$1,130.5M Total burden on individuals 1st in the U.S.
$645.2M Excess TM premiums 1st in the U.S.
$176.8M State fiscal burden 1st in the U.S.
$164.4M Federal fiscal burden 1st in the U.S.
$341.2M Total public sector fiscal
burden 1st
in the U.S.
About this data update
This monthly update reports the Joint Economic Committee’s latest
estimates of excess Part B premiums attributable to Medicare Advantage
(MA) overpayments for California and its congressional
districts.
By law, Medicare Part B premiums are set to finance 25 percent of
projected Part B spending, with some paying additional premiums based on
income. This financing design means that 25 percent of any increase in
Part B spending is automatically passed through to enrollees as higher
Part B premiums. These premiums apply equally to beneficiaries
regardless of whether they enroll in Traditional Medicare or MA. Because
payments to MA plans are financed through Part B, it costs more to cover
enrollees in MA than to cover those in Traditional Medicare, which
increases total Part B spending and mechanically raises Part B premiums
for beneficiaries nationwide, including in Traditional Medicare.
While the premium increase applies uniformly, the resulting dollar
burden varies across states, congressional districts, and individuals
based on beneficiary income (income-related premiums, or IRMAA), the
share of beneficiaries with publicly subsidized premiums, and local
Medicare enrollment levels.
The Joint Economic Committee’s forthcoming issue brief documents this
mechanism in detail and estimates that MA overpayments increased Part B
premiums by over $13 billion nationally in 2025. This data update
quantifies that burden for seniors in California both
for individuals through greater Social Security deductions and for the
public collectively through higher state Medicaid expenditures, which
are financed by state tax revenues.
Distribution of the excess Part B premium burden as
of November 2025
This section decomposes the total excess Part B premium amount as of
November 2025 into mutually exclusive components based on who ultimately
bears its burden. We begin with the gross excess premium increase,
before offsets and irrespective of who pays. We then separate the
premium liability borne directly by beneficiaries from premiums financed
through Medicaid and other public subsidy mechanisms.
$1,471,688,164 Excess Part B premiums in
California Gross
premium increase, before offsets, irrespective of who
pays
$1,130,456,541 Total burden on individuals Premium
increases faced by beneficiaries, typically deducted from Social
Security checks
$341,231,622 Total public sector fiscal
burden Premiums
financed through Medicaid and other public subsidy mechanisms, creating
fiscal pressure on state and federal budgets
$176,799,412 State
fiscal burden
$164,432,210 Federal
fiscal burden
Consequences of Medicare Advantage overpayments for
Traditional Medicare beneficiaries
The effect of Medicare Advantage (MA) overpayments on Part B premiums
is uniform whether a beneficiary enrolls in Traditional Medicare or MA.
However, MA overpayments help finance more generous MA benefits that are
not available in Traditional Medicare. This includes Part B premium
“givebacks,” under which an MA plan pays some or all of the Part B
premium on behalf of its enrollees.
As a result, redistribution flows from Traditional Medicare to MA. In
California, there are 7.8 Traditional Medicare
beneficiaries bearing this higher premium burden for every 10 MA
beneficiaries who ultimately receive the greater benefits. This means
that 0.8 Traditional Medicare beneficiaries pay $175 in excess for each
MA beneficiary in California.
$645,158,380 Excess TM premiums Excess Part
B premiums faced by Traditional Medicare enrollees despite not receiving
Medicare Advantage benefits
$175 Amount paid in excess by TM
beneficiaries for every MA beneficiary Excess Part
B premiums faced by Traditional Medicare enrollees for each MA
beneficiary
7.8 Number
of TM beneficiaries for every 10 MA beneficiaries
Distribution across congressional districts in
California
Medicare enrollment, Medicare Advantage penetration, and income
distributions vary across states and congressional districts, leading to
substantial variation in the excess Part B premium burden.
Summary of methodology
To quantify the excess premium burden borne by constituents in each
congressional district, we crosswalk local enrollment patterns from
monthly CMS enrollment files at the county level to congressional
districts using Census population weights. Our results reflect
gross premium liability; for some MA enrollees, the net
out-of-pocket effect may be lower when Part B premiums are fully or
partially covered by the plan as a supplemental benefit.
