Medicare And Medicaid Act Of 1965


An Excerpt From Lbj’s Medicare Signing Speech

Medicare and Medicaid: Which is Which? 1965

It was a generation ago that Harry Truman said, and I quote him: ‘Millions of our citizens do not now have a full measure of opportunity to achieve and to enjoy good health. Millions do not now have protection or security against the economic effects of sickness. And the time has now arrived for action to help them attain that opportunity and to help them get that protection.’ Well, today, Mr. President, and my fellow Americans, we are taking such action20 years later.”

President Lyndon Johnson, July 30, 1965

Voting On The Original Medicare And Medicare Act In 1965

Summary: These resources were compiled by Dr. David Slusky for his Fall 2016 First Year Experience Seminar, ECON 177: The Affordable Care Act. The Social Security Amendments of 1965 was a piece of President Lyndon B. Johnson’s Great Society program enacted on July 30, 1965. The legislation called for federally-provided health insurance for the elderly and poor families, and resulted in the creation of Medicare and Medicaid.

Date Range: 1964-1966

Online materials: Constituent correspondence, correspondence from medical professionals and organizations, bill draft, and publicity materials

Additional materials: Constituent correspondence and legislative material

Title: Correspondence relating to the inclusion of podiatrists in the Medicare Program

Date: c. 1966

Citation: Robert J. Dole House of Representatives Papers, 1960-1969, Box 14, Folder 9, Robert J. Dole Institute of Politics Archive and Special Collections, University of Kansas

Title: Correspondence relating Medicare reimbursement for extended care facilities

Date: c. 1966

Citation: Robert J. Dole House of Representatives Papers, 1960-1969, Box 14, Folder 9, Robert J. Dole Institute of Politics Archive and Special Collections, University of Kansas

Title: Anti-Medicare letter with Dole’s reply

Date: 1964-09

Citation: Robert J. Dole House of Representatives Papers, 1960-1969, Box 81, Folder 3, Robert J. Dole Institute of Politics Archive and Special Collections, University of Kansas

Date: 1964-09

Date: 1964-09

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    Second World War And Its Aftermath

    It was tempting and, in the mobilization for war, apparently plausible for the Social Security Board to take the daring step of recommending to Congress that the States be bypassed in any national health insurance program that Congress chose to create. State administrators, such as Mary Donlon of the New York State Workmen’s Compensation Program, of course felt differently about being superceded in the administrative structure of the American welfare State . As a practical matter, the States were already too imbedded in the welfare system to be swept aside. Federal bureaucrats nonetheless entertained notions of making unemployment compensation Federal and of creating national, rather than State, health insurance and disability programs. They hoped this manner to establish a unified comprehensive system of contributory social insurance with no gaps, no overlaps, and no discrepancies .

    Legislative proposals for national health insurance which appeared in 1943, 1945, and 1947âthe latter two with the endorsement of President Trumanâthus featured Federal rather than State administration. If national health insurance had passed in this era, it would have provided health care for people of all ages . National health insurance, which formerly had been linked with the States and the unemployment insurance program, now became associated with the old-age insurance or the Social Security program. In effect, health insurance was to be an extension of Social Security .

    What You Can Do


    Our database of roll call votes from 1789-1989 comes from an academic data source,, that has digitized paper records going back more than 200 years. Because of the difficulty of this task, the accuracy of these vote records is reduced.

    From October 2014 through July 2015, we displayed incorrect vote totals in some cases. Although the total correctly reflected the announced positions of Members of Congress, the totals incorrectly included paired votes, which is when two Members of Congress, one planning to vote in favor and the other against, plan ahead of time to both abstain.

    In addition, these records do not always distinguish between Members of Congress not voting from Members of Congress who were not eligible to vote because they had not yet taken office, or for other reasons. As a result, you may see extra not-voting entries and in these cases Senate votes may show more than 100 senators listed!

    Aye and Yea mean the same thing, and so do No and Nay. Congress uses different words in different sorts of votes.

    The U.S. Constitution says that bills should be decided on by the yeas and nays . Congress takes this literally and uses yea and nay when voting on the final passage of bills.

    All Senate votes use these words. But the House of Representatives uses Aye and No in other sorts of votes.

    Pearson, James

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    Children’s Health Insurance Program

    The Children’s Health Insurance Program was signed into law in 1997 and provides federal matching funds to states to provide health coverage to children in families with incomes too high to qualify for Medicaid, but who can’t afford private coverage. All states have expanded children’s coverage significantly through their CHIP programs, with nearly every state providing coverage for children up to at least 200 percent of the Federal Poverty Level .

