What Has Half a Century of Medicaid Meant for U.S.?

On July 30, 1965, President Lyndon Johnson signed controversial legislation creating two ambitious national health programs. Fifty years later, Medicare and Medicaid are still controversial, but for different reasons.

The idea of national health care first surfaced at a high level in 1945 when President Harry Truman proposed a national health insurance fund to be administered by the federal government. The American Medical Association and most of Congress opposed the idea of “socialized medicine” and it went on the back burner for 20 years. After Johnson signed the 1965 legislation, the first Medicare card was issued to Truman.

Several assessments of the programs’ effects over the first half century have been published this year, including “Medicaid at 50” from the Kaiser Family Foundation and “Medicare’s 50th Anniversary” from the Center for Medicare Advocacy.

Medicare, aimed at seniors and people with disabilities, is a federal program and involves little participation from states.

Medicaid, aimed at low-income people of all ages, is a partnership between states and the federal government, and programs vary from state to state.

Medicaid has grown significantly in recent years, especially in California, which operates the country’s largest program. Medi-Cal covers more than 12 million Californians — almost one third of the state’s population. Among children the percentage is even higher:  About half of California kids under 20 are Medi-Cal beneficiaries.

We asked experts and stakeholders to respond to two questions:

• What has the first 50 years of Medicaid meant for the country?
• What’s in store for Medicaid in the future?

We received responses from: