On July 30, 1965, President Lyndon Johnson traveled to the Truman Library in Independence, Missouri, to sign Medicare into law. His gesture drew attention to the 20 years it had taken Congress to enact government health insurance for senior citizens after Harry Truman had proposed it. In fact, Medicare’s history dated back even further. Congress held its first hearings on government health insurance in 1916 during the Progressive Era. During the New Deal, health coverage became part of the deliberations over the Social Security program, but President Franklin Roosevelt decided it was better strategy to pass the old-age pension provisions first. In 1939 Senator Robert Wagner introduced national health legislation and held hearings, but the outbreak of World War II caused his bill to be shelved. It was not until after the war, in November 1945, that Harry Truman sent Congress the first comprehensive federal health insurance proposal. That bill went nowhere. During Dwight Eisenhower’s presidency Congress enacted the Kerr-Mills bill for cases of “medical indigency,” to cover elderly individuals who needed help with their medical bills but who failed to qualify for welfare in their states. But reformers regarded Kerr-Mills as inadequate, given the rising number of elderly and the rising cost of hospital care. In 1961 President John F. Kennedy made Medicare a legislative priority and recruited Clinton Anderson of New Mexico to manage his bill. Anderson, a pragmatic and effective legislator, had suffered frequent bouts of illness throughout his life. “Perhaps a man who has spent much of his life fighting off the effects of illness,” he once wrote, “acquires…an understanding of the importance of professional health care to all people.” Though public opinion polls suggested strong support for the bill, Anderson faced powerful opponents, including the House Ways and Means chairman, the American Medical Association, and Senate Finance Committee chairman Harry Byrd of Virginia. The bill’s opponents prevailed, narrowly defeating the bill in 1962. It was reintroduced in 1963, and following Kennedy’s assassination, Anderson worked painstakingly to build solid, bipartisan Senate support. Under intense pressure Anderson’s own health faltered, forcing him to manage portions of the bill from a hospital bed at Walter Reed. In 1964 the House and Senate passed alternative versions of the bill but failed to resolve those differences in conference. Lyndon Johnson’s long coattails in the 1964 presidential contest increased support for Medicare in both chambers of Congress. Anderson seized the moment, working closely with House members to expand the scope of the original bill. On July 27 and 28, 1965, the House and the Senate agreed to the conference report on the final bill, which offered a “three layer cake” of coverage: hospital insurance for the aged, physicians’ insurance for the elderly, and expanded federal assistance to supplement state medical payments for the poor. In recognition of Anderson’s efforts, President Johnson invited him to attend the Medicare signing ceremony in Independence, Missouri, with former president Harry Truman.
Anniversary of the passing of the Social Security Act Amendments establishing Medicare and Medicaid
July 30, 1965, President Lyndon Johnson signed into law the Social Security Act Amendments, know as the Medicare Bill, providing federal health insurance for elderly and low-income Americans. President Harry S. Truman, longtime advocate of such legislation, was present at the signing and received the first Medicare registration card. PDF
Details October 30, 1972, President Richard Nixon signs into law the first major adjustment to Medicare after its enactment expanding benefits. PDF Details
Watch the video of President Johnson signing the Medicare Bill at the Truman Library and presenting President Truman with the first Medicare card on the LBJ Presidential Library’s website.
79 Stat. 286 - Medicare Law - July 30, 1965 On July 30, 1965, President Johnson signed the Medicare Law as part of the Social Security Act Amendments. This established both Medicare, the health insurance program for Americans over 65, and Medicaid, the health insurance program for low-income Americans. 79 Stat. 286 - Social Security Amendments of 1965 This article needs additional citations for verification. (August 2008) The Social Security Amendments of 1965, Pub.L. 89–97, 79 Stat. 286, enacted July 30, 1965, was legislation in the United States whose most important provisions resulted in creation of two programs: Medicare and Medicaid. The legislation initially provided federal health insurance for the elderly (over 65) and for financially challenged families.
