Apples to Apples Comparison Act of 2025

The "Apples to Apples Comparison Act of 2025" aims to enhance transparency and comparability of Medicare expenditure data. It mandates the Secretary of Health and Human Services to publish comprehensive Medicare expenditure information on the Centers for Medicare & Medicaid Services (CMS) public website, starting in 2025. This data must be provided in machine-readable files, broken down by geographic area (county and Metropolitan Statistical Area) and categorized by various beneficiary enrollment types, including those with different Medicare parts, prescription drug plans, or other health coverage. The publication will include both historical (10 years) and projected (up to 5 years) expenditure data. Additionally, the bill requires the Medicare Payment Advisory Commission (MEDPAC) to conduct a detailed retrospective analysis, beginning in 2026, comparing average expenditures for individuals enrolled in Medicare Advantage plans versus those in traditional Fee-for-Service Medicare . This analysis must consider differences in value, such as supplemental benefits and out-of-pocket caps, and demographic variations, while accounting for HCC risk scores. To ensure transparency, MEDPAC must make all data public, allow for replication, publish its methodology for public comment, and respond to feedback. Finally, the legislation directs the Boards of Trustees of the Federal Hospital Insurance Trust Fund and Federal Supplementary Medical Insurance Trust Fund to include disaggregated expenditure information in their annual reports, starting in 2026. This information will detail aggregate and average expenditures for specific categories of beneficiaries, such as those with Part A only, Part B only, or Part A and B without Medicare Advantage enrollment, providing a clearer understanding of Medicare costs across different program structures.