Sponsor
Nathaniel Moran
Representative · R-TX
Representative · R-TX
The bill increases transparency and consumer comparability of Medicare Advantage plans to improve accountability and taxpayer oversight, but creates compliance and IT burdens (and potential competitive risks) that could raise costs and delays benefits until 2029.
Medicare Advantage enrollees (millions of beneficiaries) will get plan-level financial breakdowns (revenue, claims spending, non-claims costs) and, in a uniform electronic format, clearer benefit information to compare plans starting in 2029.
Consumers can more easily compare MA plans because benefit and financial information must follow a uniform, consumer-friendly electronic format, improving informed choice and plan selection.
Public reporting of plan-level (and potentially aggregate) financials increases accountability of Medicare Advantage organizations and gives policymakers and taxpayers better data to assess value and oversight of Medicare payments.
Medicare Advantage organizations will incur new compliance, reporting, and IT costs to collect, format, and publish detailed plan-level financials, and those costs could be passed on to beneficiaries or taxpayers through higher premiums or reduced benefits.
Smaller MA organizations, hospitals, health systems, and CMS may face substantial IT and interoperability burdens to implement the required uniform electronic reporting format, straining resources and implementation capacity.
Detailed public financial disclosures could reveal competitively sensitive information about insurers, potentially reducing competition, prompting legal challenges, or harming smaller market participants.
Based on analysis of 2 sections of legislative text.
Requires MA organizations to publish plan-level MLR and revenue/expense data and adopt a uniform electronic format for benefit information.
Official title: To amend title XVIII of the Social Security Act to promote transparency of Medicare Advantage plan information.
Introduced July 13, 2026 by Nathaniel Moran · Last progress July 13, 2026
Requires Medicare Advantage (MA) organizations to publish standardized, plan-level medical loss ratio (MLR) and revenue/expense data in a consumer-friendly format and to provide MA benefit information electronically using a uniform format similar to group health plan rules. The MLR and revenue disclosures take effect for plan years beginning on or after January 1, 2029; the electronic uniform formatting requirement applies to benefit information made available at least one year after enactment.