Apples to Apples Comparison Act of 2026

This bill amends the Social Security Act to require the Secretary of Health and Human Services to publish detailed Medicare expenditure information, and requires the Medicare Payment Advisory Commission (MedPAC) and the Boards of Trustees to conduct related analyses and reports. Sec. 2, Publication of Medicare expenditure information: The Secretary must, starting in 2027, publish on the CMS website machine-readable files showing total and average monthly Medicare expenditures per county and Metropolitan Statistical Area for various categories of individuals (e.g., those with Part A only, Part B only, both, with or without Part D, Medicare Advantage, employer group waiver plans, etc.), including historical data back to 2015 and projected data for up to 5 years. Sec. 3, MedPAC analysis of Medicare Advantage vs. fee-for-service expenditures: Starting in 2027, MedPAC must include in its annual report a retrospective analysis comparing average expenditures for Medicare Advantage enrollees versus those eligible but not enrolled in such plans, considering differences in value, demographics, and risk scores (but not favorable selection), and must publish data and methodology for public comment. Sec. 4, Trustees' report of expenditure information: Starting in 2027, the Boards of Trustees of the Medicare trust funds must include in their annual reports aggregate and average expenditures for individuals with Part A only, Part B only, and both (excluding Medicare Advantage), and must disaggregate public expenditure data by these categories.