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When it was passed into law six years ago, Obamacare created the Centers for Medicare and Medicaid Innovation (CMMI) and tasked the agency with conducting demonstrations over new health care delivery and payment models in Medicare, Medicaid, and the Children’s Health Insurance Program with the intent of reducing healthcare costs. 

While CMMI tests are supposed to increase the efficiency of healthcare programs, the agency has pushed tests with little evidence they will result in savings, while strong-arming providers into participating. At the same time, the Congressional Budget Office is utilizing unsuitable scorekeeping over CMMI tests, which has limited the ability of Congress to conduct routine oversight.

In a letter to lawmakers, a coalition of conservative groups, including ATR urged Congress to prioritize restraining or repealing this unaccountable agency next year. The letter can be found below or here.

Dear Member of Congress:

As policymakers wrap up business this year as well as prepare for a new Congress and administration, repealing and replacing Obamacare is at the top of the agenda. There are dozens of complex policy issues surrounding health care reform. One standout that urgently needs scrutiny is the Center for Medicare and Medicaid Innovation (CMMI.)

CMMI was created by Obamacare in order to facilitate demonstration projects for payments and services within those programs. Unfortunately, the outgoing Obama Administration chose to engage in executive overreach on several CMMI initiatives by making them involuntary, nationwide policy changes. Perhaps the most alarming example so far is the Medicare Part B demonstration project, which impacts cancer patients and doctors in 49 states. 

Another reason to repeal CMMI, or at least to construct guardrails that can curb abusive measures like the Part B Demo, is the way that the Congressional Budget Office has scored the agency’s activities. CBO thinks that CMMI’s unelected bureaucrats will save tens of billions of dollars from Medicare and Medicaid, but if the people’s elected representatives want to set policy instead, it will “cost” taxpayer dollars. This is not only bad scoring, it’s an inappropriate weakening of Congress’ right to make entitlement policy. Any CMMI changes short of repeal should correct this grave scorekeeping error, before it further upsets the balance of power in the policymaking process.


Grover Norquist
President, Americans for Tax Reform

Tom Schatz
President, Council for Citizens Against Government Waste

Pete Sepp
President, National Taxpayers Union