Legislation introduced in the U.S. House of Representatives would eliminate the Center for Medicare and Medicaid Innovation (CMMI), a federal agency established under the Affordable Care Act in 2010 to test new healthcare payment models for Medicare, Medicaid, and the Children's Health Insurance Program. Representative Aaron Bean, Republican from Florida's 4th District, is sponsoring the Abolish CMMI Act, arguing that after 15 years of poor performance, the program should be terminated.

The center was created with a $10 billion-per-decade mandatory budget to develop payment models intended to reduce costs and improve patient care. Supporters of the legislation say the agency has failed to meet those objectives and represents an unaccountable expansion of federal authority over healthcare decisions.

What the Left Is Saying

Progressive Democrats and healthcare advocates who support CMMI argue that the center represents a necessary laboratory for testing innovative approaches to healthcare delivery and payment. They contend that transforming a complex healthcare system requires experimentation, and not every model will succeed on its first attempt. These supporters say the program's low expansion rate reflects the difficulty of healthcare reform rather than fundamental failure, and point out that even successful models take years to develop and evaluate.

Democratic lawmakers have noted that CMMI has produced some models that showed promise in specific areas, particularly around value-based care arrangements that reward quality over volume. They argue that abolishing the agency would eliminate a tool for addressing healthcare costs without congressional gridlock, and that reforms through standard appropriations oversight could achieve better results than complete elimination.

Healthcare policy advocates who support the center's continuation have raised concerns that eliminating CMMI would remove a mechanism for testing new approaches to reducing costs outside traditional legislative battles. They say the agency provides flexibility to pilot programs that might not survive the congressional appropriations process, and that its mandatory funding stream protects innovation from political cycles.

What the Right Is Saying

Representative Aaron Bean argues in an op-ed for The Hill that CMMI has failed on both of its core objectives: reducing costs and improving care. He points to Congressional Budget Office estimates showing the program was projected to save $2.8 billion between 2011 and 2020 but instead lost $5.4 billion, with projections indicating another $1.3 billion in losses through 2030.

Tom Schatz, president of the Council for Citizens Against Government Waste, co-authored the piece arguing that CMMI has become a backdoor for government-controlled healthcare. They write that unelected bureaucrats are spending billions on a trial-and-error exercise that imposes broad mandatory changes on patients and doctors without congressional input or oversight.

Conservative critics say each administration uses CMMI to advance its own healthcare agenda, with the next administration often reversing course, leaving patients and providers caught in constantly shifting federal mandates. They argue this creates instability and uncertainty in healthcare policy rather than the predictable, accountable system that should accompany taxpayer-funded programs.

Supporters of abolition contend that if a federal agency is needed to develop payment models, it should operate through the standard appropriations process where spending decisions receive regular congressional scrutiny rather than through mandatory funding that bypasses annual budget reviews.

What the Numbers Show

According to a March 27, 2026 Government Accountability Office report, only four of 70 models tested by CMMI met the criteria to be expanded nationwide. That represents a success rate of less than 6 percent over the program's 15-year history.

The Congressional Budget Office originally estimated in 2010 that CMMI would save $2.8 billion between 2011 and 2020 through its payment model experiments. Actual results showed the program lost $5.4 billion during that period, a difference of more than $8 billion from projections. CBO projections indicate additional losses of approximately $1.3 billion through 2030.

An October 2025 survey found that 78 percent of voters expressed concern about CMMI increasing government control over personal healthcare decisions after learning about the program. The poll did not ask specifically about abolishing the agency or alternative approaches to reform.

CMMI was established with mandatory spending authority of $10 billion per decade, meaning funding continues without annual congressional appropriations review. This mandatory funding structure means Congress cannot easily reduce or eliminate CMMI's budget through standard budget processes.

The Bottom Line

The Abolish CMMI Act represents an escalating Republican effort to scale back elements of the Affordable Care Act beyond what has already been modified through previous legislation and executive actions. Representative Bean's bill would require separate legislative action in both chambers with presidential signature to become law, making its path forward dependent on maintaining party unity in a narrowly divided Congress.

The debate centers on fundamental questions about federal authority over healthcare: whether experimentation should occur through agencies with protected funding or through traditional congressional processes, and how to balance innovation against accountability when testing changes to Medicare and Medicaid. The low success rate cited by GAO provides ammunition for both sides—proponents of abolition say it demonstrates systemic failure while supporters of reform argue that a 6 percent expansion rate from dozens of pilots represents valuable learning in a complex system.

Healthcare providers, patient advocacy groups, and industry stakeholders are expected to weigh in as the legislation moves through committee. What happens next: The bill requires companion legislation in the Senate and significant Republican support to advance. Congressional hearings on CMMI's performance would likely precede any floor votes.