AP Photo Medicare becomes law of the land, July 30, 1965

On this day in 1965, President Lyndon B. Johnson signed into law Medicare, which provides federally subsidized hospitalization and medical insurance for the nation's elderly. The legislation remains an important legacy of LBJ’s “Great Society” initiative.

Thirty years earlier, Congress had shelved the first government-mandated health insurance proposal, put forward as a companion to the then-new Social Security program championed by President Franklin D. Roosevelt.


On Nov. 19, 1945, seven months into his presidency, Harry S. Truman called on Congress to create a national health insurance fund that would be open to all Americans. The plan Truman envisioned would provide health coverage to individuals, paying for doctor and hospital visits, laboratory services, dental care and nursing services.

By the time Truman prepared to leave office in early 1953, he had backed off from his universal coverage plan. The focus increasingly turned toward offering wider insurance coverage to Social Security beneficiaries. Nearly two decades of debate ensued, with conservative opponents, joined by the American Medical Association, warning of the dangers of “socialized medicine.”

President John F. Kennedy also made an unsuccessful effort to enact a health care program for seniors after a national study showed that 56 percent of Americans over the age of 65 remained uncovered by health insurance.

The legislative logjam broke with the election of 1964, which swept LBJ into the White House for a full term behind large Democratic majorities in both houses of Congress. Shortly after that election, a breakthrough occurred when House Ways and Means Chairman Rep. Wilbur Mills (D-Ark.), who had previously blocked Medicare proposals, said, “I can support a payroll tax for financing health benefits just as I have supported a payroll tax for [Social Security] benefits.”

When the long-stalled Medicare effort came before Congress in January 1965, congressional leaders designated the bills as H.R. 1 and S. 1. Despite resistance by organized medicine and some of its congressional allies, the Medicare bill moved forward. A Mills rewrite cleared the House on April 8 by a vote of 313-115. The Senate approved its version on July 9 by a vote of 68-21. A conference committee labored for more than a week in mid-July to reconcile 513 differences between the two versions.

At a bill-signing ceremony in Independence, Missouri, where Truman was born and reared, Johnson enrolled the former president as the first Medicare beneficiary and presented him with the nation’s first Medicare card.

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In 1972, President Richard 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.

Currently, 44 million beneficiaries—some 15 percent of all Americans—are enrolled in Medicare. Under current law, enrollment is projected to rise to 79 million by 2030. One in 10 beneficiaries relies solely on the basic Medicare program for health care coverage.

SOURCE: WWW.MEDICARERESOURCES.ORG

