The federal government's flagship Medicare innovation program, born out of the Affordable Care Act and sold as a way to modernize health care, burned through nearly $8 billion over the past decade while producing savings of just $2.6 billion. A new Government Accountability Office report lays out the damage: more than 70 experimental programs launched, and only four performed well enough to expand nationwide. Taxpayers absorbed the rest, north of $5 billion in net losses.
The Center for Medicare and Medicaid Innovation, known as CMMI, was created under Obamacare with a straightforward promise. It would test new payment models, lower costs, and improve care for everyday Americans. A decade later, the GAO's accounting tells a different story, one of sprawling ambition, minimal results, and a bureaucracy that kept spending long after the evidence pointed to failure.
House Republicans have seized on the findings. Rep. Aaron Bean, a Florida Republican, recently introduced legislation to abolish CMMI entirely. And the rhetoric from GOP lawmakers leaves little doubt about the mood on Capitol Hill.
House Budget Committee Chairman Jodey Arrington, a Texas Republican, framed the GAO's findings in blunt terms, as reported by Breitbart:
"A 5 percent success rate isn't innovation, it's failure."
That five percent figure comes from the ratio: four programs expanded out of more than 70 attempted. The rest either failed to produce savings, failed to improve care, or both, and were shut down or left to wind down quietly while the bills kept coming.
Ohio Republican Rep. Bob Latta warned that the program is too complex, lacks transparency and accountability, and simply is not delivering results. No elaborate explanation is needed when the math speaks this clearly. Nearly $8 billion spent. Roughly $2.6 billion saved. The gap, more than $5 billion, landed squarely on the taxpayer.
And the losses are not expected to stop. The program, according to federal budget experts cited in the reporting, is projected to keep losing money going forward.
Bean's bill, House Bill 8293 in the 119th Congress, would eliminate CMMI outright. The Florida congressman did not mince words about his reasoning.
"Taxpayers are tired of getting ripped off, and I'm fed up, too. Every dollar stolen from taxpayers is one dollar too many."
That kind of language from a sitting member of Congress reflects more than partisan frustration. It reflects a growing pattern in Washington: federal health care programs launched with grand promises, funded with enormous sums, and left to run on autopilot long past the point where the numbers justified the spending. The broader push to root out waste and fraud in government health programs has picked up speed, the Vance anti-fraud task force recently flagged $6.3 billion in suspect government contracts across multiple agencies.
Conservatives in Congress have raised red flags about CMMI for years. But the GAO report gives those warnings something they previously lacked: a comprehensive, nonpartisan accounting of just how far the program fell short of its stated mission.
CMMI was a signature piece of the Affordable Care Act's architecture. Democrats created it to give the federal government a testing ground for new approaches to Medicare payment and care delivery. The idea was not inherently unreasonable, pilot programs can identify efficiencies before scaling them system-wide.
But the execution tells a cautionary tale about what happens when a government agency gets broad authority, a large budget, and weak accountability mechanisms. More than 70 models were tried. The overwhelming majority failed. And the agency kept launching new ones.
The pattern is familiar to anyone who has watched federal health care spending over the past several years. Colorado's health care program for illegal immigrants, for instance, now costs seven times its original estimate, another case of a government health initiative that blew past its projections with little apparent consequence for the officials who designed it.
CMMI's four expanded programs represent the exception, not the rule. And even those successes must be weighed against the staggering cost of the 66-plus failures that preceded them. In private industry, a venture fund with a five percent hit rate and billions in losses would face a reckoning from its investors. In Washington, it took a decade and a formal GAO audit to get to the same conversation.
The GAO report, catalogued under reference number GAO-26-107953, provides the clearest public accounting yet of CMMI's track record. But several questions remain unanswered. Which specific programs were among the 70-plus that failed? Which four succeeded? What internal metrics, if any, did CMMI use to decide when to pull the plug on underperforming models?
Those details matter. Without them, the public cannot fully assess whether CMMI's leadership exercised reasonable judgment or simply kept the money flowing to justify the program's existence. The lack of transparency that Rep. Latta flagged is not a minor procedural complaint, it goes to the heart of whether a program this expensive was ever subject to meaningful oversight.
The administration's broader effort to crack down on health care fraud adds context. The Treasury Department's new whistleblower bounty program is designed to surface exactly this kind of waste, billions in taxpayer money flowing through federal health programs with insufficient guardrails.
And CMMI is hardly the only corner of the health care bureaucracy drawing scrutiny. Federal investigators recently suspended 470 Los Angeles health care providers over $600 million in suspected fraud, a reminder that the scale of waste in government-backed medical programs extends well beyond any single agency.
Bean's legislation to abolish CMMI will face the usual obstacles: committee markups, floor votes, and the reality that any bill touching the Affordable Care Act's structure draws fierce opposition from Democrats who view the law as settled policy. But the GAO's findings make the status quo harder to defend. A program that lost more than $5 billion over a decade, with a success rate that rounds to five percent, is not easy to champion on the merits.
Additional reporting from Breitbart noted that Republicans are framing the CMMI fight as part of a broader push to cut waste and fraud across federal health programs, a message that resonates as the national debt continues to climb and voters grow more skeptical of Washington's ability to manage their money.
The question now is whether Congress will act on the GAO's findings or file the report alongside the dozens of previous audits that identified waste, generated headlines, and changed nothing.
Washington has a long history of calling failure "innovation." Taxpayers have a long history of paying for it.
