U.S. House of Representatives Committee on the Budget

04/26/2024 | Press release | Distributed by Public on 04/26/2024 09:58

Chairman Arrington, Health Care Task Force Chair Burgess Request Investigation into Obamacare Program Driving Deficits

April 26, 2024

Chairman Arrington, Health Care Task Force Chair Burgess Request Investigation into Obamacare Program Driving Deficits

WASHINGTON, D.C. - Today, House Budget Committee Chairman Jodey Arrington (R-TX) and Budget Committee Health Care Task Force (HCTF) Chair Michael C. Burgess, M.D. (R-TX) sent a letter to Comptroller General Gene Dodaro of the U.S. Government Accountability Office (GAO) requesting an updated report on the cost of the Center for Medicare and Medicaid Innovation (CMMI) and its effect on the federal budget.

The Relationship Between Federal Spending and CMMI:

  • The Patient Protection and Affordable Care Act (PPACA) established the Center for Medicare and Medicaid Innovation (CMMI) within the Centers for Medicare and Medicaid Services (CMS) to test new approaches to health care delivery that could curb spending while providing better care.
  • In establishing CMMI, the law provided CMS with additional authority when testing new health care delivery and payment approaches, known as "models."
  • The creation of CMMI also provided a permanent mandatory appropriation stream for testing models-$10 billion for the CMMI's activities for the period of fiscal years 2011 through 2019 and $10 billion every decade beginning in fiscal year 2020.
  • In 2010, the nonpartisan Congressional Budget Office (CBO) originally estimated funding for CMMI would result in net savings of $1.3 billion over the ten-year budget window.
  • A September 2023 report from CBO revised the agency's prior analysis, estimating CMMI's activities increased direct spending by $5.4 billion, or 0.1 percent of net spending on Medicare, between 2011 and 2020.
  • CBO now currently projects that CMMI's activities will increase net federal spending by $1.3 billion, or 0.01 percent of net spending on Medicare, over the center's second decade, which extends from 2021 to 2030."

Counting the Cost of CMMI:

Established by Obamacare with the goal of saving taxpayer money and improving the quality of care for beneficiaries, CMMI has failed to deliver on its mandate.

In 2010, the Congressional Budget Office (CBO) projectedthat CMMI would produce net savings over the 10-year budget window. CBO revised its analysis last year, finding that CMMI is not saving tax dollars but rather has increased federal spending by billions of dollars.

In the letter penned by the House Budget Committee's Health Care Task Force, the committee requests that GAO issue a report updating previous work it has done on CMMI focusing on its use of dedicated mandatory funding and an assessment of its performance.

The letter directs GAO to examine the following:

  • How CMMI has used dedicated funding to develop models and carry out other agency functions;
  • How much of CMMI's first $10 billion mandatory appropriation did CMMI utilizeprior toreceiving its second $10 billion in funding in Fiscal Year 2020;
  • The status of CMMI's testing of models, including models that have saved money or increased spending per the Administration; and
  • How CMMI determines what types of providers to include in models - focusing on the discrepancy between the number of models focused on primary care physicianscompared to specialists.

Background:

The letter follows a recent HCTF member roundtable focused on examining why CMMI is adding billions to the national debt, rather than generating budgetary savings as the program intended.

The roundtable brought together members of the HCTF, CBO Director Phillip Swagel, and Demetrios Kouzoukas of Paragon Health Institute, who previously served as the head of the Medicare program under the Trump Administration

Pictured left to right: Demetrios Kouzoukas with Paragon Health Institute, HCTF Chair Michael C. Burgess (R-TX), CBO Director Phillip Swagel, and Rep. Rudy Yakym (R-IN)

Members, CBO, and stakeholders discussed how mandatory health care programs are the primary drivers of our nation's out-of-control $34 trillion in national debt.

The CBO baseline shows that spending on major health care programs will exceed $3.2 trillion in 2034, three times larger than the amount projected to be spent on national defense in the same year. As a result, we must conduct budgetary oversight of mandatory health care programs such as CMMI that are adding to our national debt and not delivering for taxpayers or patients.

More from the Health Care Task Force(HCTF):

Click HERE for the House Budget Committee release on the HCTF member roundtable.

Click HERE for the House Budget Committee release on "The Cost Of...The Center for Medicare and Medicaid Innovation."