Makes me sad; it's still the go-to tool to paste screenshots in, do cutting if need be and adding a small shape. The near-instant startup helps a lot.
It's also fantastic for "annotating" images. MS Paint saves one from having to print an image out, scrawl unseemly things on it in crayon, and then scan it back in. If you're bad enough with the 1px pencil tool, that works just as well!