A Republican bill with 2 Democratic cosponsors · See all 3 cosponsors
Last activity — Referred to the House Committee on Energy and Commerce.
In committee
Introduced and handed to a committee in the chamber it started in.
The committee holds it, and most bills are never heard from again. A hearing or a committee vote would be news; silence is the usual outcome, and it kills the bill without anyone voting against it.
Its path through Congress
- Introduced
- In Committee
What this bill would do
The "Better Care, Better Cost Act" amends the Social Security Act regarding the Medicaid program. It requires States to consider the performance scores of managed care entities when assigning individuals to them. States must create a system to evaluate these entities based on cost, outcomes, and individual satisfaction. Additionally, States must publish an annual report on enrollment differences and estimated expenditure reductions. This bill would take effect for enrollments on or after January 1, 2028.
Yes· 3 of 27
- Scored +5
Would households on low incomes be better off under this?
Directly benefits low-income individuals by ensuring their Medicaid providers are evaluated on quality and satisfaction.
- Scored +5
Does this make what the government does easier for the public to see?
States are required to publish annual reports on enrollment differences and expenditure reductions.
- Scored +4
Would people with disabilities be better off under this?
People with disabilities are high users of Medicaid and will benefit from higher quality managed care.
The opposite
- Scored -2
Does this leave more decisions to the states?
It restricts State autonomy in how they assign individuals to managed care entities.
Who it would affect, and how
Potential Positive Impacts for People
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Performance-Based Assignments: Because States must use performance scores to assign individuals to managed care entities (Section 2(a)(1)), people may be placed with entities that provide better care.
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Focus on Care Quality: The use of measures like avoidable hospital readmissions, avoidable emergency department visits, and avoidable hospital admissions (Section 2(a)(2)(ii)(II)-(IV)) encourages entities to improve health outcomes.
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Accountability through Satisfaction: Including individual satisfaction measures and the rate at which people terminate enrollment (Section 2(a)(2)(ii)(V)) ensures that the patient's experience is considered in the performance score.
Potential Negative Impacts for People
- No negative impacts for individuals are explicitly stated in the provided text.
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Tap or hover a score for the reason it gave.
- Demographic And Interest Groups
- Would households on low incomes be better off under this? — Directly benefits low-income individuals by ensuring their Medicaid providers are evaluated on quality and satisfaction. Would people with disabilities be better off under this? — People with disabilities are high users of Medicaid and will benefit from higher quality managed care. Would retired people be better off under this? — Retirees on Medicaid benefit from a focus on avoidable hospitalizations. Would people over 65 be better off under this? — Seniors on Medicaid benefit from reduced avoidable hospitalizations and better care quality. Would Black Americans be better off under this? — Disproportionately affects groups with higher Medicaid enrollment by improving care quality. Would Asian Americans be better off under this? — Disproportionately affects groups with higher Medicaid enrollment by improving care quality. Would children be better off under this? — Children on Medicaid may receive better care through higher-performing managed care entities. Would Hispanic Americans be better off under this? — Disproportionately affects groups with higher Medicaid enrollment by improving care quality. Would LGBTQ people be better off under this? — Beneficial for LGBTQ individuals enrolled in Medicaid. Would men be better off under this? — Beneficial for men enrolled in Medicaid. Would people in middle age be better off under this? — Middle-aged adults on Medicaid may receive better care through higher-performing managed care entities. Would Native Americans be better off under this? — Disproportionately affects groups with higher Medicaid enrollment by improving care quality. Would people in rural areas be better off under this? — Rural Medicaid recipients may see improved provider quality. Would people in cities be better off under this? — Urban Medicaid recipients may see improved provider quality. Would veterans be better off under this, taking everything together? — Beneficial for veterans enrolled in Medicaid. Would white Americans be better off under this? — Beneficial for any Medicaid recipient regardless of race. Would women be better off under this? — Beneficial for women enrolled in Medicaid. Would people in their twenties and thirties be better off under this? — Young adults on Medicaid may receive better care through higher-performing managed care entities.
- Economy And Finance
- Does this make the government pay for what it commits to? — It requires states to evaluate and report on the cost-effectiveness and expenditure reductions of managed care entities. Does this give people more protection from unfair business practices? — It improves the quality of service for Medicaid recipients by assigning them to higher-performing entities. Does this reduce what the federal government spends? — By prioritizing high-performing and cost-effective managed care entities, the bill seeks to reduce total expenditures. Does this reduce what the federal government owes? — The bill aims to quantify and achieve estimated reductions in Medicaid expenditures.
- Healthcare
- Does this make health care easier to get in general? — Recipients are more likely to be assigned to entities with better outcomes and higher satisfaction scores. Does this lower what a hospital stay costs? — The bill incentivizes the reduction of avoidable hospital readmissions and emergency department visits.
- Governance And Ideology
- Does this make what the government does easier for the public to see? — States are required to publish annual reports on enrollment differences and expenditure reductions. Does this give the federal government more power? — The bill mandates new requirements that States must follow regarding Medicaid administration. Does this leave more decisions to the states? — It restricts State autonomy in how they assign individuals to managed care entities.
- Social Issues And Justice
- Is this likely to lift people out of poverty? — Better health outcomes for low-income Medicaid recipients can lead to improved overall stability.
- 7/20/2026
- 2 Cosponsors added.
- 6/18/2026
- Referred to the House Committee on Energy and Commerce.
- 1 Cosponsor added.
- Introduced in House
Donald NorcrossDemocrat · New Jersey
August PflugerRepublican · Texas
Jimmy PanettaDemocrat · California