50th Anniversary of Medicare and Medicaid

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Download: Medicare and Medicaid Fact Sheet

At the top of President Lyndon Johnson’s legislative agenda in 1965 was Medicare, a federally funded insurance program to provide low-cost medical and hospital care for America’s elderly under Social Security. Half of the country’s population over age sixty-five had no medical insurance, and a third of the aged lived in poverty, unable to afford proper medical care; Johnson believed it was high time to do something about this.

Shortly after his November election win, he told Health, Education, and Welfare’s assistant secretary, Wilbur Cohen, to make Medicare the administration’s "number one priority." On January 4, Johnson put the issue front and center in his State of the Union message (full text); three days later he pressed for passage of Medicare, issuing a statement to Congress demanding that America’s senior citizens "be spared the darkness of sickness without hope."

Franklin Roosevelt was the first president to seriously consider a federal health insurance program. As Congress churned out New Deal legislation, Roosevelt advocated inclusion of a federal health insurance component in his Social Security Act of 1935, before dropping it to avoid jeopardizing the bill’s passage. Fourteen years later, Harry Truman sent the House a bill that would offer health insurance to those age sixty-five and older, but it was blocked by an intractable Ways and Means Committee. Kennedy tried, too, sending a comparable bill to Capitol Hill in 1962, where it missed passage in the Senate by a few votes.

In each case, the American Medical Association (AMA) was the chief culprit in killing the legislation, spending millions to brand the concept as "socialized medicine," an ambiguous characterization that nonetheless made it intrinsically un-American. Conservatives also cast a wary eye. Actor Ronald Reagan, a darling of the growing conservative movement and soon-to-be California gubernatorial candidate, warned that such a program would "invade every area of freedom in this country" and would, in years to come, have Americans waxing wistful to future generations about "what it was like in America when men were free."  


President Lyndon Johnson signs the Medicare Bill at the Harry S. Truman Library and Museum in
Independence, Missouri. LBJ Library photo by unknown, 34897-22. Taken July 30, 1965.

But sixteen years after Truman’s efforts were derailed by an unwilling Congress, Johnson believed "the times had caught up with the idea." On July 30, 1965, Johnson traveled to the Harry S. Truman Library and Museum in Independence, Missouri, where the eighty-one-year-old Truman, lean and bent with age, his wife, Bess, in tow, watched Johnson sign Medicare into law.

Proclaiming the thirty-third president the "real daddy" of Medicare, Johnson awarded President and Mrs. Truman the first two Medicare cards, numbers one and two. "He had started it all, so many years before," Johnson wrote of Truman later. "I wanted him to know that America remembered."

Excerpt from Indomitable Will: LBJ in the Presidency by Mark K. Updegrove



Additional Archival Items


Full text: President Johnson's Remarks at the Medicare Bill Signing (July 30, 1965, The American Presidency Project)


1964 Medicare Ad


Newsreel: Medicare Bill Signing - Download video


President Lyndon Johnson and President Harry S. Truman shake hands at the Medicare Bill Signing at Harry S. Truman Library and Museum in Independence, Missouri. LBJ Library photo by unknown, 34897-14. Taken July 30, 1965.


President Lyndon Johnson, President Harry S. Truman, and others walk through the Harry S. Truman Library and Museum during the Medicare Bill signing event. LBJ Library photo by Yoichi Okamoto, A986-26a. Taken July 30, 1965.


President Harry S. Truman and President Lyndon Johnson speaking. Medicare Bill signing event at the Harry S. Truman Library and Museum. LBJ Library photo by Yoichi Okamoto, A982-22a. Taken July 30, 1965.  

To see more photos from the Medicare Bill signing, we recommend searching our photo archive and using "Medicare" in the search field. All photos are public domain and may be downloaded.

 
Medicare Bill

 
First Two Medicare Cards Given to President Harry S. Truman
and Bess W. Truman by President Johnson
 

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Telephone conversation with President Johnson, Congressman Wilbur Mills, and Health, Education, and Welfare Assistant Secretary Wilbur Cohen on strategy to pass the Medicare Bill. March 23, 1965, 4:54 p.m. [Download - Right Click "Save Link As"]



LBJ: When are you going to take it up?

Mills: I’ve got to go to the Rules Committee next week.

LBJ: You always get your rules pretty quickly though, don’t you?

Mills: Yeah, that’s right.

LBJ: . . . For God’s sake, let’s get it before Easter! . . . They make a poll every Easter. . . . You know it. On what has Congress accomplished up till then. Then the rest of the year they use that record to write editorials about. So anything that we can grind through before Easter will be twice as important as after Easter.

[Mills gets off the line as Johnson continues the conversation with Cohen.]

LBJ: Now, remember this. Nine out of ten things that I get in trouble on is because they lay around. And tell the Speaker and Wilbur [Mills] to please get a rule just the moment they can.

Cohen: They want to bring it up next week, Mr. President.

LBJ: Yeah, but you just tell them not to let it lay around. Do that! They want to but they might not. That gets the doctors organized. Then they get the others organized. And I damn near killed my education bill, letting it lay around.

Cohen: Yeah.

LBJ: It stinks. It’s just like a dead cat on the door. When a committee reports it, you better either bury that cat or get it some life in it . . . [to Mills as he gets back on the line:] For God’s sakes! “Don’t let dead cats stand on your porch,” Mr. Rayburn used to say. They stunk and they stunk and they stunk. When you get one out of that committee, you call that son of a bitch up before [our opponents] can get their letters written.

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President Johnson's top domestic advisor, Joseph A. Califano, Jr., reveals how the president convinced the head of the American Medical Association to support Medicare. Anecdote told during a Friends of the LBJ Library event on Thursday, March 26, 2015 at the LBJ Presidential Library.


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Medicare and Medicaid Summit


On Wednesday, April 15, 2015, the LBJ Presidential Library commemorated the 50th anniversary of Medicare and Medicaid with a one-day summit (co-hosted by the Aspen Institute and the Robert Wood Johnson Foundation) in Washington, D.C.

Two former Secretaries of the Department of Health and Human Services chronicled the rapid growth of Medicare and Medicaid over the decades, while two former Administrators of the Centers for Medicare and Medicaid forecasted the future of the government healthcare programs. President Johnson’s daughter, Lynda Johnson Robb, discussed her father’s passion for social reform, while former LBJ Special Counsel Larry Levinson reflected on why LBJ succeeded in passing Medicare when others had failed.

The summit was free and open to the public.

Press release | View event gallery

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