First introduced as Medicare+Choice in 1997, Medicare Advantage took just 25 years to become the coverage choice of a majority of Medicare enrollees, and its momentum is still building. In 2020, MA’s share of Medicare enrollment was 42 percent; in 2025, it’s now 54 percent; and in 2030, it’s projected to reach 61 percent. Despite the rapid change in MA penetration over time, the age distribution of MA vs. traditional Medicare (TM) is extremely balanced. In 2022, just as MA enrollment was on the verge of the majority, the Medicare population ages 65-84 was split evenly between MA and TM. Only among the oldest enrollees did TM prove more popular, while those with qualifying disabilities under age 65 were opting more for MA.
 
Seniors’ growing preference for MA plans over traditional Medicare (TM) can be attributed to MA’s supplemental benefits, prescription drug coverage savings, and cost-sharing limits (i.e. $0 premiums and copays), although aggressive marketing tactics and brokers’ financial incentives are also helping drive seniors’ decisions. A fully informed decision between MA and TM often comes down to a tradeoff of affordability and access, constrained by utilization management and network availability. TM offers virtually no limitations on physician choice and enables ease of specialty access, but with more cost-sharing. MA plans offer narrower networks but more cost protections. Because of this, perhaps the most significant difference between MA and TM enrollees is income. 47 percent of TM enrollees report an annual income of $40K or more, compared to only 32 percent of MA enrollees. If the choice between MA and TM is almost entirely financial, it raises important questions about whether a policy shift toward further privatization genuinely reflects consumer choice.