This bill mandates increased public transparency regarding detailed Medicare spending data by HHS, requires MedPAC to conduct annual, apples-to-apples comparisons of Medicare Advantage and traditional Medicare expenditures, and updates the Trustees' annual report with categorized spending information.
Aaron Bean
Representative
FL-4
The Apples to Apples Comparison Act of 2025 mandates greater public transparency regarding Medicare spending by requiring the Secretary of HHS to publish detailed, machine-readable expenditure data broken down by county and beneficiary type. Furthermore, the bill requires the Medicare Payment Advisory Commission (MedPAC) to annually compare the average cost of Medicare Advantage enrollees versus traditional Medicare beneficiaries, accounting for plan differences and risk factors. Finally, the Medicare Trustees must also report detailed expenditure information categorized by specific beneficiary enrollment statuses.
Medicare Transparency Bill Demands County-Level Spending Data and Full Public Comparison of Medicare Advantage Costs
If you’ve ever wondered exactly where Medicare dollars go—and specifically, how much is spent in your county versus the next, or on people in traditional Medicare versus those in Medicare Advantage (MA)—this bill is for you. The Apples to Apples Comparison Act of 2025 is all about pulling back the curtain on Medicare spending, demanding massive amounts of public data and a straight-up, transparent comparison of the program’s two main tracks.
The Data Dump: Your County’s Medicare Spending, Down to the Dollar
Section 2 mandates a serious data upgrade from the Department of Health and Human Services (HHS). Every year, HHS must publish detailed Medicare spending figures, broken down by every single county and Metropolitan Statistical Area (MSA) in the country. This isn't just a big number; the data has to be categorized by incredibly specific beneficiary groups—like people only enrolled in Part A (hospital), people with both A and B but no MA plan, or people in MA plans with Part D coverage. The kicker? This data must be in machine-readable files, meaning researchers and watchdogs can easily download it and run their own analyses. For the average person, this means that for the first time, you could potentially see if Medicare spending per person in your area is significantly higher or lower than in a neighboring town, and who, exactly, is driving those costs.
Comparing Apples to Apples: The MA vs. Traditional Medicare Showdown
Section 3 tackles the long-running debate over whether Medicare Advantage (MA) plans save the government money compared to traditional Medicare. The Medicare Payment Advisory Commission (MedPAC) must now conduct an annual comparison of the average amount Medicare spends on people in MA versus those in traditional Medicare. This isn't a simple calculation; MedPAC has to adjust for key differences, like the fact that MA plans often cap out-of-pocket costs and offer extra benefits (like dental or vision) that traditional Medicare doesn’t. They also have to adjust for demographic differences.
What makes this analysis truly transparent is the process: MedPAC must publish its entire methodology 60 days before the report is due, allow 30 days for public comments, and then publish a response to every single comment. They also have to release the raw, non-private data they used. This level of required transparency is huge for policy analysts and taxpayers, ensuring that the critical comparison between MA and traditional Medicare is scrutinized by everyone, not just government insiders.
The Fine Print: Who’s Carrying the Load?
While the public benefits from this transparency, the administrative lift is significant. HHS staff will have a major new burden in processing and publishing this detailed, granular data, and MedPAC analysts will face intense pressure to get their annual comparison exactly right under public scrutiny. Furthermore, Section 4 requires the Medicare Trustees (who manage the program’s finances) to include these newly detailed spending breakdowns in their annual reports, reinforcing the transparency mandate across all major Medicare reporting bodies. This bill essentially turns up the lights on Medicare’s finances, forcing all agencies to speak the same language about where the money is going.