With the November midterm elections approaching, 2026 offers a lucrative but narrowing opportunity for Republicans to show voters that they can solve real problems through reforms that strengthen freedom and choice for individuals, while restoring accountability and trust for public institutions.
More specifically, as Congress considers how to clean up the mess left behind by Obamacare, it should support legislation recently introduced by Rep. Aaron Bean (R-FL) to eliminate the failed Center for Medicare and Medicaid Innovation.
CMMI is simply the Obama-era healthcare bureaucracy that quietly amassed sweeping authority to shape healthcare policy over the past decade. Largely beyond the public eye, CMMI’s track record since 2010 provides yet another example of why waste in healthcare has skyrocketed while public trust in public health institutions has plummeted. Simply put, CMMI massively reduces freedom in healthcare decision-making and amounts to a vehicle used to serve agenda-driven bureaucrats.
CMMI’s prioritization of “health equity” under the Biden administration offers just one example.
Beyond that high-profile example, however, CMMI simply possesses too much power to impose partisan policies without accountability to the public or Congress. Across numerous CMMI models, weak guardrails and insufficient program oversight have made it increasingly easy for decision-making authority to shift away from patients, providers, and Congress, and toward unelected officials insulated from the consequences of poor outcomes.
That problem is magnified by CMMI’s use of “mandatory” models, which allow it to effectively rewrite existing law and unilaterally impose sweeping policy changes and force patients and providers into rigid, one-size-fits-all systems that undermine personalized healthcare decision-making and create uncertainty around care delivery.
For instance, the Global Benchmark for Efficient Drug Pricing and Guarding U.S. Medicare Against Rising Drug Costs models seek to impose broad healthcare policy changes by implementing foreign drug price controls that risk limiting patient access to critical drugs and treatments.
GLOBE and GUARD, through CMMI, were passed without congressional approval, silencing stakeholder input and bypassing proper legislative protocols. That approach is incompatible with an “America first” agenda, and underscores the urgent need for Congress to reassert its authority by advancing new legislation to eliminate CMMI.
While expanding bureaucratic control over healthcare over the past 15 years, CMMI has failed to deliver meaningful quality improvement or cost reduction. For example, a 2023 Congressional Budget Office report found that between 2011 and 2020, CMMI cost taxpayers $5.4 billion, spending its $10 billion per decade in mandatory funding on failed models while producing no net savings.
Once seen as emblematic of the promise of technocratic expertise in solving U.S. healthcare’s challenges, CMMI has thus become nothing more than a costly, open-ended experiment in government-run healthcare that has repeatedly failed to deliver. It now offers a textbook illustration of why healthcare costs are up and public trust is down.
Accordingly, as lawmakers head into this autumn’s election cycle, prioritizing patients over bureaucracy should mean supporting new legislation to eliminate CMMI rather than continuing to rely on incremental reforms. Republicans who approach November with growing concern would be wise to demonstrate leadership by backing efforts to permanently sunset CMMI and restore Congress’s role in shaping Medicare policy.
At the minimum, that would demonstrate a genuine commitment to the public, rather than to self-serving interests or unaccountable government bureaucrats.
As we also celebrate the 250th anniversary of a nation founded on principles of individual liberty, citizens and political leaders alike cannot afford to lose sight of that responsibility. Eliminating CMMI would curb wasteful spending, restore policymaking authority to Congress, strengthen accountability to the people, and protect patients from sweeping policy changes imposed without congressional approval.
WASHINGTON CANNOT KEEP UNDERMINING THE DOCTORS AMERICANS DEPEND ON
Republicans possess a valuable opportunity to prove that individual liberty and institutional accountability aren’t merely campaign slogans, but principles put into practice. One easy but meaningful step in that direction would be to pass Rep. Bean’s legislation eliminating CMMI once and for all.
Failing to act, conversely, risks allowing the year 2026 to perpetuate a wasteful budget expense that expands government control and diminishes patient choice.
Timothy Lee is senior vice president of Legal and Public Affairs at Center for Individual Freedom.