Medicaid steering toward better plans—but who defines 'better'?
H.R. 9336 — Better Care, Better Cost Act · Filed by Craig Goldman (R-TX) · 1 cosponsor · Introduced Jun 18, 2026 · Referred to committee
Your members of Congress
Enter a ZIP to see where your representative and both senators stood on this bill.
Looked up on this device — your ZIP is never stored on our servers.
What it does
This bill requires states to evaluate Medicaid managed care companies based on their performance—measuring costs, hospital readmissions, emergency visits, and patient satisfaction—and use those scores to steer new Medicaid enrollees toward better-performing plans. States must publish annual reports showing how many people are steered this way and estimate any savings. The rule takes effect January 1, 2028.
Why we flagged it
The bill's core function is to create a performance-scoring system for Medicaid managed care plans and use those scores to influence enrollment. It is a regulatory/administrative reform, not a funding or commemorative measure.
What the text implies
- States gain discretion to define 'performance'—measures like cost and readmission are specified, but states choose which ones to weight and how. This could create variation in which plans are favored across states.
- Managed care entities with lower cost scores may see enrollment decline, potentially reducing their revenue and market share. Plans serving sicker or more complex populations may score lower on cost metrics even if quality is high, creating perverse incentives.
The full analysis lists 4 implications of this text.
Who stands to gain
Medicaid managed care plans with strong cost and quality performance; States (via reduced Medicaid expenditures); Costco (mapped stock reference—likely due to healthcare cost/value angle, though not directly named