This bill mandates the publication of detailed Medicare expenditure data by county and MSA, and requires MedPAC to analyze and report on spending comparisons between Medicare Advantage and traditional fee-for-service enrollees.
Tim Scott
Senator
SC
The Apples to Apples Comparison Act of 2026 mandates increased transparency regarding Medicare spending by requiring the Secretary of HHS to publish detailed expenditure data broken down by county and beneficiary type. It also directs the Medicare Payment Advisory Commission (MedPAC) to conduct and publicly release an annual analysis comparing spending between Medicare Advantage and traditional fee-for-service beneficiaries. Finally, the bill requires the Boards of Trustees to include specific expenditure breakdowns for different Medicare enrollment statuses in their annual reports.
New Medicare Transparency Act Mandates Public Spending Reports by County and Coverage Type Starting in 2027.
The 'Apples to Apples Comparison Act of 2026' is essentially a massive open-books policy for Medicare. It requires the Department of Health and Human Services (HHS) to stop keeping Medicare spending data in the basement and start publishing it on the CMS website for everyone to see. Within 30 days of the end of each year, the government will have to post exactly how much is being spent on healthcare, broken down by every single county and Metropolitan Statistical Area in the country. This isn't just a total number; it includes a 10-year look back at history and a projected look into the future, giving us a clear picture of where the money is going and where it’s headed.
The Local Receipt
Think of this like getting an itemized receipt for your taxes at the local level. Under Section 2, the data must be hyper-specific. It won't just say 'Medicare spent X amount'; it will break it down by whether people are on traditional Medicare (Parts A and B), Medicare Advantage (Part C), or have extra coverage like Medigap or TRICARE. For a small business owner in a rural county or a software dev in a major city, this means you can finally see if your area is getting the same value for its healthcare dollars as the next town over. By 2027, they’ll even have to upload historical enrollment data, making it easier to spot trends—like whether certain types of plans are taking over your specific region.
Putting Medicare Advantage Under the Microscope
Section 3 tackles the long-standing debate over whether Medicare Advantage (the private insurance version of Medicare) is actually a better deal than the traditional government-run version. The bill orders the Medicare Payment Advisory Commission (MedPAC) to run a 'retrospective analysis'—basically a deep-dive audit—comparing the two. Crucially, they have to account for the 'extra' stuff private plans offer, like gym memberships or drug coverage, while also adjusting for how sick or healthy the people in those plans are. To keep things honest, MedPAC has to post their math (methodology) 60 days early and let the public poke holes in it before the final report goes to Congress.
Accountability for the Trust Funds
Finally, the folks who manage the Medicare Trust Funds are being put on notice. Section 4 requires the Boards of Trustees to include much more granular data in their annual reports. They’ll have to show the aggregate and average spending for different groups—like people who only have hospital insurance versus those who have the full suite of coverage. By forcing this level of detail, the bill aims to prevent 'favorable selection'—where plans might try to cherry-pick healthy patients to look more efficient. For the average person juggling a career and aging parents, this transparency is a tool to ensure the program stays solvent and fair, without the usual bureaucratic smoke and mirrors.