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    The Medicare Bill Of 1965

    On July 30, 1965, President Lyndon B. Johnson signed into law the Social Security Act Amendments, popularly known as the Medicare bill. It established Medicare, a health insurance program for the elderly, and Medicaid, a health insurance program for the poor.

    Former President Truman participated in the signing ceremony with President Johnson. Harry S. Truman and Bess Truman received Medicare registration cards numbers one and two. At the time, Mr. Truman was 81 years old, and he described it as a profound personal experience for me.

    More on the Medicare bill:

    This is the Medicare card believed to have been given to Harry Truman by President Lyndon Johnson on the occasion of the signing of the Social Security Amendments of 1965 in Independence, Missouri.

    Medicares History: Key Takeaways

    Medicare And Medicaid Turn 50

    Discussion about a national health insurance system for Americans goes all the way back to the days of President Teddy Roosevelt, whose platform included health insurance when he ran for president in 1912. But the idea for a national health plan didnt gain steam until it was pushed by U.S. President Harry S Truman.

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    C: Medicare Advantage Plans

    With the passage of the Balanced Budget Act of 1997, Medicare beneficiaries were formally given the option to receive their Original Medicare benefits through capitated health insurance Part C health plans, instead of through the Original fee for service Medicare payment system. Many had previously had that option via a series of demonstration projects that dated back to the early 1970s. These Part C plans were initially known in 1997 as “Medicare+Choice”. As of the Medicare Modernization Act of 2003, most “Medicare+Choice” plans were re-branded as “Medicare Advantage” plans . Other plan types, such as 1876 Cost plans, are also available in limited areas of the country. Cost plans are not Medicare Advantage plans and are not capitated. Instead, beneficiaries keep their Original Medicare benefits while their sponsor administers their Part A and Part B benefits. The sponsor of a Part C plan could be an integrated health delivery system or spin-out, a union, a religious organization, an insurance company or other type of organization.

    The intention of both the 1997 and 2003 law was that the differences between fee for service and capitated fee beneficiaries would reach parity over time and that has mostly been achieved, given that it can never literally be achieved without a major reform of Medicare because the Part C capitated fee in one year is based on the fee for service spending the previous year.

    In The Beginning: Medicare And Medicaid

    The law LBJ signed on July 30, 1965, directly affects more than 100 million Americans

    The first enrollee in Medicare might have been the most famous. On July 30, 1965, President Lyndon Johnson boarded Air Force One for a flight to Independence, Missouri, where he would sign the Social Security Amendments of 1965 into law at the Truman Presidential Librarywith former President Truman at his side. The act established Medicare to provide health insurance to the elderly and Medicaid to provide the same to the poor and disabledand taxes to pay for both. After attaching his signature to the legislation, Johnson presented the first two Social Security Administration health insurance cards to Truman and his wife, Bess.

    Today, Medicare and Medicaid are immensely significant in human, economic, and political terms. According to the Centers for Medicare and Medicaid Services, which administer the programs, roughly 57 million Americans are enrolled in Medicare and 70.9 million in Medicaid, with nearly 12 million in both. Medicare and Medicaid account for more than a third of the $3.2 trillion health care industry that represents 17.8 percent of the US economy . And Americans continue to vigorously debate the role of the federal government in providing the physical and economic security afforded by health insurance.

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    Broadening And Liberalizing Requirement

    Section 1903 and the 1965 Medicaid law provided:

    The Secretary shall not make payments under the preceding provisions of this section to any State unless the State makes a satisfactory showing that it is making efforts in the direction of broadening the scope of the care and services made available under the plan and in the direction of liberalizing the eligibility requirements for medical assistance, with a view toward furnishing by July 1, 1975, comprehensive care and services to substantially all individuals who meet the plan’s eligibility standards with respect to income and resources, including services to enable such individuals to attain or retain independence or self-care.

    What Did George W Bush Accomplish

    I Was There When Medicare Got Passed. Heres How it ...

    A U.S. president, George W. Bush initiated what he called the war on terrorism, portrayed as an American-led global counterterrorism campaign launched in response to the terrorist attacks of . Included were the Afghanistan and Iraq wars. Also, his administration sponsored reforms of Medicare and the U.S. education system.

