I 
119TH CONGRESS 
1ST SESSION H. R. 4093 
To amend title XVIII of the Social Security Act to require the Secretary 
of Health and Human Services to publish information on expenditures 
under the Medicare program, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 24, 2025 
Mr. BEAN of Florida (for himself and Mr. HERN of Oklahoma) introduced the 
following bill; which was referred to the Committee on Ways and Means, 
and in addition to the Committee on Energy and Commerce, for a period 
to be subsequently determined by the Speaker, in each case for consider-
ation of such provisions as fall within the jurisdiction of the committee 
concerned 
A BILL 
To amend title XVIII of the Social Security Act to require 
the Secretary of Health and Human Services to publish 
information on expenditures under the Medicare pro-
gram, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Apples to Apples Com-
parison Act of 2025’’. 
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SEC. 2. REQUIRING THE SECRETARY OF HEALTH AND 
HUMAN SERVICES TO PUBLISH INFORMA-
TION ON EXPENDITURES UNDER THE MEDI-
CARE PROGRAM. 
Section 1874 of the Social Security Act (42 U.S.C. 
1395kk) is amended— 
(1) in subsection (g)— 
(A) in paragraph (1)— 
(i) in the matter preceding subpara-
graph (A), by inserting ‘‘(and, beginning 
with 2025, publish on the public website of 
the Centers for Medicare & Medicaid Serv-
ices in machine-readable files information 
on)’’ after ‘‘a report on’’; 
(ii) in subparagraph (A), by inserting 
‘‘(and, beginning with 2025, by county and 
Metropolitan 
Statistical 
Area)’’ 
after 
‘‘State’’; and 
(iii) in subparagraph (B)— 
(I) in clause (ii), by striking 
‘‘and’’ at the end; 
(II) in clause (iii), by striking the 
period and inserting ‘‘; and’’; and 
(III) by adding at the end the 
following new clause: 
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‘‘(iv) beginning with 2025, each cat-
egory of individuals described in subsection 
(h)(1).’’; and 
(B) by adding at the end the following new 
paragraph: 
‘‘(3) SPECIAL
RULE
FOR
2025
REPORT
AND 
PUBLICATION OF INFORMATION.—As part of the re-
port and publication of information required under 
paragraph (1) for 2025, the Secretary shall include 
enrollment information submitted under this sub-
section for each preceding year (beginning with 
2015), broken down by county and Metropolitan 
Statistical Area and provided for each category of 
individuals described in subsection (h)(1).’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(h) INFORMATION ON EXPENDITURES.— 
‘‘(1) IN
GENERAL.—Not later than 30 days 
after the last day of each year (beginning with 
2025), the Secretary shall, for each county and each 
Metropolitan Statistical Area, publish on the public 
website of the Centers for Medicare & Medicaid 
Services in machine-readable files the total and aver-
age expenditures under this title for items and serv-
ices furnished to individuals entitled to benefits 
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‘‘(F) Individuals described in subpara-
graph (C) who are enrolled in a prescription 
drug plan under part D. 
‘‘(G) Individuals described in subpara-
graph (A) who are not enrolled in a prescription 
drug plan under part D. 
‘‘(H) Individuals described in subpara-
graph (B) who are not enrolled in a prescrip-
tion drug plan under part D. 
‘‘(I) Individuals described in subparagraph 
(C) who are not enrolled in a prescription drug 
plan under part D. 
‘‘(J) Individuals described in subparagraph 
(A) who are enrolled in a Federal health care 
program (as defined in section 1128B) or a 
health plan under chapter 89 of title 5, United 
States Code. 
‘‘(K) Individuals described in subpara-
graph (B) who are enrolled in such a program 
or plan. 
‘‘(L) Individuals described in subparagraph 
(C) who are enrolled in such a program or plan. 
‘‘(M) Individuals described in subpara-
graph (A) who are not enrolled in such a pro-
gram or plan. 
