People who choose Medicare Advantage (MA) face additional hurdles during the initial enrollment and annual plan selection processes. The MA plan choice landscape is cluttered, complicated, and confusing. Other MA features, like prior authorization, narrow provider networks, and predatory plan marketing, can worsen decision-making and access problems. It is also expensive. MA costs more, both overall and per enrollee, than Original Medicare. This drives up spending for the program, beneficiaries, and taxpayers; though little is known about how plans are using these dollars, or about overall plan quality. As MA enrollment grows, addressing its financing flaws and programmatic pitfalls becomes ever-more important. We support comprehensive reforms to ensure all beneficiaries can rely on their earned Medicare coverage.