In 2022, the U.S. Census Bureau adopted Connecticut’s nine new
planning regions, which replaced its eight counties. As a result, the
JEC was unable to include Connecticut in the district-level analysis.
Therefore, the total number of districts included is
431, including DC’s at-large district and excluding
Connecticut’s five districts.
Full methodology, assumptions, and national estimates are provided in
the forthcoming JEC issue brief.
Congressional District 1
Rep. Doug LaMalfa (R)
$33,540,520
Total excess Part B premium burden 118th out of 431 districts,
where 1st is highest
$25.1M
Total burden on individuals
$27.0M
Excess premiums for TM beneficiaries
41.2
TM beneficiaries for every 10 MA beneficiaries
Congressional District 2
Rep. Jared Huffman (D)
$43,529,130
Total excess Part B premium burden 18th out of 431 districts,
where 1st is highest
$35.3M
Total burden on individuals
$32.2M
Excess premiums for TM beneficiaries
28.3
TM beneficiaries for every 10 MA beneficiaries
Congressional District 3
Rep. Kevin Kiley (R)
$40,215,921
Total excess Part B premium burden 27th out of 431 districts,
where 1st is highest
$35.1M
Total burden on individuals
$28.7M
Excess premiums for TM beneficiaries
25.0
TM beneficiaries for every 10 MA beneficiaries
Congressional District 4
Rep. Mike Thompson (D)
$36,831,966
Total excess Part B premium burden 57th out of 431 districts,
where 1st is highest
$30.3M
Total burden on individuals
$19.0M
Excess premiums for TM beneficiaries
10.6
TM beneficiaries for every 10 MA beneficiaries
Congressional District 5
Rep. Tom McClintock (R)
$37,773,146
Total excess Part B premium burden 46th out of 431 districts,
where 1st is highest
$32.2M
Total burden on individuals
$24.1M
Excess premiums for TM beneficiaries
17.7
TM beneficiaries for every 10 MA beneficiaries
Congressional District 6
Rep. Ami Bera (D)
$26,855,076
Total excess Part B premium burden 313th out of 431 districts,
where 1st is highest
$20.5M
Total burden on individuals
$8.4M
Excess premiums for TM beneficiaries
4.6
TM beneficiaries for every 10 MA beneficiaries
Congressional District 7
Rep. Doris O. Matsui (D)
$26,452,258
Total excess Part B premium burden 326th out of 431 districts,
where 1st is highest
$20.7M
Total burden on individuals
$9.2M
Excess premiums for TM beneficiaries
5.4
TM beneficiaries for every 10 MA beneficiaries
Congressional District 8
Rep. John Garamendi (D)
$28,423,524
Total excess Part B premium burden 282nd out of 431 districts,
where 1st is highest
$23.9M
Total burden on individuals
$10.6M
Excess premiums for TM beneficiaries
5.9
TM beneficiaries for every 10 MA beneficiaries
Congressional District 9
Rep. Josh Harder (D)
$24,485,703
Total excess Part B premium burden 365th out of 431 districts,
where 1st is highest
$18.5M
Total burden on individuals
$9.4M
Excess premiums for TM beneficiaries
6.3
TM beneficiaries for every 10 MA beneficiaries
Congressional District 10
Rep. Mark DeSaulnier (D)
$32,412,755
Total excess Part B premium burden 150th out of 431 districts,
where 1st is highest
$27.8M
Total burden on individuals
$12.8M
Excess premiums for TM beneficiaries
6.5
TM beneficiaries for every 10 MA beneficiaries
Congressional District 11
Rep. Nancy Pelosi (D)
$29,314,163
Total excess Part B premium burden 251st out of 431 districts,
where 1st is highest
$20.4M
Total burden on individuals
$12.2M
Excess premiums for TM beneficiaries
7.2
TM beneficiaries for every 10 MA beneficiaries
Congressional District 12
Rep. Lateefah Simon (D)
$28,688,217
Total excess Part B premium burden 272nd out of 431 districts,
where 1st is highest
$22.6M
Total burden on individuals
$11.4M