    George W. Bush, in full George Walker Bush, , 43rd president of the United States , who led his countrys response to the in 2001 and initiated the Iraq War in 2003. Narrowly winning the electoral college vote in 2000 over Vice Pres. Al Gore in one of the closest and most-controversial elections in American history, George W. Bush became the first person since Benjamin Harrison in 1888 to be elected president despite having lost the nationwide popular vote. Before his election as president, Bush was a businessman and served as governor of Texas .

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    Health Insurance In The Fifties

    These problems led to yet another iteration of the national health insurance idea during the fifties. As Social Security became more popular in that decade and Congress passed bills raising Social Security benefit levels in 1950, 1952, 1954, 1956, and 1958, reformers thought in terms of extending health insurance coverage to Social Security beneficiaries who were, with the exception of the dependents of deceased workers and other beneficiaries, elderly individuals . These individuals fared less well in the private health insurance market than did their younger counterparts. Many of them, after all, had lost their ties to employers, who had financed their health care . With relatively high morbidity rates, they represented a particularly bad risk for private companies to insure . The Federal Government could therefore insinuate itself as a provider of health insurance through the creation of what ultimately came to be called Medicare. First proposed publicly in 1952, this idea of limiting federally financed national health insurance to the elderly received attention in Congress beginning in 1957 .

    Effects Of The Patient Protection And Affordable Care Act

    The Patient Protection and Affordable Care Act of 2010 made a number of changes to the Medicare program. Several provisions of the law were designed to reduce the cost of Medicare. The most substantial provisions slowed the growth rate of payments to hospitals and skilled nursing facilities under Parts A of Medicare, through a variety of methods .

    PPACA also slightly reduced annual increases in payments to physicians and to hospitals that serve a disproportionate share of low-income patients. Along with other minor adjustments, these changes reduced Medicare’s projected cost over the next decade by $455 billion.

    Additionally, the PPACA created the Independent Payment Advisory Board , which was empowered to submit legislative proposals to reduce the cost of Medicare if the program’s per-capita spending grows faster than per-capita GDP plus one percent. The IPAB was never formed and was formally repealed by the Balanced Budget Act of 2018.

    Meanwhile, Medicare Part B and D premiums were restructured in ways that reduced costs for most people while raising contributions from the wealthiest people with Medicare. The law also expanded coverage of or eliminated co-pays for some preventive services.

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    Comparison With Private Insurance

    Medicare differs from private insurance available to working Americans in that it is a social insurance program. Social insurance programs provide statutorily guaranteed benefits to the entire population . These benefits are financed in significant part through universal taxes. In effect, Medicare is a mechanism by which the state takes a portion of its citizens’ resources to provide health and financial security to its citizens in old age or in case of disability, helping them cope with the enormous, unpredictable cost of health care. In its universality, Medicare differs substantially from private insurers, which must decide whom to cover and what benefits to offer to manage their risk pools and ensure that their costs do not exceed premiums.

    Medicare also has an important role in driving changes in the entire health care system. Because Medicare pays for a huge share of health care in every region of the country, it has a great deal of power to set delivery and payment policies. For example, Medicare promoted the adaptation of prospective payments based on DRG’s, which prevents unscrupulous providers from setting their own exorbitant prices. Meanwhile, the Patient Protection and Affordable Care Act has given Medicare the mandate to promote cost-containment throughout the health care system, for example, by promoting the creation of accountable care organizations or by replacing fee-for-service payments with bundled payments.

    Prohibition Against Federal Interference

    Medicare Bill Signed – 1965 | Today In History | 30 July 17

    Section 1801 of the Medicare law provides:

    Nothing in this title shall be construed to authorize any Federal officer or employee to exercise any supervision or control over the practice of medicine or the manner in which medical services are provided, or over the selection, tenture, or compensation of any officer or employee of any institution, agency, or person providing health services or to exercise any supervision or control over the administration or operation of any such institution, agency, or person.

    Section 1801 was included in the law to offset the criticism made by opponents of the proposal that Federal legislation would give Federal officials the opportunity and the right to interfere in the diagnosis and treatment of the individual. Similar language was also included in bills and laws relating to education. The basic provision was originally included in the Forand bills, in 1957 and 1959 , made more specific and enlarged by the legal staff of the Department of Health, Education, and Welfare when President Kennedy’s Administration bill was introduced by Representative Cecil King and Senator Clinton Anderson on February 13, 1961. No effort has been made, as far as I know, to amend or repeal this general provision.

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