An Optimist’s Take on What's Next for Health Tech in Medicaid

2025 was a tough year for Medicaid. I've spent the past decade consulting and researching across the Medicaid space, which covers almost 80 million Americans, and 2025 hit hard.  

For the uninitiated, Medicaid is America’s health insurance program for low-income individuals, which includes 40% of all kids, 40% of all births, and 60% of all nursing home residents. Nearly 70% of adults have some connection to the Medicaid program – as a member themselves, or through a family member or close friend – although many don’t even realize it. And Medicaid was a lifeline during the pandemic – providing healthcare to millions of individuals who lost their jobs, and letting them stay on the program until the end of the Public Health Emergency, despite income changes. 

But memories are short, and the political winds have shifted. The budget reconciliation bill (H.R. 1), signed into law on July 4, 2025, implements funding cuts and more stringent eligibility requirements, among other hits to the program. It is inevitable that millions of people will lose access to Medicaid. And policy priorities have shifted away from allowing the use of Medicaid funds to cover interventions that address the social drivers of health (e.g., housing and transportation), although those factors contribute to 80% or more of health outcomes. 

Despite the headwinds, there are still companies thriving in the Medicaid space – doing well and doing good – and there’s a lot to learn from them. 

Over the past few months, I’ve been researching these players and spending time with their investors to understand how they’re adapting in the current market. I walked away feeling motivated. I’m not a venture capitalist, but I do know that the best investment returns involve contrarian bets, meaning not everyone will be rushing in the same direction to throw down capital. So for those looking for a more creative, outside-the-box opportunity – why not Medicaid? 

There are at least two dozen rapidly-growing VC-backed companies that are already building technology specifically for Medicaid – either building explicitly for Medicaid members, or building for providers, systems or processes predominantly serving Medicaid members. These companies are providing care coordination, extra support during high-need times such as pregnancy and childbirth or substance abuse treatment, and reducing transportation barriers and administrative burden with tech-enabled or virtual care. Established platforms are also stepping into the Medicaid space, even despite the challenges. For instance, Maven Clinic, in the women’s health space, is developing and scaling in Medicaid after building up its primary business selling into the commercial market. Elektra Health is serving the Medicaid market too.