Medicare and Medicaid turn 50

On July 30^th, 1965, President Lyndon Johnson signed into law the Social Security Amendment Act that created Medicare and Medicaid. At the signing ceremony, President Johnson enrolled President Truman as the first Medicare beneficiary and gave a speech on the importance of the legislation. The President’s description of the law’s impact describes the conditions it aimed to alleviate:

No longer will older Americans be denied the healing miracle of modern medicine. No longer will illness crush and destroy the savings that they have so carefully put away over a lifetime so that they might enjoy dignity in their later years. No longer will young families see their own incomes, and their own hopes, eaten away simply because they are carrying out their deep moral obligations to their parents, and to their uncles, and their aunts.

… there is another tradition that we share today. It calls upon us never to be indifferent toward despair. It commands us never to turn away from helplessness. It directs us never to ignore or to spurn those who suffer untended in a land that is bursting with abundance.

In 1966, there were 19 million Medicare enrollees; by 2014, the program covered 54 million. In 2010, Medicaid financed 48% of all births. Today, nearly 71 million people have Medicaid coverage. Together, Medicare and Medicaid cover nearly one out of three Americans, the Centers for Medicare and Medicaid reports. (For a more in-depth look, check out the Kaiser Family Foundation’s Medicare & Medicaid at 50 and Beyond site.)

These two programs help beneficiaries get preventive care, lifesaving treatments, and care that improves their quality of life. They make it less likely that people will have to choose between desperately needed care and their families’ financial wellbeing. They help millions of people stay healthy, active, and engaged in their communities.

Medicaid enrollment has increased rapidly over the past few years thanks to the Affordable Care Act, which expanded Medicaid eligibility to all legal-resident adults with incomes up to 133% of the federal poverty level. The Supreme Court’s decision to make that Medicaid expansion optional for states has resulted in this benefit being unevenly distributed across the country. Even so, CDC analysis of data from the National Health Interview Survey found that the portion of the population uninsured at the time of interview dropped from 15.4 in 2009 to 11.5 in 2014.

It’s still shameful that 12% of people in one of the world’s wealthiest countries don’t have health insurance. And even among those who are insured, many still struggle to pay their deductibles, premiums, and co-payments. Access to providers is far from perfect. But over the past five decades, we’ve made progress.

When he signed the Affordable Care Act on March 23, 2010, President Obama stated, “We have now just enshrined … the core principle that everybody should have some basic security when it comes to their healthcare.” In 1965, we took the position that being elderly or impoverished shouldn’t mean foregoing healthcare. Now, we’ve committed to making healthcare coverage attainable for the US population as a whole. Efforts to improve healthcare quality and health outcomes while keeping costs affordable for both individuals and the government are far from complete, but they are underway.

I hope in another 50 years we’ll be able to look back again and say that we’ve come a long way – not just toward assuring access to healthcare, but toward improving health.