September 16, 2025

U.S. Senate
United States Congress
Washington, D.C. 20510

Dear Senator,

On behalf of the more than one million members and supporters of the Council for Citizens Against Government Waste (CCAGW), I urge you to support the elimination of the Center for Medicare and Medicaid Innovation (CMMI).

CMMI was created in 2010 under the Affordable Care Act to create new payment and service delivery models that were supposed to reduce patient costs and improve quality of care.  But CMMI has unequivocally failed to deliver on either front.

The Congressional Budget Office (CBO) estimated that CMMI would save $2.8 billion between 2011-2020 but instead it cost $5.4 billion. CBO projects it will cost another $1.3 billion between 2021-2030.  Only four of the 49 models (8 percent) created between 2011-2020 showed enough potential to save money and improve care that they were continued.  The losses from Medicare Advantage Value-Based Insurance Design, which began in 2017, reached $4.5 billion in 2021-2022, and after changes were made to save the program failed, it will be cancelled at the end of fiscal year 2025.  The Trump administration has cancelled four other models that will never save money or improve care.

CMMI was supposed to save money and improve healthcare but instead has cost money and failed to help patients, making it a prime example of wasteful spending.  CBO assumes CMMI will “get better” at identifying effective savings models, but the results contradict that expectation as losses grow and models fail.  CMMI’s unaccountable mandatory budget of $10 billion for each decade is a burden on taxpayers that will continue to deliver a negative return on investment.

Since the lack of effectiveness of CMMI models has been amply proven, CCAGW urges you to support the immediate suspension of all pending and proposed CMMI models.  While elimination of the program would be the most effective decision by Congress, if that does not occur, there must be clear guardrails with patient protections, additional accountability and transparency, and clarification of CMMI’s mission.  I urge you to act quickly on CMMI to protect taxpayers and patients.

Sincerely,
Tom Schatz
President, CCAGW