Congress orders Medicare to show its spending cards—by county, plan type, and patient.
S. 3848 — Apples to Apples Comparison Act of 2026 · Filed by Tim Scott (R-SC) · Introduced Feb 11, 2026 · Referred to committee
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What it does
This bill requires the federal government to publish detailed Medicare spending data broken down by county, demographic group, and insurance type starting in 2027. It mandates the Medicare Payment Advisory Commission (MedPAC) to analyze and publicly report how much Medicare Advantage plans cost compared to traditional Medicare, with full methodology transparency and public comment periods. Citizens and researchers gain access to granular spending information that was previously unavailable or scattered.
Why we flagged it
The bill's core mechanism is mandatory publication of Medicare expenditure data and comparative analysis. It is fundamentally a transparency and accountability measure, not a reimbursement change or coverage restriction.
What the text implies
- Detailed county-level and demographic breakdowns may expose regional disparities in Medicare spending, potentially triggering political pressure for reimbursement adjustments or policy changes that could affect provider networks and insurance plan design.
- Mandatory MedPAC analysis comparing Medicare Advantage to fee-for-service, with explicit instruction to exclude 'favorable selection' bias, may shift the narrative around MA plan value and could influence future payment policy or enrollment incentives.
- Machine-readable file requirements enable third-party analysis and data visualization tools, potentially creating new market opportunities for health data analytics firms and policy research organizations.
- The 10-year historical data requirement (back to 2015) plus 5-year projections creates a large, complex dataset that may be difficult for smaller researchers or patient advocates to analyze without technical support, concentrating interpretive power among well-resourced institutions.
- Public methodology disclosure and comment periods may slow publication timelines and create opportunities for stakeholder lobbying before final reports are released, potentially influencing how data is framed or presented.
Section numbers refer to the bill text the analysis read — linked under Primary records below.
Who it affects
The bill increases government transparency and public access to Medicare spending data, enabling citizens, researchers, and policymakers to understand program costs and compare insurance options. The mandatory publication of methodology and public comment requirements strengthen democratic accountability. No restrictions on citizen rights or remedies are imposed.
Who stands to gain
- health data analytics and business intelligence firms
- policy research organizations and think tanks
- academic medical centers and health services research institutions
Named in the bill
Centers for Medicare & Medicaid Services (CMS), Medicare Payment Advisory Commission (MedPAC), Federal Hospital Insurance Trust Fund, Federal Supplementary Medical Insurance Trust Fund, Medicare Advantage plans, Bristol Myers Squibb (BMY), Guardant Health (GH), Pfizer (PFE), DaVita (DVA), Johnson & Johnson (JNJ)
Where it stands
- Feb 11, 2026 — Introduced · Congress.gov: “Introduced in Senate”
- Feb 11, 2026 — Referred to Senate Committee on Finance · Congress.gov: “Read twice and referred to the Committee on Finance”
Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.
Money around this bill
2 lobbying clients named this bill on 3 disclosure filings across 2 quarters, Mar 2026 to Jun 2026. Those filings disclosed $4,240,000 in lobbying spend. A filing names 16 bills on average, so that figure is what each filing reported, not a share belonging to this bill.
More lobbying clients named this bill than 41% of bills with at least one filing.
Tim Scott, the sponsor, reported $214,300 in PAC receipts in the 2026 cycle. $3,500 of that came from 1 PAC tied to these lobbying clients.
- Elevance Health, Inc. — $4,010,000 on 2 filings
- Highmark Inc — $230,000 on 1 filing
Lobbying Disclosure Act filings through Jul 20, 2026. A filing shows who paid to lobby on a bill it names, not what changed.
How this was measured
Analysis — Quorum's AI read the bill text published by Congress.gov (9,946 characters) on Aug 15, 2026. Section numbers in the findings refer to that text, linked below; transparency and hidden-provision scores are compared against the median of 16,222 analysed bills.
Status and sponsors — Congress.gov's bill record — actions, committee referrals and cosponsors — loaded nightly. The timeline shows status changes, not every procedural action.
Money — Senate Lobbying Disclosure Act filings whose specific-issue field names this bill for quarters ending Mar 2026 to Jun 2026. A filing's amount is reported whole beside the median number of bills a filing names; it is never divided across them. PAC receipts are FEC-reported contributions to the sponsor's candidate committee in the 2026 cycle.
As of — lobbying records through Jul 20, 2026 · page rendered 2026-10-20.
“Congress orders Medicare to show its spending cards—by county, plan type, and patient.” QuorumCivic. https://share.quorumcivic.app/bill/119/s3848 Report an error
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