Payments to private Medicare Advantage plans have exceeded Medicare fee-for-service costs ever since those payments were increased by Congress in 2003. According to a new issue brief, in 2010, payments to such plans exceeded average costs in fee-for-service Medicare nationally by 8.9 percent—a total of $8.9 billion. Under the Affordable Care Act, payments to Medicare Advantage plans will be reduced beginning in 2012, to be more in line with those in fee-for-service Medicare.