Apples to Apples Comparison Act of 2025

The Apples to Apples Comparison Act of 2025 would significantly expand transparency around Medicare expenditures. It would require the Secretary of Health and Human Services to publish county- and Metropolitan Statistical Area (MSA)-level, monthly expenditures under Medicare (Parts A and B) in machine-readable files starting in 2025, with detailed breakdowns by a long list of beneficiary enrollment categories (including various combinations of Part A/B enrollment, Medicare Advantage, Part D, group health plans, and other coverages). A special rule for 2025 would also publish enrollment information for prior years (going back to 2015). The bill also adds a new MedPAC analysis comparing Medicare Advantage (MA) expenditures to traditional fee-for-service (FFS) expenditures, with publication requirements for methods, data, and public comment. Finally, it directs the Trustees to jointly report, starting in 2026, aggregate and average expenditures broken down by similar beneficiary categories in their annual expenditure reports. In short, the bill would require broad, ongoing, granular, public reporting of Medicare spending by geography and beneficiary type to enable “apples-to-apples” comparisons.