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An Obamacare Relic That Needs to Go

February 4, 2026
in Americas

As lawmakers continue to grapple with the impending expiration of a key Biden-era policy that has significantly expanded Obamacare’s insurance subsidies, it’s time to address one of the law’s original flaws – the Center for Medicare and Medicaid Innovation, or CMMI.

When the Affordable Care Act was first introduced in 2010, it included provisions for the establishment of CMMI, a research and development center aimed at testing innovative payment and service delivery models for Medicare and Medicaid. The goal was to improve the quality of healthcare while reducing costs for these government programs. However, over the years, it has become clear that CMMI is not living up to its intended purpose and has instead become a hindrance to the American healthcare system.

One of the main issues with CMMI is its lack of accountability and oversight. The center has been given broad authority to test new payment models without any clear guidelines or benchmarks for success. This has resulted in a number of failed experiments that have cost taxpayers billions of dollars. In fact, a 2019 report from the Government Accountability Office found that out of the 37 payment models tested by CMMI, only three had been successfully implemented.

Moreover, CMMI has become a bureaucratic nightmare for healthcare providers, who are burdened with constantly changing payment models and regulations. This not only creates confusion and frustration for doctors and hospitals, but it also takes away valuable time and resources that could be better spent on patient care.

In addition, CMMI has been accused of overstepping its boundaries and interfering with the doctor-patient relationship. Some of the payment models being tested by the center require doctors to follow strict protocols and limit their treatment options, which can result in subpar care for patients. This is a concerning trend that goes against the very foundation of the American healthcare system – the relationship between a patient and their doctor.

It’s time for Congress to take a hard look at CMMI and consider whether it is truly serving its intended purpose. The center has been given enormous power and resources, but it has failed to deliver on its promises. It’s time to rethink its role and make necessary changes to ensure that it is actually improving the healthcare system for all Americans.

Fortunately, there are already efforts underway to reform CMMI. The Medicare Payment Advisory Commission (MedPAC) has recommended that Congress establish clear parameters and goals for the center’s experiments, as well as improve its oversight and accountability. This would be a step in the right direction and could potentially salvage CMMI’s original purpose.

However, some argue that CMMI is simply beyond repair and should be eliminated altogether. This would not only save taxpayers billions of dollars, but it would also remove the burden and uncertainty placed on healthcare providers. With the expiration of the Biden-era policy that increased Obamacare’s insurance subsidies, now is the perfect opportunity to reassess the role of CMMI and determine whether it is truly necessary.

In the end, whether CMMI is reformed or eliminated, one thing is clear – it is an Obamacare relic that no longer serves its intended purpose and needs to go. As lawmakers continue to grapple with the future of healthcare in America, they must not overlook this flawed and ineffective center. It’s time to put the focus back on improving the quality of care for patients and reducing healthcare costs, and CMMI is not the solution to achieving these goals.

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