Proposed Changes to Medicaid Managed Care Access
October 14, 2025
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Where This Stands
Currently Died in Health Care Facilities & Systems Subcommittee. The next step in the legislative lifecycle is Floor Vote.
Procedural history
6 actions- Jan 13, 2026HouseIntroduced1st Reading (Original Filed Version)
- Oct 21, 2025HouseNow in Health Care Facilities & Systems Subcommittee
- Oct 21, 2025HouseCommitteeReferred to Health & Human Services Committee
- Oct 21, 2025HouseCommitteeReferred to Health Care Budget Subcommittee
- Oct 21, 2025HouseCommitteeReferred to Health Care Facilities & Systems Subcommittee
- Oct 14, 2025HouseIntroducedFiled
Version history
Only one version on file - nothing to compare yet. As later stages (committee substitute, engrossed, enrolled) are captured, the redline appears here.
View official text →The Frame
If enacted, this bill would change how and when Medicaid enrollees can access primary care by requiring at least 50% of network providers to offer appointments outside of standard 8 a.m. to 5 p.m. business hours.
Potentially affected actors named in the source documents. Mention is not a position.
Medicaid enrollees
Enrollees would have access to a larger window of appointment times and more transparent, searchable information regarding provider availability and drug coverage.
Medicaid managed care plans
Plans must update their provider databases, ensure 50% of primary care providers offer extended hours, and improve electronic data sharing and prior authorization processes.
Children in the custody of the Department of Children and Families
Their medical, dental, and behavioral health records would be subject to mandatory coordination between their managed care plans and the Department of Children and Families.
Current stage: Died in Health Care Facilities & Systems Subcommittee.
Floor Vote.
Summary
Key Facts
You don't have to trust us. Each fact below is taken straight from the official document - click any one to see the exact passage, highlighted in the original.
Frequently Asked Questions
What counts as 'outside of regular business hours' under this bill?
Will I be able to see if a doctor is actually accepting new patients?
Does this bill affect how I get my prescription drugs?
Why It Matters
If enacted, this bill would change how and when Medicaid enrollees can access primary care by requiring at least 50% of network providers to offer appointments outside of standard 8 a.m. to 5 p.m. business hours.
News Coverage
Lobbying Activity
60 Plus Association
2026
“Signed a coalition letter opposing any efforts to raise the corporate tax rate above the 21% level set in the 2017 Tax Cuts and Jobs Act (TCJA). Signed a coalition in support of the Family Business Legacy Act, H.R. 6329. This legislation creates parity in the tax code between the estate and gift taxes by allowing an estate tax deduction for contributions to 501(c)(4), (c)(5), and (c)(6) organizations. Signed a coalition letter urging opposition to proposals that would raise taxes on carried interest investment income.The letter is urging Congress to reject the misnamed Carried Interest Fairness Act, legislation recently reintroduced by Senators Tammy Baldwin, Elizabeth Warren, Bernie Sanders, and other progressive members of Congress. This legislation that would increase the tax rate on carried interest investment by 70%, from 23.8% to 40.8%. Signed a coalition letter in support of H.R.574 - ALIGN Act and highlight the 100% bonus depreciation provision's importance as the tax cut reauthorization efforts continue. Signed a coalition to support of repealing IRA's green new deal subsidies in reconciliation to pay for tax cuts. Signed a coalition letter regarding digital services taxes (DST) in an effort to stop Canadas imposition of a discriminatory digital services tax (DST) on U.S. firms and your efforts to include restrictions on the imposition of DSTs and other unfair digital policies in recently announced trade agreements-providing a model for future trade negotiations. Signed a coalition letter urging the President to index capital gains for inflation.”
BARNES & THORNBURG, LLP
on behalf of SUPERIOR AIR GROUND AMBULANCE SERVICE, INC.
ADAPTIVE GOVERNMENT RELATIONS
on behalf of SEATTLE CHILDREN'S
SINGISER SOLUTIONS LLC
on behalf of PLANNED PARENTHOOD FEDERATION OF AMERICA
LOBBYING FOR IMPROVEMENTS
on behalf of LIFEWAY FOODS, INC
LOBBYING FOR IMPROVEMENTS
on behalf of LIFEWAY FOODS, INC
(C) MANAGEMENT INC.
on behalf of Association of Community Cancer Centers
2021
“THE TELEHEALTH MODERNIZATION ACT (H.R. 1332/ S.368) Organized a Virtual Capitol Hill Day for ACCC members (70+) on May 12th, 2021. Created one-pagers and talking points on importance of this legislation. ACCC views telehealth expansion as critical for cancer patient access to healthcare providers. THE SAFE STEP ACT (H.R.2163/S.464) Organized a Virtual Capitol Hill Day for ACCC members (70+) on May 12th, 2021. Created one-pagers and talking points on importance of this legislation. ACCC views step therapy in the use of cancer care delivery to be a hinderance to best practice and timely treatment/access of care for patients. THE ACCESS TO GENETIC COUNSELOR SERVICES ACT (H.R. 2144/S.1450) Organized a Virtual Capitol Hill Day for ACCC members (70+) on May 12th, 2021. Created one-pagers and talking points on importance of this legislation. ACCC views genetic counselors as integral members of the cancer care delivery team in oncology programs/practices in the US. THE RESEARCH INVESTMENT TO SPARK THE ECONOMY (RISE) ACT (H.R. 869/S.289) Organized a Virtual Capitol Hill Day for ACCC members (70+) on May 12th, 2021. Created one-pagers and talking points on importance of this legislation. ACCC understands the importance of research funding for the NIH and oncology investigators to promote clinical trials that impact improving cancer outcomes. THE MEDICARE MULTI-CANCER EARLY DETECTION SCREENING COVERAGE ACT OF 2021 (H.R. 1946) Organized a Virtual Capitol Hill Day for ACCC members (70+) on May 12th, 2021. Created one-pagers and talking points on importance of this legislation. ACCC advocates for the use and coverage of cancer screening modalities that will diagnose cancer at earlier stages therefore improving patient outcomes. MOST FAVORED NATION (Proposed by Trump Administration at end of 2020) ACCC entered into a lawsuit against HHS in December 2020 opposing the Most Favored Nation proposal tying drug reimbursements to international reference pricing. By lowering reimbursement to cancer programs and practices, patient access to care would be limited as supportive cancer care services limited due to lack of reimbursement to cover positions. ACCC was concerned over programs/practices closing if proposal were to move forward. ACCC met with one Senators office on this topic expressing concern in January 2021. RADIATION ONCOLOGY MODEL (Proposed by CMMI) ACCC met with 1 Senate office and 1 House office over concerns re: this alternative payment model. ACCC has concerns over mandatory nature of Radiation Oncology model testing reimbursement rates and potentially limiting access to care for patients who are recommended radiation for their cancer diagnosis, particularly in rural areas of the U.S. ”
Sponsors
Discoveries
Patterns POLISCOPE noticed across the record. These are observations to investigate, not conclusions.
Shift toward electronic and real-time transparency
The bill marks a clear policy shift toward requiring real-time digital transparency for drug formularies and provider databases, moving away from static or manual reporting.
Connected Entities
Sources
openstates.org
Analysis Score
0–100- Significance65How much this matters to a regular citizen
- Controversy40Intensity of disagreement among stakeholders
- Entertainment5Compellingness for a non-policy-wonk reader
- Buzz20Current news / social attention level
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