H.R. 4093: Apples to Apples Comparison Act of 2025

Introduced Jun 24, 202516 cosponsors

Sponsor

Aaron Bean

Aaron Bean

Republican · FL-4

Bill Progress

IntroducedJun 24
Committee 
Pass House 
Pass Senate 
Signed 
Law 

Latest Action · Jun 24, 2025

1/2

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

Bill Forces Public View of Local Medicare Spending Gaps

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?

1

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

2

10-Year Historical Data

Must include 10 years of historical data and up to 5 years of projected data across 35 distinct beneficiary categories

3

MedPAC Comparative Analysis

Requires comparative analysis of Medicare Advantage vs traditional fee-for-service starting 2026, accounting for demographics and risk scores

4

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

1 actions

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

Aaron Bean

Republican, Florida's 4th congressional district · 3 years in Congress

Committees: Ways and Means

View full profile →

Cosponsors (16)

No new cosponsors in 112 days — momentum stalled

All 16 cosponsors are Republicans. Cosponsors represent 11 states: Florida, Indiana, Minnesota, and 8 more.

16Republicans·11 states

Committee Sponsors

Energy and Commerce Committee

24D30R
|4 signed50 not yet

4 of 54 committee members cosponsored

41 Republicans across these committees haven't cosponsored yet. Mobilize their constituents

What laws does H.R. 4093 change?

1 changes

Full Text

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

Constituent Resources

Get notified when this bill moves
Write a letter to your legislator about this bill

Official Sources

H.R. 4093 on Congress.gov

Official bill page with full text, actions timeline, cosponsors, and status for the Apples to Apples Comparison Act of 2025.

CMS Medicare Geographic Variation Data (by County)

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.

CMS Medicare Fee-for-Service Data by County (2015–2024)

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 — What We Do

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.

Medicare Trustees Report & Trust Funds (CMS)

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.

Medicare Advantage Health Plans (CMS)

CMS overview of the Medicare Advantage program, the private-plan alternative to traditional Medicare that HR 4093 subjects to county-level spending comparison.

House Ways and Means Committee

Primary committee of referral for HR 4093, with jurisdiction over Medicare payment policy and the Hospital Insurance Trust Fund.

House Energy and Commerce Committee

Second committee of referral for HR 4093, with jurisdiction over public health programs and CMS oversight.

H.R. 4093 Bill Text

PDF

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

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