The Rural Policy Research Institute (RUPRI) presented this data report as an interim review of Medicare Advantage (MA) enrollment while awaiting the release of updated detailed Medicare enrollment data.
The MA rate of penetration (i.e., the proportion of Medicare enrollees in MA plans) in the United States has grown, since at least 2009, and surpassed 50 percent in 2023. While nonmetropolitan MA penetration has also grown steadily during that time, it has not yet passed the 50 percent level. Although MA penetration rates continued to grow in 2025, there were signs of a substantial slowing in the rate of growth. In 2025, over 22 percent of counties saw a decline in their MA penetration rate.