H.R. 4093: Apples to Apples Comparison Act of 2025
Sponsor
Aaron Bean
Republican · FL-4
Bill Progress
Latest Action · Jun 24, 2025
Referred to 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 consideration of such provisions as fall within the jurisdiction of the committee concerned. for review
Why it matters
Revealing detailed, county-level Medicare costs—and comparing Medicare Advantage to traditional plans—could reshape payment policy, expose regional inequities and influence where billions in federal health dollars flow.
Requires the Secretary of Health and Human Services to publish detailed Medicare expenditure data in machine-readable format on the CMS website, broken down by county and Metropolitan Statistical Area. Mandates comparative analysis of Medicare Advantage versus traditional fee-for-service expenditures.
What does H.R. 4093 do?
Medicare Expenditure Data Publication
Requires publishing total and average Medicare expenditures within 30 days after each year-end, organized by county and Metropolitan Statistical Area
10-Year Historical Data
Must include 10 years of historical data and up to 5 years of projected data across 35 distinct beneficiary categories
MedPAC Comparative Analysis
Requires comparative analysis of Medicare Advantage vs traditional fee-for-service starting 2026, accounting for demographics and risk scores
Public Methodology Disclosure
Mandates public methodology disclosure with 30-day comment period for transparency
Who benefits from H.R. 4093?
Medicare Beneficiaries
Better access to cost comparison data to make informed healthcare decisions
Healthcare Researchers
Machine-readable data enables comprehensive Medicare spending analysis
Policymakers
Data-driven insights for Medicare reform and budget decisions
Taxpayers
Greater transparency in how Medicare funds are spent
Who is affected by H.R. 4093?
Centers for Medicare & Medicaid Services
New data publication and reporting requirements
Medicare Advantage Plans
Subject to comparative analysis against traditional Medicare
Hospital Insurance Trust Fund
Must include disaggregated expenditure data in trustees' reports
H.R. 4093 Common Questions
How soon would CMS have to post Medicare spending data each year under HR 4093?
CMS would have to publish the Medicare expenditure data no later than 30 days after the last day of each year, beginning with 2025, according to HR4093 Section 2.
What are the Medicare spending categories required to be published under the Apples to Apples Comparison Act?
The bill requires expenditure reporting across 59 specific beneficiary categories, including Medicare Advantage, Part D, employer group waiver plans, other federal health program enrollees, and people with or without supplemental coverage under the Apples to Apples Comparison Act (Section 2).
How many years of Medicare history and projections would HR 4093 require CMS to publish?
Under HR4093 Section 2, CMS would publish 10 years of historical Medicare data and may include projected data for up to 5 years.
Can I see Medicare spending by county and metro area under the Apples to Apples Comparison Act?
Yes. Under the Apples to Apples Comparison Act (Section 2), HHS must publish Medicare expenditure data on the CMS website broken down by county and Metropolitan Statistical Area.
Does HR 4093 require Medicare data to be downloadable in machine-readable files?
Yes. According to HR4093 Section 2, the Medicare expenditure information must be posted on the CMS website in machine-readable files.
Can Medicare Advantage spending be compared with traditional Medicare under HR 4093?
Yes. Beginning with the 2026 report, MedPAC must compare average spending for Medicare Advantage enrollees with traditional Medicare beneficiaries under HR4093 Section 3.
What factors must MedPAC include when comparing Medicare Advantage and fee-for-service spending?
Under HR4093 Section 3, MedPAC must account for out-of-pocket caps, supplemental benefits, Part D integration, demographic differences, and HCC risk scores.
Does the Apples to Apples Comparison Act ban adjusting for favorable selection in Medicare Advantage analysis?
Yes. Under the Apples to Apples Comparison Act (Section 3), MedPAC may not account for favorable selection differences when comparing Medicare Advantage with traditional Medicare.
Can the public comment on MedPAC's Medicare Advantage methodology under HR 4093?
Yes. According to HR4093 Section 3, MedPAC must publish its methodology at least 60 days before the analysis and allow at least 30 days for public comment.
Which Medicare groups must the Trustees reports break out starting in 2026 under HR 4093?
Under HR4093 Section 4, Trustees reports must separately show spending for people with Part A only, Part B only, and people with Parts A and B who are not in Medicare Advantage; the last group must be split by Part A and Part B.
Based on H.R. 4093 bill text
HR4093 Legislative Journey
House: Committee Action
Jun 24, 2025
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 consideration of such provisions as fall within the jurisdiction of the committee concerned.
