Apples to Apples Comparison Act of 2026
Sponsored By: Senator Tim Scott
Introduced
Summary
This bill would require CMS to publish county- and MSA-level, month-by-month Medicare expenditure data in machine-readable files. It would also direct the Medicare Payment Advisory Commission to compare Medicare Advantage and fee-for-service spending and require the Medicare Trustees to include disaggregated Part A and Part B expenditure figures in their annual reports.
Show full summary
- Families and local advocates would get public, local spending data by enrollment type and month. The first expanded dataset must begin in 2027 and include historical data back to 2015.
- Researchers, policymakers, and insurers would access a nationwide, machine-readable dataset broken down by an extensive matrix of enrollment and coverage categories, including Part A, Part B, Part C (Medicare Advantage), Part D, MA-PD, specialized MA plans, group health plans, and Federal programs. The dataset must include month-by-month historical figures and projected figures for a window up to 5 years.
- The Medicare Payment Advisory Commission would be required to publish retrospective annual comparisons of Medicare Advantage versus fee-for-service spending for each year starting in 2027, with public methodology and a comment period. The Medicare Trustees must add aggregate and average Part A and Part B expenditure data for three specified enrollment categories to their annual reports starting in 2027.
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Bill Overview
Analyzed Economic Effects
3 provisions identified: 3 benefits, 0 costs, 0 mixed.
Compare Medicare Advantage and fee-for-service
The bill would require MedPAC to publish an annual, retrospective comparison (starting with the 2027 report) of average spending for Medicare Advantage versus fee-for-service Medicare. MedPAC would use data from the Chief Actuary and Trustees and adjust for differences in out-of-pocket caps, supplemental benefits and Part D integration, demographics, and HCC risk scores, but would not make favorable selection adjustments. MedPAC must publish its methodology at least 60 days before submission, allow at least 30 days for public comment, publish responses to comments, and make underlying data publicly available in a replicable form while protecting confidentiality.
Monthly Medicare spending by county and metro
This bill would require HHS (through CMS) to publish machine-readable files each year starting in 2027. Files would show monthly total and average Medicare spending for every county and metro area for a 10-year historical period and projected months up to 5 years as set by the Secretary. The 2027 release must also include enrollment counts back to 2015. All data would be broken down by many beneficiary categories (Part A/B/C/D status, Medicare Advantage types, dual eligibles, Medigap, group coverage, and similar cross-tabs).
Trustees must report new Medicare spending breakdowns
The bill would require the Boards of Trustees for the Hospital Insurance and Supplementary Medical Insurance Trust Funds to add new spending details starting with reports for 2027. Trustees would report aggregate and average Part A and Part B expenditures for three groups: Part A only, Part B only, and people with both Part A and Part B who are not in Medicare Advantage. For the last group, Trustees would separate spending into Part A versus Part B and would further disaggregate data when practicable.
Sponsors & CoSponsors
Sponsor
Tim Scott
SC • R
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
No roll call votes available for this bill.
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