Excess premiums for TM beneficiaries
6.6
TM beneficiaries for every 10 MA beneficiaries
Congressional District 13
Rep. Adam Gray (D)
$20,326,017
Total excess Part B premium burden 414th out of 431 districts,
where 1st is highest
$14.6M
Total burden on individuals
$10.5M
Excess premiums for TM beneficiaries
10.6
TM beneficiaries for every 10 MA beneficiaries
Congressional District 14
Rep. Eric Swalwell (D)
$26,224,110
Total excess Part B premium burden 331st out of 431 districts,
where 1st is highest
$20.7M
Total burden on individuals
$10.4M
Excess premiums for TM beneficiaries
6.6
TM beneficiaries for every 10 MA beneficiaries
Congressional District 15
Rep. Kevin Mullin (D)
$31,720,664
Total excess Part B premium burden 168th out of 431 districts,
where 1st is highest
$27.2M
Total burden on individuals
$12.9M
Excess premiums for TM beneficiaries
6.9
TM beneficiaries for every 10 MA beneficiaries
Congressional District 16
Rep. Sam T. Liccardo (D)
$31,942,216
Total excess Part B premium burden 163rd out of 431 districts,
where 1st is highest
$26.9M
Total burden on individuals
$13.0M
Excess premiums for TM beneficiaries
6.9
TM beneficiaries for every 10 MA beneficiaries
Congressional District 17
Rep. Ro Khanna (D)
$23,554,558
Total excess Part B premium burden 379th out of 431 districts,
where 1st is highest
$18.9M
Total burden on individuals
$9.6M
Excess premiums for TM beneficiaries
6.9
TM beneficiaries for every 10 MA beneficiaries
Congressional District 18
Rep. Zoe Lofgren (D)
$21,295,258
Total excess Part B premium burden 401st out of 431 districts,
where 1st is highest
$17.6M
Total burden on individuals
$15.0M
Excess premiums for TM beneficiaries
24.0
TM beneficiaries for every 10 MA beneficiaries
Congressional District 19
Rep. Jimmy Panetta (D)
$39,713,712
Total excess Part B premium burden 29th out of 431 districts,
where 1st is highest
$34.1M
Total burden on individuals
$27.0M
Excess premiums for TM beneficiaries
21.2
TM beneficiaries for every 10 MA beneficiaries
Congressional District 20
Rep. Vince Fong (R)
$27,302,768
Total excess Part B premium burden 304th out of 431 districts,
where 1st is highest
$18.7M
Total burden on individuals
$14.0M
Excess premiums for TM beneficiaries
10.6
TM beneficiaries for every 10 MA beneficiaries
Congressional District 21
Rep. Jim Costa (D)
$19,924,994
Total excess Part B premium burden 418th out of 431 districts,
where 1st is highest
$13.5M
Total burden on individuals
$9.8M
Excess premiums for TM beneficiaries
9.8
TM beneficiaries for every 10 MA beneficiaries
Congressional District 22
Rep. David G. Valadao (R)
$17,751,442
Total excess Part B premium burden 428th out of 431 districts,
where 1st is highest
$11.8M
Total burden on individuals
$9.4M
Excess premiums for TM beneficiaries
11.3
TM beneficiaries for every 10 MA beneficiaries
Congressional District 23
Rep. Jay Obernolte (R)
$26,344,651
Total excess Part B premium burden 329th out of 431 districts,
where 1st is highest
$19.2M
Total burden on individuals
$7.1M
Excess premiums for TM beneficiaries
3.7
TM beneficiaries for every 10 MA beneficiaries
Congressional District 24
Rep. Salud O. Carbajal (D)
$35,031,622
Total excess Part B premium burden 87th out of 431 districts,
where 1st is highest
$30.4M
Total burden on individuals
$24.5M
Excess premiums for TM beneficiaries
23.2
TM beneficiaries for every 10 MA beneficiaries
Congressional District 25
Rep. Raul Ruiz (D)
$28,943,961
Total excess Part B premium burden 263rd out of 431 districts,
where 1st is highest
$16.7M
Total burden on individuals
$14.5M
Excess premiums for TM beneficiaries
10.1
TM beneficiaries for every 10 MA beneficiaries
