On this day July 30, 1965

U.S. President Lyndon B. Johnson signed the Social Security Act into law, establishing Medicare and Medicaid to provide federal health insurance for the elderly and for low income families, respectively.


Johnson signing Medicare

The fight for national health insurance began in the early 1900s and greatly caught the public’s attention during Truman’s presidency.

Between 1958 and 1964 controversy grew and the bill was drafted. The signing of the act, as part of LBJ’s Great Society, heralded in an era with a greater emphasis on public health issues.

The idea of national health insurance came about around 1915 when the group American Association for Labor Legislation attempted to introduce a medical insurance bill to some state legislatures.

These attempts were not successful and as a result the controversy about national insurance came about. National groups supporting the idea of government health aid included the AFL-CIO, American Nurses Association, National Association of Social Workers, and the Socialist Party USA.

The most prominent opponent of national medical insurance was the American Medical Association (AMA); others included the American Hospital Association, the Chamber of Commerce and the Life Insurance Association of America.

In 1935, when President Franklin D. Roosevelt signed the Social Security Act, medical benefits were left out of the bill. While Roosevelt wished to include some sort of national health care clause in the bill, he believed the American population would not be ready and the idea would be unpopular. Still, the idea of government medical care insurance stayed in the minds of some politicians.

Harry Truman took on the idea of national medical care and tried to integrate it into his Fair Deal program. Unfortunately, Truman’s attempts were also unsuccessful; however, during his presidency the fight for national medical care became specific to the aged population.

Medicare is a social insurance program administered by the United States government, providing health insurance coverage to people who are aged 65 and over, or who meet other special criteria. Medicare operates as a single-payer health care system. At the bill-signing ceremony President Johnson enrolled former President Harry S. Truman as the first Medicare beneficiary and presented him with the first Medicare card.

Medicaid is the United States health program for eligible individuals and families with low incomes and resources. It is a means-tested program that is jointly funded by the states and federal government, and is managed by the states. Among the groups of people served by Medicaid are certain eligible U.S. citizens and resident aliens, including low-income adults and their children, and people with certain disabilities.

Poverty alone does not necessarily qualify an individual for Medicaid. It is estimated that approximately 60 percent of poor Americans are not covered by Medicaid. Medicaid is the largest source of funding for medical and health-related services for people with limited income in the United States. Because of the aging population, the fastest growing aspect of Medicaid is nursing home coverage.


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