Sweden has one of the best elderly cares in Europe and the Swedish care work is also one of the best in terms of quality, compared to other European countries. In recent years, higher demands have been set on the care work and the number of privatizations of public services has increased. In 2009 a new law came into force, the Act on System of Choice (LOV) which increased individual’s right to a greater participation and a free choice in the selection of health and social care providers. This paper aims to highlight the impact of the law, system of choice. By using the method of qualitative surveys and interviews with care managers, and an exploration of relevant studies and reports, I was able to complete this study. With institutional theory and other sociological concepts such as isomorphism and street-level bureaucracy, I made an analysis of both the care managers and also at an organizational level. In the conclusions I argue that the system of choice has had a greater impact at an organizational level rather than on the care managers. The paper also highlights the fact that the knowledge of processes of implementation and political governance has had a significant role. The three main issues are how the law has influenced care managers work, how organizations have changed, how and if the active choices work in practice.