Congressional District 26
Rep. Julia Brownley (D)
$31,653,225
Total excess Part B premium burden 169th out of 431 districts,
where 1st is highest
$27.2M
Total burden on individuals
$16.2M
Excess premiums for TM beneficiaries
10.4
TM beneficiaries for every 10 MA beneficiaries
Congressional District 27
Rep. George Whitesides (D)
$24,944,481
Total excess Part B premium burden 353rd out of 431 districts,
where 1st is highest
$17.7M
Total burden on individuals
$8.9M
Excess premiums for TM beneficiaries
5.5
TM beneficiaries for every 10 MA beneficiaries
Congressional District 28
Rep. Judy Chu (D)
$33,895,636
Total excess Part B premium burden 113th out of 431 districts,
where 1st is highest
$25.0M
Total burden on individuals
$11.0M
Excess premiums for TM beneficiaries
4.8
TM beneficiaries for every 10 MA beneficiaries
Congressional District 29
Rep. Luz M. Rivas (D)
$20,434,924
Total excess Part B premium burden 412th out of 431 districts,
where 1st is highest
$14.2M
Total burden on individuals
$7.3M
Excess premiums for TM beneficiaries
5.5
TM beneficiaries for every 10 MA beneficiaries
Congressional District 30
Rep. Laura Friedman (D)
$27,415,130
Total excess Part B premium burden 302nd out of 431 districts,
where 1st is highest
$19.3M
Total burden on individuals
$9.8M
Excess premiums for TM beneficiaries
5.5
TM beneficiaries for every 10 MA beneficiaries
Congressional District 31
Rep. Gilbert Ray Cisneros Jr. (D)
$28,271,375
Total excess Part B premium burden 285th out of 431 districts,
where 1st is highest
$19.7M
Total burden on individuals
$10.1M
Excess premiums for TM beneficiaries
5.5
TM beneficiaries for every 10 MA beneficiaries
Congressional District 32
Rep. Brad Sherman (D)
$33,142,270
Total excess Part B premium burden 130th out of 431 districts,
where 1st is highest
$24.5M
Total burden on individuals
$12.0M
Excess premiums for TM beneficiaries
5.6
TM beneficiaries for every 10 MA beneficiaries
Congressional District 33
Rep. Pete Aguilar (D)
$19,211,756
Total excess Part B premium burden 424th out of 431 districts,
where 1st is highest
$14.1M
Total burden on individuals
$4.9M
Excess premiums for TM beneficiaries
3.4
TM beneficiaries for every 10 MA beneficiaries
Congressional District 34
Rep. Jimmy Gomez (D)
$22,340,340
Total excess Part B premium burden 395th out of 431 districts,
where 1st is highest
$15.2M
Total burden on individuals
$8.0M
Excess premiums for TM beneficiaries
5.5
TM beneficiaries for every 10 MA beneficiaries
Congressional District 35
Rep. Norma J. Torres (D)
$20,415,596
Total excess Part B premium burden 413th out of 431 districts,
where 1st is highest
$15.0M
Total burden on individuals
$5.4M
Excess premiums for TM beneficiaries
3.6
TM beneficiaries for every 10 MA beneficiaries
Congressional District 36
Rep. Ted Lieu (D)
$32,025,169
Total excess Part B premium burden 160th out of 431 districts,
where 1st is highest
$23.6M
Total burden on individuals
$11.4M
Excess premiums for TM beneficiaries
5.5
TM beneficiaries for every 10 MA beneficiaries
Congressional District 37
Rep. Sydney Kamlager-Dove (D)
$21,525,084
Total excess Part B premium burden 400th out of 431 districts,
where 1st is highest
$15.0M
Total burden on individuals
$7.7M
Excess premiums for TM beneficiaries
5.5
TM beneficiaries for every 10 MA beneficiaries
Congressional District 38
Rep. Linda T. Sanchez (D)
$28,699,663
Total excess Part B premium burden 271st out of 431 districts,
where 1st is highest
$20.9M
Total burden on individuals
$10.3M
Excess premiums for TM beneficiaries
5.6
TM beneficiaries for every 10 MA beneficiaries
Congressional District 39
Rep. Mark Takano (D)
$20,642,218