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‘‘(N) Individuals described in subpara-
graph (B) who are not enrolled in such a pro-
gram or plan. 
‘‘(O) Individuals described in subpara-
graph (C) who are not enrolled in such a pro-
gram or plan. 
‘‘(P) Individuals described in subparagraph 
(A) who are enrolled in a group health plan (as 
defined in section 2791 of the Public Health 
Service Act) or a medicare supplemental policy 
under section 1882. 
‘‘(Q) Individuals described in subpara-
graph (B) who are enrolled in such a plan or 
policy. 
‘‘(R) Individuals described in subpara-
graph (C) who are enrolled in such a plan or 
policy. 
‘‘(S) Individuals described in subparagraph 
(A) who are not enrolled in such a plan or pol-
icy. 
‘‘(T) Individuals described in subparagraph 
(B) who are not enrolled in such a plan or pol-
icy. 
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‘‘(U) Individuals described in subpara-
graph (C) who are not enrolled in such a plan 
or policy. 
‘‘(V) Individuals enrolled in a specialized 
MA plan for special needs individuals, broken 
down by each type of plan. 
‘‘(W) Individuals enrolled in an MA plan 
other than a plan described in subparagraph 
(V). 
‘‘(X) Individuals enrolled in an MA plan. 
‘‘(Y) Individuals described in subparagraph 
(X) who are enrolled in a Federal health care 
program (as defined in section 1128B) or a 
health plan under chapter 89 of title 5, United 
States Code. 
‘‘(Z) Individuals described in subparagraph 
(X) who are not enrolled in such a program or 
plan. 
‘‘(AA) Individuals described in subpara-
graph (X) who are enrolled in a group health 
plan (as defined in section 2791 of the Public 
Health Service Act) or a medicare supplemental 
policy under section 1882. 
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‘‘(BB) Individuals described in subpara-
graph (X) who are not enrolled in such a plan 
or policy. 
‘‘(CC) Individuals described in subpara-
graph (X) who are enrolled in a prescription 
drug plan under part D. 
‘‘(DD) Individuals described in subpara-
graph (X) who are not enrolled in such a plan. 
‘‘(EE) Individuals described in subpara-
graph (X) who are enrolled in an MA–PD plan. 
‘‘(FF) Individuals described in subpara-
graph (X) who are not enrolled in such a plan. 
‘‘(GG) Individuals described in subpara-
graph (CC) or (EE) who are enrolled in a Fed-
eral health care program (as defined in section 
1128B) or a health plan under chapter 89 of 
title 5, United States Code. 
‘‘(HH) Individuals described in subpara-
graph (CC) or (EE) who are not enrolled in 
such a program or plan. 
‘‘(II) Individuals enrolled in an employer 
group waiver plan. 
‘‘(2) DEFINITIONS.—For purposes of this sub-
section: 
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‘‘(A) SPECIFIED
HISTORICAL
PERIOD.— 
The term ‘specified historical period’ means, 
with respect to a year, the 10-year period end-
ing on the last day of such year. 
‘‘(B) SPECIFIED
PROJECTED
PERIOD.— 
The term ‘specified projected period’ means, 
with respect to a year, the period beginning on 
the first day of the subsequent year of a dura-
tion specified by the Secretary (but in no case 
to exceed a duration of 5 years).’’. 
SEC. 3. MEDPAC ANALYSIS OF MEDICARE ADVANTAGE AND 
FEE-FOR-SERVICE EXPENDITURES. 
Section 1805(b) of the Social Security Act (42 U.S.C. 
