Better Care, Better Cost Act
Sponsored By: Representative Goldman, Craig A. [R-TX-12]
Introduced
Summary
This bill would require States to factor managed care performance into default Medicaid managed care assignments. It would make States score plans on costs, avoidable hospital use, readmissions, emergency visits, and member satisfaction and publish an annual report on results.
Show full summary
- Families and enrollees: Default plan assignments would be influenced by plan performance scores, which could steer more people to higher‑scoring plans and affect which plan people are placed in by default.
- States: Would have to build a system to evaluate managed care entities, publish an annual report comparing actual default enrollments with hypothetical enrollments that ignore scores, and quantify any estimated expenditure reductions tied to using scores.
- Managed care entities: Would receive annual performance scores based on costs, outcomes, and individual satisfaction. Scores would be used in default enrollment decisions and could change how many people are auto‑assigned to each entity.
Effective date: Would apply to enrollments on or after January 1, 2028.
Personalized for You
How does this bill affect your finances?
Personalize government policy and PRIA will tell you what this bill means for your household, plus every other piece of legislation we track. PRIA reads each provision against your financial profile to show you exactly what matters to your wallet.
Bill Overview
Analyzed Economic Effects
1 provisions identified: 1 benefits, 0 costs, 0 mixed.
Medicaid plan quality scores for enrollment
This bill would require each State to score every Medicaid managed care plan on costs, outcomes, and member satisfaction. Beginning on January 1, 2028, States would have to use those scores when placing people who do not choose a plan into default managed care enrollments. States would publish a yearly report comparing default placements with and without scores and would estimate any reduced Medicaid spending from using those scores. Measures a State may use include plan spending, avoidable hospital readmissions, avoidable emergency visits and admissions, enrollee satisfaction, and the rate people terminate enrollment.
Sponsors & CoSponsors
Sponsor
Goldman, Craig A. [R-TX-12]
TX • R
Cosponsors
Rep. Pfluger, August [R-TX-11]
TX • R
Sponsored 6/18/2026
Rep. Panetta, Jimmy [D-CA-19]
CA • D
Sponsored 7/20/2026
Rep. Norcross, Donald [D-NJ-1]
NJ • D
Sponsored 7/20/2026
Roll Call Votes
No roll call votes available for this bill.
View on Congress.gov