Total excess Part B premium burden 409th out of 431 districts,
where 1st is highest
$16.3M
Total burden on individuals
$6.1M
Excess premiums for TM beneficiaries
4.2
TM beneficiaries for every 10 MA beneficiaries
Congressional District 40
Rep. Young Kim (R)
$33,936,907
Total excess Part B premium burden 112th out of 431 districts,
where 1st is highest
$27.7M
Total burden on individuals
$12.1M
Excess premiums for TM beneficiaries
5.6
TM beneficiaries for every 10 MA beneficiaries
Congressional District 41
Rep. Ken Calvert (R)
$38,557,252
Total excess Part B premium burden 38th out of 431 districts,
where 1st is highest
$30.8M
Total burden on individuals
$11.5M
Excess premiums for TM beneficiaries
4.2
TM beneficiaries for every 10 MA beneficiaries
Congressional District 42
Rep. Robert Garcia (D)
$21,010,668
Total excess Part B premium burden 405th out of 431 districts,
where 1st is highest
$14.7M
Total burden on individuals
$7.5M
Excess premiums for TM beneficiaries
5.5
TM beneficiaries for every 10 MA beneficiaries
Congressional District 43
Rep. Maxine Waters (D)
$21,571,563
Total excess Part B premium burden 398th out of 431 districts,
where 1st is highest
$15.0M
Total burden on individuals
$7.7M
Excess premiums for TM beneficiaries
5.5
TM beneficiaries for every 10 MA beneficiaries
Congressional District 44
Rep. Nanette Diaz Barragan (D)
$26,156,356
Total excess Part B premium burden 332nd out of 431 districts,
where 1st is highest
$18.3M
Total burden on individuals
$9.3M
Excess premiums for TM beneficiaries
5.5
TM beneficiaries for every 10 MA beneficiaries
Congressional District 45
Rep. Derek Tran (D)
$30,911,183
Total excess Part B premium burden 197th out of 431 districts,
where 1st is highest
$24.9M
Total burden on individuals
$11.4M
Excess premiums for TM beneficiaries
5.9
TM beneficiaries for every 10 MA beneficiaries
Congressional District 46
Rep. J. Luis Correa (D)
$20,637,457
Total excess Part B premium burden 410th out of 431 districts,
where 1st is highest
$16.4M
Total burden on individuals
$7.7M
Excess premiums for TM beneficiaries
5.9
TM beneficiaries for every 10 MA beneficiaries
Congressional District 47
Rep. Dave Min (D)
$31,147,477
Total excess Part B premium burden 188th out of 431 districts,
where 1st is highest
$25.7M
Total burden on individuals
$11.5M
Excess premiums for TM beneficiaries
5.9
TM beneficiaries for every 10 MA beneficiaries
Congressional District 48
Rep. Darrell Issa (R)
$29,288,581
Total excess Part B premium burden 253rd out of 431 districts,
where 1st is highest
$23.8M
Total burden on individuals
$10.2M
Excess premiums for TM beneficiaries
5.3
TM beneficiaries for every 10 MA beneficiaries
Congressional District 49
Rep. Mike Levin (D)
$33,264,190
Total excess Part B premium burden 127th out of 431 districts,
where 1st is highest
$27.4M
Total burden on individuals
$12.6M
Excess premiums for TM beneficiaries
6.1
TM beneficiaries for every 10 MA beneficiaries
Congressional District 50
Rep. Scott H. Peters (D)
$30,029,956
Total excess Part B premium burden 232nd out of 431 districts,
where 1st is highest
$25.0M
Total burden on individuals
$11.5M
Excess premiums for TM beneficiaries
6.2
TM beneficiaries for every 10 MA beneficiaries
Congressional District 51
Rep. Sara Jacobs (D)
$24,627,096
Total excess Part B premium burden 363rd out of 431 districts,
where 1st is highest
$20.1M
Total burden on individuals
$9.4M
Excess premiums for TM beneficiaries
6.2
TM beneficiaries for every 10 MA beneficiaries
Congressional District 52
Rep. Juan Vargas (D)
$23,144,560
Total excess Part B premium burden 384th out of 431 districts,
where 1st is highest
