for four core priorities:
1. Prioritize the First Thousand Days
The period from pregnancy through age two shapes lifelong health. AI tools supporting families during this critical window could prevent chronic disease for decades. Yet the RFI doesn’t mention early childhood once. We’re making the case that this should be a top research and funding priority.
2. Build AI for Patients, Not Just Providers
Most AI discussion focuses on administrative efficiency. We’re arguing that patient-facing tools—systems that help people understand diagnoses, navigate insurance, access preventive care—may do more to improve health outcomes than backend optimization ever could.
3. Design for Transparency and Trust
People need to know when AI is making decisions about their care, understand how those decisions are made, and have real ways to challenge them. We’re proposing that federal funding and reimbursement be conditioned on AI systems meeting transparency standards.
4. Reframe Cost Reduction as Prevention
True cost deflation doesn’t come from faster billing. It comes from keeping people healthy in the first place. We’re making the economic case that prevention-focused AI will reduce spending far more than efficiency-focused AI ever could.
But here’s the thing: our response isn’t the point. Citizen participation is the point.
What Project 2026 Is Building
Project 2026 is our initiative to rebuild democratic capability—to ensure that “government of the people, by the people, for the people” works in practice, not just in principle.
It’s built on three pillars: Democracy, Opportunity, and Citizenship.
Democracy means citizens have real power to shape decisions that affect their lives—not through protests or petitions, but through formal mechanisms like the Administrative Procedure Act.
Opportunity means everyone has access to the conditions needed for a flourishing life—including health, which is foundational to everything else.
Citizenship means showing up, learning together, and taking responsibility for governing the systems we all depend on.
The HHS RFI is a perfect test case. It’s technical enough that most people feel excluded. It’s consequential enough that exclusion matters. And it’s open enough that informed participation can genuinely influence outcomes.
So we’re not just submitting our response. We’re building infrastructure to help others participate:
Plain-language guides explaining what the RFI really asks
Evidence-based frameworks for thinking through complex tradeoffs
Practical templates showing how to write effective comments
Collaborative spaces where citizens can discuss, draft, and refine arguments together
A complete series of articles providing the context, history, and substance you need to engage meaningfully
We’re treating this as a demonstration: Can citizens meaningfully participate in complex technical policy? Can democracy adapt to technological acceleration? Can governance be both expert-informed and democratically accountable?
We believe the answer is yes. But only if we do the work.
Why Your Voice Matters
You might be thinking: “I’m not an expert in AI or healthcare policy. What do I have to contribute?”
Everything.
Experts can tell you how algorithms work. Only you can tell them what problems need solving.
If you’ve raised children, you know what support would have mattered most in those early years—and what was missing. If you’ve navigated chronic illness, you understand which parts of the healthcare system are unnecessarily complex and which AI tools would actually help. If you’ve dealt with insurance denials or confusing medical bills, you know exactly where transparency matters.
Your lived experience is evidence. Policy should reflect it.
Effective comments don’t require technical expertise. They require specificity. Instead of saying “AI should be fair,” describe what fairness looks like in your life. Instead of saying “costs matter,” explain which costs fall on you and your family. Instead of saying “transparency is important,” identify which decisions you’d want to understand and challenge.
That’s all democracy requires. And it’s everything it needs.
A Moment That Matters
We’re living through a rare convergence. Artificial intelligence is reshaping healthcare faster than democratic institutions can process. The Department of Health and Human Services is explicitly asking for public input. The Administrative Procedure Act gives that input legal weight. And we’re approaching the 250th anniversary of the Declaration of Independence—a moment to ask whether we’re living up to the promise that governments derive their just powers from the consent of the governed.
This isn’t about opposing AI or resisting change. It’s about ensuring that change serves human flourishing rather than just system efficiency.
It’s about insisting that a healthcare system spending nearly twice as much per capita as peer nations while achieving worse outcomes needs to optimize for different goals.
It’s about recognizing that the most powerful technology in human history should be guided by the most fundamental democratic principle: that sovereignty belongs to the people.
The comment period closes February 23, 2026. Between now and then, we’re doing everything we can to make participation meaningful, accessible, and effective.
We hope you’ll join us.
How to Get Involved
Follow our series: We’re publishing weekly articles through February at moonshot.press/rfi-response, covering everything from the Administrative Procedure Act to the salutogenic framework to our complete submission.
Use our tools: We’re creating templates, guides, and frameworks to help you craft your own comments.
Join the discussion: We’re hosting online forums where citizens can discuss, learn, and draft together.
Submit your comment: Visit regulations.gov and search “HHS Health Sector AI RFI” or document number 2025-23641. You can submit electronically or by mail (addresses in the Federal Register notice).
Share this letter: If you know someone who cares about healthcare, children’s health, democratic participation, or the future of AI—pass this along.
The Larger Vision
Moonshot Press exists to ensure that life, liberty, and the pursuit of happiness aren’t just inspiring words—they’re lived realities for every American. That requires systems that work: healthcare that keeps people healthy, information that keeps people informed, and governance that keeps people empowered.
Project 2026 is our commitment to building those systems through citizen action. Not by waiting for institutions to fix themselves, but by showing up, doing the work, and demonstrating what’s possible when people take seriously their role as citizens.
The HHS RFI is one opportunity among many. But it’s a real one, with a clear timeline and legal weight. It’s a chance to practice democracy in its most practical form: engaging seriously with complex questions, offering evidence-based arguments, and insisting that policy serve the people it governs.
This is how change happens—not through single heroic moments, but through sustained collective effort. Not through rage or resignation, but through informed, purposeful participation.
We can build a healthcare system where everyone can get the care they need to live healthy, flourishing lives. But we can only build it together.
Will you join us?
With hope and determination,
The Moonshot Press Team