October 16, 2025

Dear Senator,

We, the undersigned organizations, 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 the quality of care. Unfortunately, CMMI has failed to achieve either part of that mission.

The Congressional Budget Office (CBO) estimated that CMMI would save $2.8 billion from 2011-2020. Instead, it cost $5.4 billion during that period and is projected to cost another $1.3 billion between 2021 and 2030. From 2011-2020, only four of the 49 models, or eight percent, showed enough potential to save money and improve care. The losses from the Medicare Advantage Value-Based Insurance Design alone, which began in 2017, reached $4.5 billion in 2021-2022. After several attempts to save the program failed, it was cancelled at the end of fiscal year 2025. In addition, the Trump administration has cancelled four other models that did not save money or improve care.

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 per decade is a burden on taxpayers that will continue to deliver a negative return on investment. As President Trump and Congress look for ways to reduce waste, fraud, and abuse, eliminating CMMI would go a long way in that regard.

The lack of effectiveness of CMMI models is clear. Therefore, we urge you to support the immediate suspension of all pending and proposed CMMI models. If complete elimination of CMMI is not possible, at a minimum we urge you to establish clear and meaningful guardrails that protect patients; provide accountability and transparency; and ensure that taxpayer dollars are not wasted any longer.

Sincerely,

Tom Schatz
President, Council for Citizens Against Government Waste

Grover Norquist
President, Americans for Tax Reform

Dick Patten
President, American Business Defense Council

Phil Kerpen
President, American Commitment

Ryan Ellis
President, Center for a Free Economy

Jeremy Nighohossian
Senior Fellow & Economist, Competitive Enterprise Institute

Pete Sepp
President, National Taxpayers Union

Terry Wilcox
President, Patients Rising

Mike Gibbons
President, RetireSafe

John Czwartacki
Founder & Chairman, Survivors for Solutions

David Williams
President, Taxpayers Protection Alliance