About the Sponsor
Aaron Bean
Republican, Florida's 4th congressional district · 3 years in Congress
Committees: Ways and Means
View full profile →
Cosponsors (16)
All 16 cosponsors are Republicans. Cosponsors represent 11 states: Florida, Indiana, Minnesota, and 8 more.
Kevin Hern
Republican · OK
Rudy Yakym
Republican · IN
Carol Miller
Republican · WV
Beth Van Duyne
Republican · TX
Claudia Tenney
Republican · NY
W. Steube
Republican · FL
Michelle Fischbach
Republican · MN
Mike Carey
Republican · OH
Jefferson Shreve
Republican · IN
Kat Cammack
Republican · FL
Nicholas Langworthy
Republican · NY
Blake Moore
Republican · UT
Committee Sponsors
Energy and Commerce Committee
4 of 54 committee members cosponsored
Ways and Means Committee
11 of 45 committee members cosponsored
41 Republicans across these committees haven't cosponsored yet. Mobilize their constituents
What laws does H.R. 4093 change?
1 changes
Sections Amended
Section 1805(b) of Social Security Act (42 U.S.C. 1395b-6(b))
adding at the end the following new paragraph: ``(12) Analysis of medicare advantage and fee-for-service expenditures
H.R. 4093 Quick Facts
- Committee
- Energy and Commerce
- Chamber
- House
- Policy
- Health
- Introduced
- Jun 24, 2025
Referred to 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 consideration of such provisions as fall within the jurisdiction of the committee concerned. for review
Jun 24, 2025
Constituent Resources
Official Sources
Official bill page with full text, actions timeline, cosponsors, and status for the Apples to Apples Comparison Act of 2025.
Existing CMS dataset providing Medicare spending variation by county and state — the type of data HR 4093 would mandate be published annually in machine-readable format.
County-level FFS reimbursement and enrollment data for Medicare Parts A and B, the baseline comparison dataset for Medicare Advantage versus traditional Medicare analysis.
MedPAC is the independent congressional agency that HR 4093 Section 3 tasks with producing the annual comparative analysis of Medicare Advantage vs. fee-for-service spending.
Annual Trustees reports on the Hospital Insurance Trust Fund. HR 4093 Section 4 requires these reports to disaggregate expenditures by Part A only, Part B only, and Parts A+B beneficiaries not in Medicare Advantage.
CMS overview of the Medicare Advantage program, the private-plan alternative to traditional Medicare that HR 4093 subjects to county-level spending comparison.
Primary committee of referral for HR 4093, with jurisdiction over Medicare payment policy and the Hospital Insurance Trust Fund.
Second committee of referral for HR 4093, with jurisdiction over public health programs and CMS oversight.
H.R. 4093 Bill Text
“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.”
Source: U.S. Government Publishing Office
Get notified when H.R. 4093 moves
Committee votes, floor action, cosponsor changes — straight to your inbox.
Bill alerts + Legisletter's monthly briefing. Unsubscribe anytime.
Health Bills
9 related bills we're tracking
Give Kids a Chance Act of 2025
Motion to reconsider laid on the table Agreed to without objection.
Dec 1, 2025
Improving Seniors’ Timely Access to Care Act of 2025
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 consideration of such provisions as fall within the jurisdiction of the committee concerned.
May 20, 2025
CONNECT for Health Act of 2025
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Jun 26, 2025
Right to Contraception Act
Referred to the House Committee on Energy and Commerce.
Feb 5, 2025
Medicare Patient Access and Practice Stabilization Act of 2025
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Jan 31, 2025
Chiropractic Medicare Coverage Modernization Act of 2025
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Jan 16, 2025
988 LGBTQ+ Youth Access Act of 2025
Referred to the House Committee on Energy and Commerce.
Sep 17, 2025
Ensuring Lasting Smiles Act
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and Workforce, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
May 8, 2025
Pride In Mental Health Act of 2025
Referred to the House Committee on Energy and Commerce.
Jun 5, 2025
Trending Right Now
Bills gaining momentum across Congress
Federal Extreme Risk Protection Order Act of 2026
Referred to the House Committee on the Judiciary.
Feb 17, 2026
ALERT Act
Referred to the Committee on Transportation and Infrastructure, and in addition to the Committee on Armed Services, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Feb 20, 2026
Fair Housing for Survivors Act of 2026
Referred to the House Committee on the Judiciary.
Mar 5, 2026
Tracking Health in Congress? Monitor bills, track cosponsor momentum, and launch advocacy campaigns — all from one advocacy platform.