Kids’ Access to Primary Care Act of 2025

This bill makes Medicaid pay at least the same as Medicare for primary care visits going forward. It also expands who can get this higher rate to more types of providers, like obstetricians and other specialists who do primary care, nurse practitioners, physician assistants, certified nurse-midwives, and certain clinics (such as rural health clinics and federally qualified health centers) when they provide primary care services . Medicaid managed care plans must pay at least these amounts and keep records to prove it; value-based payments are allowed if they meet fair rules and documentation.

The bill also orders a study within about a year to see how many children are enrolled in Medicaid, how many providers are being paid for primary care, and how payment rates change across states, with $200,000 authorized for the study. It encourages providers to follow the American Academy of Pediatrics’ Bright Futures guidelines for kids’ checkups and screenings.

• Who is affected: Children on Medicaid and families seeking primary care; primary care doctors; OB-GYNs and related subspecialists; nurse practitioners, physician assistants, and certified nurse-midwives; rural health clinics and federally qualified health centers; Medicaid managed care plans .
• What changes: Primary care pay in Medicaid must be at least Medicare rates; more provider types qualify; managed care plans must comply and document payments; nurse practitioners, PAs, and midwives must be paid no less than what they would receive under Medicare for their services; value-based arrangements are allowed with safeguards .
• When: Applies to services after the bill becomes law; managed care contract rules apply to contracts entered into on or after enactment; the study is due roughly 13 months after enactment, with FY2026 funds authorized .