Enrollment in Medicare Advantage, the private plan alternative to traditional Medicare, has increased steadily over the past two decades, with more than half of eligible beneficiaries enrolled in Medicare Advantage since 2023. The growth in enrollment has implications for federal spending, because according to the Medicare Payment Advisory Commission (MedPAC), Medicare payments to private plans are higher than spending for similar beneficiaries in traditional Medicare. In 2026, payments are 14% more per person, which translates into an additional $76 billion in federal spending this year. While payments per person relative to traditional Medicare are similar to a decade ago (15% higher), the impact on federal spending was substantially lower at $24 billion because enrollment was substantially lower with about one-third of eligible beneficiaries enrolled in a Medicare Advantage plan at that time. ARTICLE
