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A brief history of Medicare in America

Landmark social program now covers 49.4 million Americans

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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 didn’t gain steam until it was pushed by U.S. President Harry S. Truman. On November 19, 1945, seven months into his presidency, Truman sent a message to Congress, calling for creation of a national health insurance fund, open to all Americans.

The plan Truman envisioned would provide health coverage to individuals, paying for such typical expenses as doctor visits, hospital visits, laboratory services, dental care and nursing services. Although Truman fought to get a bill passed during his term, he was unsuccessful and it was another 20 years before Medicare would become a reality.

President John F. Kennedy made his own unsuccessful push for a national health care program for seniors after a national study showed that 56 percent of Americans over the age of 65 were not covered by health insurance. But it wasn’t until 1965 – after legislation was signed by President Lyndon B Johnson – that Americans started receiving Medicare health coverage.

Today, Medicare continues to provide health care for those in need. By the end of 2014, there were 49,435,610 people receiving health coverage through a Medicare program. Benefits paid in 2013 amounted to $583, which was about 14 percent of the federal budget. The retirement wave of baby boomers was once expected to cause Medicare to become a budget buster, but the Congressional Budget Office is now projecting increases in spending to be much smaller than once thought, thanks in part to cost savings embedded in Obamacare.

A brief look at Medicare milestones

The ’60s

  • On July 30, 1965 President Lyndon B. Johnson made Medicare law by signing H.R. 6675 in Independence, Missouri. Former President Truman was issued the very first Medicare card during the ceremony. In 1965, the budget for Medicare was around $10 billion and 19 million individuals signed up for Medicare during its first year.
  • In 1966, Medicare’s coverage took effect, as Americans age 65 and older were enrolled in Part A and millions of other seniors signed up for Part B.

The ’70s

  • In 1972, President Richard M. Nixon signed into the law the first major change to Medicare. The legislation expanded coverage to include individuals under the age of 65 with long-term disabilities and individuals with end-stage renal disease (ERSD).

The ’80s

  • When Congress passed the Omnibus Reconciliation Act of 1980, it expanded home health services. The bill also brought Medigap – or Medicare supplement insurance – under federal oversight.
  • In 1982, hospice services for the terminally ill were added to a growing list of Medicare benefits.

The ’90s

  • New legislation required state Medicaid programs to cover premiums of the new Specified Low-Income Medicare Beneficiary (SLMB) elgibility group – those eligible for Medicare with incomes between 100 and 120 percent of the federal poverty level.
  • Other legislation gave those eligible for Medicare coverage more options on the private market through Medicare Part C – Medicare Advantage. Originally known as “Medicare+Choice,” the new private options offered attractive add-on benefits such as prescription drug coverage for new enrollees.

The ’00s

  • Americans younger than age 65 with amyotrophic lateral sclerosis (ALS) are allowed to enroll in Medicare upon diagnosis of the disease.
  • President George W. Bush signed into law the Medicare Prescription Drug Improvement and Modernization Act of 2003, adding an optional prescription drug benefit. Until this time, about 25 percent of those receiving Medicare coverage did not have a prescription drug plan.

2010

  • The Patient Protection and Affordable Care Act of 2010 includes a long list of reform provisions intended to contain Medicare costs while increasing revenue, improving and streamlining its delivery systems, and even increasing services to the program.

2015

For more information, view the Kaiser Family Foundation’s comprehensive Medicare timeline.