S. 3848: Apples to Apples Comparison Act of 2026

The Apples to Apples Comparison Act of 2026 aims to enhance the transparency of Medicare expenditure data by requiring more detailed reporting by the Secretary of Health and Human Services (HHS). Here are the key components of the bill:

Publication of Medicare Expenditure Information

The bill mandates that starting in 2027, the HHS Secretary must publish information regarding Medicare expenditures. This will include:

• Monthly total and average expenditures under Medicare Programs (Parts A and B) for individuals living in each county and Metropolitan Statistical Area.
• Historical data starting from 2015, along with forecasts for future expenditures.
• Expenditures categorized by various groups, such as those eligible for Medicare but not enrolled, those enrolled in Medicare Advantage plans, and those who have prescription drug coverage.

Analysis of Expenditures

The Medicare Payment Advisory Commission (MedPAC) is required to conduct analyses comparing expenditures for individuals enrolled in Medicare Advantage plans to those eligible for but not enrolled in such plans. These analyses will take into account:

• Differences in benefits and coverage between Medicare Advantage plans and traditional Medicare.
• Demographic differences between populations enrolled in Medicare Advantage plans and those who are not.
• Healthcare risk scores that indicate the expected healthcare costs of individuals.

MedPAC must also publish all relevant data used in these analyses while preserving individual privacy and allowing for public comments on the methodology used.

Trustees Report of Expenditure Information

The bills require that the Boards of Trustees for the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund include detailed reports on Medicare expenditures in their annual reports. Specifically, they must:

• Disclose aggregate and average expenditures segmented by the type of Medicare coverage individuals have.
• Provide disaggregated data based on specific categories of individuals, such as those entitled to Part A and not enrolled in Part B.

Implementation Timeline

All these reporting and analytical requirements are set to begin in 2027, which gives time for the necessary systems to be put in place to collect and publish the data as outlined.

Overall Objective

The primary goal of the Apples to Apples Comparison Act of 2026 is to provide clearer, more accessible information on Medicare spending so that beneficiaries and policymakers can make more informed decisions regarding Medicare options and expenditures.

Relevant Companies

• UNH - UnitedHealth Group: As a major provider of Medicare Advantage plans, UnitedHealth could face increased scrutiny over its expenditure practices and benefit offerings due to the mandated comparative analyses.
• ANTM - Anthem Inc.: Similar to UnitedHealth, Anthem’s Medicare Advantage plan offerings could come under review, with implications for its pricing and marketing strategies.
• CNC - Centene Corporation: Centene is another key player in the Medicare Advantage space that may need to adjust its strategies based on new transparency requirements.