GLOBE Model and CMMI Should be Gone
President Donald Trump has made addressing healthcare costs a priority of his second term in office. While this is a noble goal, it is important that this goal is achieved while rejecting foreign price controls. On September 30, 2026, the Center for Medicare and Medicaid Innovation (CMMI) announced it had finalized the Global Benchmark for Efficient Drug Pricing (GLOBE) Model. This mandatory model would impose MFN price controls on drugs covered by Medicare Part B. Given CMMI’s abysmal track record, Congress should not permit the agency to impose MFN policies by administrative fiat.
The GLOBE model doubles down on government overreach, further entrenching the control of federal bureaucrats in healthcare. This mandatory model also imports European and Canadian healthcare policies by tying U.S. prices to those in countries that have socialized medicine and artificially lower drug costs by freeloading off U.S. research and development. During President Trump’s first term, the Council of Economic Advisers’ February 2020 report found that American patients pay more for biopharmaceutical drugs because of free-riding and price controls by foreign countries, and that reducing both would increase competition and lower drug prices for American patients. Rather than implementing MFN price controls on drugs, lawmakers should leverage trade deals to force foreign countries to end their free-riding and price controls. Adopting MFN price controls would also harm patients. According to an August 2022 University of Chicago issue brief, price controls would increase healthcare spending by $50.8 billion over the next 20 years and lead to 135 fewer drugs, which will negatively impact 2.47 million patients.
CMMI should not have the authority to implement this harmful model. The Affordable Care Act established CMMI with a $10 billion-per-decade mandatory budget to create and test new payment and services models that would save money and improve healthcare quality in Medicare, Medicaid, and the Children’s Health Insurance Program, as one of the “pay fors” in the legislation. A September 2023 Congressional Budget Office (CBO) study found that instead of saving $2.8 billion between 2011 and 2020, CMMI cost American taxpayers $5.4 billion.
CMMI created more than 50 models for 28 million patients and more than 528,000 healthcare providers, only six of which did not increase spending or reduce the quality of healthcare. The remaining programs were not only costly but also created significant administrative and legal burdens for doctors and healthcare systems. CBO’s projection for 2021-2030 shows another $1.3 billion will be lost, and that is likely a low estimate since it is based on efficiency improvements that CMMI has never been able to achieve. Indeed, a July 2026 American Council for Capital Formation report found that CMMI could cost up to $8.12 billion between 2024 and 2033, and that, “under no scenario is the program able to achieve any savings for taxpayers for the 2024-2033 budget window.”
Common sense dictates that any government program with such a track record of failures should not be continued, much less given the authority to implement mandatory price controls on pharmaceuticals.
The stated goal of the GLOBE model is to lower costs for Medicare Part B enrollees and to help them live healthier lives. However, given the history of CMMI and price controls, this model will fail to save money or improve care and likely lead to shortages and fewer drugs being developed. Rather than impose price controls through CMMI, lawmakers should lower costs for patients by enacting H.R. 8293, the Abolish the CMMI Act, and end foreign freeriding on U.S. pharmaceutical research and development.
