Medicaid rules are changing fast. People who rely on Medicaid need stable coverage. They also need reliable, coordinated care.
For over 50 years, states have relied on Medicaid managed care. That means states pay health plans a flat monthly amount per member to coordinate care for Medicaid patients.
Health plans coordinate care through primary care physicians and a network of clinics, hospitals, and specialists.
This model incentivizes health plans to design their program to prioritize prevention and outcomes.
As policy shifts due to House of Representatives Bill 1, The One Big Beautiful Bill Act, the value of Medicaid managed care has never been greater. Medicaid managed care can:
- Help people afford their care
- Help people access stable, coordinated care
- Help people and communities stay healthier and have better health outcomes
Managed care: a stabilizer during change
On July 4, 2025, HR 1 was signed into law.
HR 1 will have a large effect on Medicaid — reshaping eligibility, financing, and state operations. Several provisions take effect later this year and into 2032.
Many people with Medicaid will soon face:
- New work requirements
- More frequent renewals
- More limits on retroactive coverage
Managed care is critical for people with low incomes. It helps coordinate services and reduces gaps in care when rules — and eligibility — shift.
Research also demonstrates Medicaid managed care performs better than fee-for-service on access and patient experience, in part due to better care coordination.
Kaiser Permanente’s approach
Every member at Kaiser Permanente gets the same integrated care experience. The care is the same whether they’re enrolled in Medicaid, Medicare, or employer coverage. Within Kaiser Permanente, in Medicaid managed care:
- Care and coverage are together
- Services connect across primary care, specialty care, hospitals, pharmacies, labs, and imaging
The highest quality providers
Our hiring standards for Kaiser Permanente clinicians go above what the federal government requires.
Our physicians are paid a salary. They don’t earn more money by ordering unneeded tests and procedures. Instead, Kaiser Permanente physicians create and follow guidelines that are based on research.
This ensures every member gets world-class care based on the latest available evidence.
And, if they need it, every Kaiser Permanente Medicaid member gets high-quality hospital care.
What policymakers can do now
As we move through HR 1 implementation and beyond, there are a number of steps policy leaders should take to ensure people with Medicaid get the best care possible.
- Encourage Centers for Medicare & Medicaid Services to issue clear guidance on community engagement requirements to limit procedural disenrollments.
- Simplify renewals so eligible people don’t lose coverage due to paperwork.
- Fund navigators and assisters.
- Pair health coverage with patient-centered social support that improves health, such as housing, food, education, and job training.
- Integrate long-term services and support to better align Medicare and Medicaid for dually eligible members.
- Reduce barriers to work by expanding and sustaining support programs like childcare, transportation, and behavioral health services.
Policy leaders should also support Medicaid payment models that reward outcomes and enable integrated, value-based care, like we provide at Kaiser Permanente.
Support for these models helps providers deliver higher-value care — and helps more people achieve better health.
In a time of change, access and quality are critical for health care. Medicaid managed care is a powerful strategy to maintain both.
