Medicare & Medicaid Act (1965)

1) Link to the Text of the Act
Read historical signing statement and statute (SSA.gov)

2) Why It Was Done
The Act was passed to provide health insurance for two vulnerable groups:

• Medicare (Title XVIII): Seniors (65+) and certain disabled individuals.
• Medicaid (Title XIX): Low-income individuals and families.

It was part of President Lyndon B. Johnson’s Great Society programs.

3) Pre-existing Law or Constitutional Rights
Before 1965, older and low-income Americans often had little or no access to affordable healthcare. Employer-based insurance and charity care dominated, leaving many uninsured.

4) Overreach or Proper Role?
Supporters saw it as landmark social legislation, bringing healthcare to millions. Critics argued it expanded federal involvement in healthcare too far and increased long-term costs.

5) Who or What It Controls

• Federal government (funds and administers Medicare, partners with states for Medicaid)
• States (administer Medicaid programs under federal standards)
• Healthcare providers and insurers (must comply with federal program rules)
• Beneficiaries (gain entitlement to coverage)

6) Key Sections / Citations

• 42 U.S.C. § 1395 et seq. (Medicare – Title XVIII)
• 42 U.S.C. § 1396 et seq. (Medicaid – Title XIX)
• 42 U.S.C. § 1395c: Medicare hospital insurance benefits
• 42 U.S.C. § 1396a: State Medicaid plan requirements

7) Recent Changes or Live Controversies

• Medicare Part D (2003): Added prescription drug coverage
• ACA (2010): Expanded Medicaid eligibility in many states
• Ongoing debates about Medicare solvency, Medicaid expansion, and proposals for “Medicare for All”

8) Official Sources

• Social Security Administration – Medicare History
• U.S. Code – Medicare (42 U.S.C. § 1395)
• U.S. Code – Medicaid (42 U.S.C. § 1396)
• Centers for Medicare & Medicaid Services (CMS)

• Healthcare
• Insurance
• Medicare
• Medicaid
• Elderly
• Low Income