Apples to Apples Comparison Act of 2025
Summary
What This Bill Does
The Apples to Apples Comparison Act adds several Medicare transparency requirements. Beginning with 2025, HHS must publish CMS machine-readable files with Medicare enrollment and expenditure information by county and Metropolitan Statistical Area and by beneficiary categories, including historical enrollment data beginning with 2015 and monthly total and average expenditures for specified historical and projected periods. Beginning with 2026, MedPAC must include a retrospective analysis comparing average Medicare Advantage spending with average spending for beneficiaries in traditional Parts A and B who could enroll in MA but do not, using CMS Chief Actuary and trustee data, accounting for plan value differences, demographics, and HCC risk scores while excluding favorable selection differences, and publishing replicable data with privacy protections. Medicare trustees must also report aggregate and average expenditures for Part A-only, Part B-only, and traditional A-and-B beneficiaries, with Part A and Part B breakouts where practicable.
Who Benefits and How
Medicare researchers benefit because CMS, MedPAC, and trustee data become more granular, machine-readable, and replicable. Medicare beneficiaries benefit if policymakers can compare Medicare Advantage and fee-for-service spending on a clearer basis. Congressional health committees benefit from county, MSA, historical, projected, and beneficiary-category spending information. Traditional Medicare advocates benefit from a required MedPAC comparison that accounts for value differences, demographics, and HCC scores.
Who Bears the Burden and How
The Centers for Medicare and Medicaid Services must publish new machine-readable expenditure and enrollment files. MedPAC must conduct annual retrospective Medicare Advantage versus fee-for-service spending analysis beginning in 2026. Medicare trustees must add expenditure breakouts to Hospital Insurance and Supplementary Medical Insurance reports. Medicare Advantage plans face added public scrutiny if the new comparisons show higher costs or favorable selection concerns.
Key Provisions
- Requires CMS machine-readable Medicare enrollment and expenditure publication by county and MSA beginning with 2025.
- Requires historical enrollment data beginning with 2015 and monthly expenditure data for specified periods.
- Requires annual MedPAC analysis comparing Medicare Advantage and fee-for-service expenditures beginning in 2026.
- Requires Medicare trustees to report aggregate and average expenditures for Part A-only, Part B-only, and traditional A-and-B beneficiaries.
Evidence Chain:
This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers with clause-level evidence links.
At a Glance
What This Bill Does
Requires CMS, MedPAC, and Medicare trustees to publish more granular Medicare expenditure and enrollment data so Medicare Advantage and fee-for-service costs can be compared by geography and beneficiary category.
Key Policy Areas
Medicare, Health Care Transparency, Federal Data
Primary Purpose
Requires CMS, MedPAC, and Medicare trustees to publish more granular Medicare expenditure and enrollment data so Medicare Advantage and fee-for-service costs can be compared by geography and beneficiary category.
Policy Domains
Resolution provisions
Identified Gains
- Medicare researchers
- Medicare beneficiaries
- Congressional health committees
- Traditional Medicare advocates
Identified Costs
- Centers for Medicare and Medicaid Services
- MedPAC analysts
- Medicare trustees
- Medicare Advantage plans
Sponsors
Legislative Progress
In CommitteeMr. Bean of Florida (for himself and Mr. Hern of …
Referred to the Committee on Ways and Means, and in …
Introduced in House
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
Centers for Medicare and Medicaid Services, Congressional health committees, MedPAC analysts
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.
Learn more about our methodology