Medicare Affordability Update
Excess Part B premiums
3rd in the U.S.
Total burden on individuals
3rd in the U.S.
Excess TM premiums
3rd in the U.S.
State fiscal burden
4th in the U.S.
Federal fiscal burden
4th in the U.S.
Total public sector fiscal burden
4th 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 Texas 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 Texas 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.
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 Texas, there are 6.8 Traditional Medicare beneficiaries bearing this higher premium burden for every 10 MA beneficiaries who ultimately receive the greater benefits. This means that 0.7 Traditional Medicare beneficiaries pay $145 in excess for each MA beneficiary in Texas.
$388,260,470
Excess TM premiums
Excess Part
B premiums faced by Traditional Medicare enrollees despite not receiving
Medicare Advantage benefits
$145
Amount paid in excess by TM
beneficiaries for every MA beneficiary
Excess Part
B premiums faced by Traditional Medicare enrollees for each MA
beneficiary
6.8
Number
of TM beneficiaries for every 10 MA beneficiaries
Distribution across congressional districts in Texas
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. Nathaniel Moran (R)
165th out of 431 districts, where 1st is highest
Congressional District 2
Rep. Dan Crenshaw (R)
345th out of 431 districts, where 1st is highest
Congressional District 3
Rep. Keith Self (R)
339th out of 431 districts, where 1st is highest
Congressional District 4
Rep. Pat Fallon (R)
299th out of 431 districts, where 1st is highest
Congressional District 5
Rep. Lance Gooden (R)
247th out of 431 districts, where 1st is highest
Congressional District 6
Rep. Jake Ellzey (R)
366th out of 431 districts, where 1st is highest
Congressional District 7
Rep. Lizzie Fletcher (D)
403rd out of 431 districts, where 1st is highest
Congressional District 8
Rep. Morgan Luttrell (R)
284th out of 431 districts, where 1st is highest
Congressional District 9
Rep. Al Green (D)
417th out of 431 districts, where 1st is highest
Congressional District 10
Rep. Michael T. McCaul (R)
187th out of 431 districts, where 1st is highest
Congressional District 11
Rep. August Pfluger (R)
360th out of 431 districts, where 1st is highest
Congressional District 12
Rep. Craig A. Goldman (R)
371st out of 431 districts, where 1st is highest
Congressional District 13
Rep. Ronny Jackson (R)
319th out of 431 districts, where 1st is highest
Congressional District 14
Rep. Randy K. Weber Sr. (R)
294th out of 431 districts, where 1st is highest
Congressional District 15
Rep. Monica De La Cruz (R)
387th out of 431 districts, where 1st is highest
Congressional District 16
Rep. Veronica Escobar (D)
383rd out of 431 districts, where 1st is highest
Congressional District 17
Rep. Pete Sessions (R)
306th out of 431 districts, where 1st is highest
Congressional District 18
Vacant (V)
426th out of 431 districts, where 1st is highest
Congressional District 19
Rep. Jodey C. Arrington (R)
340th out of 431 districts, where 1st is highest
Congressional District 20
Rep. Joaquin Castro (D)
404th out of 431 districts, where 1st is highest
Congressional District 21
Rep. Chip Roy (R)
37th out of 431 districts, where 1st is highest
Congressional District 22
Rep. Troy E. Nehls (R)
334th out of 431 districts, where 1st is highest
Congressional District 23
Rep. Tony Gonzales (R)
351st out of 431 districts, where 1st is highest
Congressional District 24
Rep. Beth Van Duyne (R)
338th out of 431 districts, where 1st is highest
Congressional District 25
Rep. Roger Williams (R)
191st out of 431 districts, where 1st is highest
Congressional District 26
Rep. Brandon Gill (R)
341st out of 431 districts, where 1st is highest
Congressional District 27
Rep. Michael Cloud (R)
193rd out of 431 districts, where 1st is highest
Congressional District 28
Rep. Henry Cuellar (D)
391st out of 431 districts, where 1st is highest
Congressional District 29
Rep. Sylvia R. Garcia (D)
429th out of 431 districts, where 1st is highest
Congressional District 30
Rep. Jasmine Crockett (D)
382nd out of 431 districts, where 1st is highest
Congressional District 31
Rep. John R. Carter (R)
236th out of 431 districts, where 1st is highest
Congressional District 32
Rep. Julie Johnson (D)
430th out of 431 districts, where 1st is highest
Congressional District 33
Rep. Marc A. Veasey (D)
427th out of 431 districts, where 1st is highest
Congressional District 34
Rep. Vicente Gonzalez (D)
373rd out of 431 districts, where 1st is highest
Congressional District 35
Rep. Greg Casar (D)
421st out of 431 districts, where 1st is highest
Congressional District 36
Rep. Brian Babin (R)
327th out of 431 districts, where 1st is highest
Congressional District 37
Rep. Lloyd Doggett (D)
415th out of 431 districts, where 1st is highest
Congressional District 38
Rep. Wesley Hunt (R)
320th out of 431 districts, where 1st is highest