Many politicians were involved in drafting the final bill that was introduced to the United States Congress in March 1965. On July 30, 1965 President Lyndon B. Johnson signed the bill into law. The concept of national health insurance began in the early 20th century in the United States and then came to prominence during the Truman administration following World War II. Between 1958 and 1964, controversy grew and a bill was drafted. The signing of the act, as part of Johnson's Great Society, began an era with a greater emphasis on public health issues. Medicare and Medicaid became the country's first public health insurance programs. The legislation was vigorously opposed by the American Medical Association until it had been enacted, but the AMA obtained concessions and later co-operated in its implementation. In 1912, Theodore Roosevelt included social insurance for sickness in the platform of his Progressive Party. Around 1915 the group American Association for Labor Legislation attempted to introduce a medical insurance bill to some state legislatures. The attempts were not successful, and as a result, controversy about national insurance came about. National groups supporting the idea of government health insurance included the AFL-CIO, the 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 US Chamber of Commerce, and the Life Insurance Association of People. Previous administrationsIn 1935, when President Franklin D. Roosevelt signed the Social Security Act, medical benefits were left out of the bill. The committee that Roosevelt appointed to study issues related to Social Security wanted to include health insurance in the bill. However, the committee was concerned that amending the bill to include health insurance would kill the entire bill.[1] Harry Truman took on the idea of national medical care and tried to integrate it into his Fair Deal program. Truman's attempts were also unsuccessful, but during his presidency, the fight for national medical care became specific to the aged population. Once the targeted age was decided, a lengthy debate began over presenting a coherent medical care bill to Congress. The Conservative Coalition dominated the House Ways and Means Committee, which complicated attempts to pass social health programs. Wilbur Mills (D-AR), the chair of the committee, later played a role in creating the health care program that was integrated into the Social Security Act. In 1960, the Kerr-Mills Act created the Medical Assistance for the Aged (MAA), a program that gave states the power to decide which patients needed financial assistance. The federal government would provide matching funds to the states for the program. Some states did not participate in or abide by the Act.[2] Another preliminary bill, the King-Anderson Bill, was introduced in 1962. Under it, some hospital and nursing home costs for patients 65 and older would have been covered. Although the bill was defeated in committee, the vote was narrow (12–11), signaling a shift in attitudes. Johnson administrationWith the election of Lyndon B. Johnson in 1964, Democrats controlled both the presidency and the Congress, claiming a 2:1 ratio to Republicans in the House and 32 more seats in the Senate. The Democrats in the House Ways and Means Committee shifted away from Southern Democrats, making the committee more sympathetic towards health insurance reform. Those who had worked on the King-Anderson Bill drafted a new bill providing coverage of the aged, limited hospitalization and nursing home insurance benefits, and Social Security financing. Wilbur Cohen, Assistant Secretary for Legislation of the Department of Health, Education and Welfare (and later Secretary), pushed the Medicare bill. Cohen convinced Johnson to give the bill high priority, and Johnson declared its importance to his Great Society program. The bill was introduced as companion bills,[3] H.R. 1 and S. 1, with the numbers being the first bills introduced in each house of a new Congress. House of RepresentativesThe groups previously opposed to the legislation switched their focus from opposing the bill to creating new versions of it. As a result, three forms of the bill emerged: John Byrnes's, the American Medical Association's, and the administration's bill (known as Medicare). Byrnes was a Republican committee member who proposed for doctors' services and drugs to be financed; participation in coverage would be voluntary for the aged. An elderly patient who needed the help would have financing "scaled to the amounts of the participant's Social Security cash benefits," and the financing would come from the government's revenues. The AMA proposed Eldercare, which provided government financing for physician's services, surgical charges, drugs, nursing home costs, X-ray and lab services. When brought back to the Ways and Means committee, three bills were presented: Byrnes's, Eldercare, and Medicare. When deliberations began in 1965, both AMA members and their suggestions were rejected. Wilbur Mills, the chair of the Ways and Means committee, suggested combining Byrnes's ideas and Medicare. His committee took on the task of drafting H.R. 6675, the bill that ultimately became law. In combining the two bills, Byrnes's suggestion, which included lower taxes, had to be altered as higher taxes were necessary for the program's predicted costs. The Ways and Means Committee reported favorably on the new bill to the full House of Representatives on March 29 after a straight-party committee vote of 17 to 8.[4] During debate on the House floor, Republicans offered a substitute bill that would have made participation fully voluntary. It was narrowly defeated 236 to 191, with 128 of 138 Republicans in favor of the substitute. H.R. 6675 was passed in the House on April 8, 1965 by a vote of 313 to 115.[4] SenateThe biggest threat to the passage of H.R. 6675 in the Senate came from liberal Democrats who were eager to expand coverage of the bill. As amended and passed in the Senate on July 19 by a vote of 68 to 21, H.R. 6675 would have cost approximately $800 million more than the House bill.[4] Final passageThe bill went to a conference committee at which Mills worked to eliminate practically all of the Senate amendments. The bill went through more than 5// amendments before being passed by majority vote in the House (307–116) on July 27 and in the Senate on July 28 (70–24).[5] The legislation made two amendments to the Social Security Act of 1935. Title XVIII, which became known as Medicare, includes Part A, which provides hospital insurance for the aged, and Part B, which provides supplementary medical insurance. Title XIX, which became known as Medicaid, provides for the states to finance health care for individuals who were at or close to the public assistance level with federal matching funds. On July 30, 1965, Johnson signed the bill, making it Public Law 89-97. The signing took place in Independence, Missouri and was attended by Truman. Johnson credited Truman with "planting the seeds of compassion and duty which have today flowered into care for the sick and serenity for the fearful." Implementation of the amendments required extensive data processing and the re-configuration of hospital policies nationwide.[6] In the late 1960s and the early 1970s, the federal government doubled the number of physicians trained in the US from 8,000 to 16,000 a year. There was a hospital building boom that moved from inpatient wards to one- and two-patient hospital rooms.[7]
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What federal legislation was enacted in 1965 to establish medicare and medicaid
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