Better Care, Better Cost Act
- Bill Number
- H.R. 9336
- Origin Chamber
- House
- Congress
- 119th Congress, Session 2
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2026-06-18: Referred to the House Committee on Energy and Commerce.
- Last Updated
- 2026-07-06T16:54:54Z
AI-Generated Summary
Purpose This legislation aims to improve the quality and efficiency of Medicaid managed care by requiring states to factor in the performance of managed care entities when making default enrollments of beneficiaries.
Key Provisions
- Amends Section 1932(a)(4) of the Social Security Act to replace equitable distribution of default enrollments with assignment based on a state's performance score for each managed care entity.
- Requires states to create a performance evaluation system using measures such as medical assistance expenditures, avoidable hospital readmissions, emergency department visits, hospital admissions, beneficiary satisfaction scores, and rates of voluntary disenrollment.
- Mandates annual public reports comparing enrollment outcomes with and without performance scores, along with estimates of any spending reductions achieved.
- Applies to enrollments on or after January 1, 2028.
Significant Changes to Existing Law The bill modifies current Medicaid rules under title XIX by shifting default assignment criteria from neutral distribution to performance-based selection. It adds new state obligations for scoring, reporting, and using outcome data that were not previously required.
Potential Impacts
- State Medicaid agencies would need to develop and maintain new evaluation systems and produce annual reports.
- Managed care entities may face incentives to improve cost control, reduce avoidable care, and increase beneficiary satisfaction to secure more default enrollments.
- Beneficiaries could experience enrollment shifts toward higher-performing plans, potentially leading to better care quality or lower overall program costs, though individual choice remains unaffected.
- No direct effects on international relations are outlined.
Main Stakeholders Affected
- State Medicaid agencies responsible for implementation and reporting.
- Managed care organizations participating in Medicaid.
- Individuals enrolled in Medicaid managed care plans.
Notable Legal, Constitutional, or Political Implications The measure expands federal requirements on state administration of Medicaid without altering core eligibility or benefit structures. It raises no apparent constitutional concerns but increases state reporting and operational responsibilities under an existing federal-state partnership program.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Rep. Goldman, Craig A. [R-TX-12]
Cosponsors (1)
Rep. Pfluger, August [R-TX-11]
Recent Actions
- 2026-06-18: Referred to the House Committee on Energy and Commerce.
- 2026-06-18: Introduced in House
- 2026-06-18: Introduced in House
Bill Versions
- Better Care, Better Cost Act — issued 2026-06-18 — PDF (4 pages)