After 15 years of failure, Obamacare has fallen short of fulfilling its goals. However, one Obamacare program that has received insufficient attention in particular has quietly become one of the most wasteful, contradictory programs in American healthcare: the Center for Medicare and Medicaid Innovation (CMMI).
CMMI is a wolf in sheep’s clothing. It is marketed as an instrument for testing ways to improve care and reduce costs, but it has actually expanded big-government overreach into our country’s healthcare system, putting a bureaucrat between patients and doctors. Operating with minimal transparency and oversight, the agency has fallen woefully short on its promises of taxpayer savings and improved care for over a decade.
Instead of reducing healthcare waste, it’s done the opposite — contributing $2.8 billion in costs instead of the billions in savings promised by the Congressional Budget Office. Fifteen years is long enough. It’s time for lawmakers to step in, stop the bleeding, and enact legislation to hold CMMI accountable for its failures by eliminating the rogue, bloated bureaucracy.
CMMI was created to design and test limited healthcare demonstrations and payment models to explore ways to lower costs for patients and enhance care. Over time, it has ballooned into an outsized program that adds to the existing waste and abuse in Washington and expands the size and role of government. Using CMMI as a vehicle to implement sweeping healthcare changes creates uncertainty for providers, disrupts patient care, and undermines stability in our healthcare system.
On a larger scale, it creates a concerning precedent: that unaccountable bureaucrats, not elected officials, can hold the power to implement drastic policy changes affecting Americans’ healthcare.
According to a national survey by the Council for Citizens Against Government Waste, 61 percent of voters agree that CMMI’s models that have routinely failed to generate substantial savings should be eliminated. It’s no surprise that only three in 10 voters (29 percent) believe that CMMI’s $10 billion budget is an appropriate use of taxpayer dollars.
Voters understand that this program isn’t just wasteful; it’s serving as a vehicle for government-controlled healthcare.
This is strikingly apparent in CMMI’s new models, the Global Benchmark for Efficient Drug Pricing (GLOBE) and Guarding U.S. Medicare Against Rising Drug Costs (GUARD). In a gross misuse of an already-failing program, these plans aim to implement sweeping changes in healthcare policy, the Most Favored Nation drug price controls in Medicare Part B and Part D. The policy would tie U.S. drug prices to those in countries with single-payer healthcare systems, where government bureaucrats, not the market, set prices.
These models don’t “test” anything except the limits of bureaucrat overreach into healthcare. To protect America’s interests, policymakers should halt efforts to use CMMI to advance these ideas.
I applaud efforts to reduce drug prices and improve healthcare affordability, but misusing an obscure agency to impose government price controls is not the answer. I have long been a staunch opponent of price controls — abroad and at home — because they consistently disincentivize innovation, stifle competition, and limit access to high-quality goods and services.
In healthcare, price controls are devastating, as every new drug that never makes it to market could be a cure for cancer or a treatment for dementia that never reaches patients. Through CMMI, bureaucrats have advanced price-control policies, deepening government intervention in America’s healthcare and adding layer upon layer of red tape.
The GLOBE and GUARD models will only intensify this issue.
While fewer federal programs can claim consistent success stories, Medicare Part D is one of them. It has delivered historic satisfaction to seniors without wasting taxpayer dollars. In a recent survey, 93 percent of seniors reported being satisfied with their Part D prescription drug coverage — a figure that reflects Part D’s longstanding record for providing reliable care.
Price controls and other Part D changes in the Inflation Reduction Act already are destabilizing this vital program. CMMI’s implementation of MFN into this program would shatter its success and risk replacing the proven successes of Part D with unnecessary bureaucracy and additional restrictions.
If policymakers are committed to incentivizing domestic innovation and improving access to care, they must eliminate this wasteful bureaucracy. The private sector innovates; government does not.
Conservative lawmakers —who rightly focused on eliminating government waste, fraud and abuse — should set their sights on CMMI, end this bureaucracy, and focus on policies that will help patients, root out bureaucratic overreach and do right by the American taxpayer.