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An Obamacare Relic That Needs to Go

Tevin McLeod - February 3, 2026



The following content is sponsored by Americans for Limited Government.
The prevailing wisdom in Washington is that Republicans are all bark and no bite when it comes to channeling their disdain of Obamacare into action. The truth is, the GOP actually has a pretty good story to tell.
It’s not often that you hear Republicans discuss what they’ve done to prevent some of Obamacare’s most harmful provisions from coming to life, but GOP lawmakers have quietly chipped away at the law for years. During President Trump’s first term, Republicans eliminated Obamacare’s individual mandate, repealed its “Cadillac tax,” terminated the law’s Independent Payment Advisory Board (IPAB), and axed its medical device tax. Each of those achievements saved taxpayers billions of dollars while stopping the law from expanding Washington’s control over our health care even further.
Now, as lawmakers wrestle with the looming expiration of a Biden-era policy that supersized Obamacare’s insurance subsidies, one of the law’s original sins is still standing – the Center for Medicare and Medicaid Innovation, better known as CMMI. Sold in 2010 as a technocratic “innovation hub,” CMMI was supposed to experiment with new payment models that would lower costs and improve quality. Instead, like so many Obamacare promises, it delivered the opposite.
According to the Congressional Budget Office, CMMI grew federal spending by $5.4 billion from 2011 to 2020. The agency is projected to cost taxpayers another $1.3 billion by 2030. Rather than saving money, it has become a sprawling, unaccountable bureaucracy that imposes experimental mandatory payment models on millions of seniors — sometimes without their consent and often without clear benefit.
And the public has noticed. A recent poll conducted by the Council for Citizens Against Government Waste found overwhelming voter frustration with CMMI’s failures. 61 percent said that any CMMI model failing to produce savings should be eliminated. Over three-fourths expressed concern that CMMI gives the federal government too much control over personal health-care decisions.
At a time when voters want health care freedom and choice, CMMI represents the opposite: Washington-driven mandates and centralized decision-making. For conservatives and those who believe in America First, this should be a no-brainer. If Republicans want to show they are serious about shrinking bureaucracy and restoring patient control, repealing CMMI is the clearest, most immediate step they can take.
It is also smart politics. With the 2026 midterms on the horizon, Republicans have an opportunity to demonstrate that their opposition to Obamacare is more than rhetoric. They can point to a track record: repealing the individual mandate penalty, the Cadillac tax, the Independent Payment Advisory Board, and the medical device tax. Repealing CMMI would give them yet another concrete accomplishment to take to voters — a proof point that they are doing exactly what they promised: fighting government overreach and protecting patients.
Moreover, eliminating CMMI would help clear the way for real innovation driven by doctors, patients, and the private sector — not by bureaucrats in Washington experimenting with people’s care. Competition, choice, and flexibility come from empowering individuals, not from federally dictated “models” that too often restrict how providers treat their patients.
CMMI was designed in the Obama era, for the Obama era. It has failed at its mission, wasted taxpayer dollars, and expanded federal control over health care. It needs to be ended before it can cause any more damage.
As Congress negotiates a health-care package to deal with expiring Obamacare subsidies, GOP lawmakers should make their move to repeal CMMI. Strike it from the books. Shut it down. Send this leftover piece of Obamacare exactly where it belongs — the ash heap of failed federal experiments.
Americans want accountability. They want choice. And they want leaders who take action. Repealing CMMI gives Republicans the chance to deliver all three.



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