1395b–6(b)) is amended by adding at the end the fol-
lowing new paragraph: 
‘‘(12) ANALYSIS
OF
MEDICARE
ADVANTAGE 
AND FEE-FOR-SERVICE EXPENDITURES.— 
‘‘(A) 
IN
GENERAL.—The 
Commission 
shall, as part of the report described in para-
graph (1)(C) submitted for each year (begin-
ning with 2026), include a retrospective anal-
ysis of average expenditures under this title for 
individuals enrolled in a Medicare Advantage 
plan under part C compared to average expend-
itures under this title for individuals entitled to 
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benefits under part A and enrolled under part 
B who are eligible to enroll under such a plan 
but who are not so enrolled. 
‘‘(B) 
CONSIDERATIONS.—In 
preparing 
each analysis described in subparagraph (A), 
the Commission shall— 
‘‘(i) use data provided by the Chief 
Actuary of the Centers for Medicare & 
Medicaid Services and the Boards of 
Trustees of the Federal Hospital Insurance 
Trust Fund established under section 1817 
and the Federal Supplementary Medical 
Insurance Trust fund established under 
section 1841 and such other data as the 
Commission determines appropriate; 
‘‘(ii) take into account— 
‘‘(I) differences in value provided 
under Medicare Advantage plans com-
pared to the value provided under 
parts A and B, such as the existence 
of out-of-pocket expenditure caps, 
supplemental benefits available under 
such plans, and the integration of 
benefits for covered part D drugs 
under certain such plans; and 
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‘‘(II) demographic differences of 
individuals enrolled in Medicare Ad-
vantage plans compared to individuals 
entitled to benefits under part A and 
enrolled under part B who are not en-
rolled in such a plan; and 
‘‘(iii) take into account differences in 
HCC risk scores but not take into account 
any favorable selection differences with re-
spect to enrollment in such plans. 
‘‘(C) PUBLICATION REQUIREMENTS.—With 
respect to each analysis described in subpara-
graph (A), the Commission shall— 
‘‘(i) make public all data used in pre-
paring such analysis in a manner that— 
‘‘(I) allows replication of such 
analysis; and 
‘‘(II) protects the confidentiality 
of personal information of individuals 
entitled to benefits under part A and 
enrolled under part B; 
‘‘(ii) not later than 60 days prior to 
the submission of such analysis, make pub-
lic the methodology used to conduct such 
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analysis and allow at least 30 days for 
public comment on such methodology; and 
‘‘(iii) make public a response to each 
such comment received on the methodology 
prior to or concurrent with the submission 
of such analysis.’’. 
SEC. 4. TRUSTEES REPORT OF EXPENDITURE INFORMA-
TION. 
Section 1874 of the Social Security Act (42 U.S.C. 
1395kk), as amended by section 2, is further amended by 
adding at the end the following new subsection: 
‘‘(i) TRUSTEES’ REPORT OF EXPENDITURE INFOR-
MATION.— 
‘‘(1) IN GENERAL.—The Boards of Trustees of 
the Federal Hospital Insurance Trust Fund estab-
lished under section 1817 and the Federal Supple-
mentary Medical Insurance Trust Fund established 
under section 1841 shall jointly, as part of the re-
ports 
described 
in 
sections 
1817(b)(2) 
and 
1841(b)(2) submitted for a year (beginning with 
2026), include information on aggregate and average 
expenditures under this title for the following cat-
egories of individuals, broken down, in the case of 
the category described in subparagraph (C), by ex-
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penditures under part A and expenditures under 
part B: 
‘‘(A) Individuals entitled to benefits under 
part A and not enrolled under part B. 
‘‘(B) Individuals enrolled under part B and 
not entitled to benefits under part A. 
‘‘(C) Individuals entitled to benefits under 
part A, enrolled under part B, and not enrolled 
in a Medicare Advantage plan under part C. 
‘‘(2) PROVISION OF DISAGGREGATED INFORMA-
TION.—The Boards of Trustees described in para-
graph (1) shall, as part of all expenditure data (in-
cluding data tables) made public by such Boards, 
disaggregate such data, to the extent practicable, 
based on the categories of individuals described in 
paragraph (1).’’. 
Æ 
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