On this day (July 30) in 1965, President Lyndon B. Johnson signed into law two federally funded and federally administered compulsory health insurance programs: Medicare and Medicaid.
On this ceremonial occasion, Johnson traveled to former fellow Democratic President Harry S. Truman’s hometown of Independence, Mo., for the signing. Amidst great fanfare, Johnson praised Truman for his pioneering but unfulfilled proposal, which Truman had made in his “Fair Deal” State of the Union Address of Jan. 5, 1949. The address called for a national publicly funded health insurance program.
After the signing, Johnson ceremoniously gave the beaming former president the first pen used in the signing. The Medicare Bill was formally enacted as Title XVIII of the Social Security Amendments of 1965, and went into effect on July 1, 1966.
It was in his second State of the Union address on Jan. 4, 1965, that Johnson had called for an extensive program of domestic reform he called the “Great Society.” The “Great Society” was really an extension of President Franklin D. Roosevelt’s “New Deal” of the 1930s, and President Truman’s “Fair Deal” of the late 1940s and early 1950s.
In this now famous State of the Union address, Johnson called for a large number of far-reaching (and controversial) domestic reforms, which included, among other proposals, an extension of the war on poverty, rigid enforcement of the Civil Rights Act, reform of immigration laws, and most importantly, a national health insurance program.
LBJ’s call for reform resulted in the first session of the 89th Congress passing the most significant amount of far-reaching legislation since the early years of the New Deal. In 1965 alone, Congress passed and the president signed the Elementary and Secondary School Act (April 11), the Medicare and Medicaid Acts (July 30), and the Voting Rights Act of 1965 (Aug. 6). It also established the Department of Housing and Urban Development (HUD) on Sept. 9, the Water Quality Act of 1965 (Oct. 2), the Air Quality Act (Oct. 20), and the Higher Education Act (Oct. 20).
Johnson began making the case for Medicare and Medicaid early in 1965, shortly after his call for reform in his 1965 State of the Union address. He called for what is now referred to as a single-pay, health insurance program, especially for the elderly. He pointed out that “almost half of the elderly have no health insurance at all,” and that “four out of five persons 65 or older have a disability or chronic disease.”
Even though most Americans today approve of Medicare and Medicaid, there was from the beginning considerable opposition. The politically powerful American Medical Association and many conservative Republicans believed that programs like Medicare would “invade every area of freedom in this country.”
Johnson also had not only to convince physicians and the Republican right wing of the efficacy and value of a federally financed national health program, he had to deal with and convince influential members of his own party.
Specifically he had to convince the powerful Democratic chairman of the House Ways and Means Committee, Wilbur Mills of Ohio, and conservative Virginia senator Harry Byrd, who chaired the Senate Finance Committee, that passage of this bill was inevitable and that it would benefit both of them politically.
Through much “arm twisting” (for which he was a master), persuasive lobbying with the AMA, and sometimes the use of guile and deceit, Johnson’s skill, perseverance and success in pushing through Congress many of his “Great Society” proposals, especially Medicare, remains unequaled.
• Crystal Lake resident Joseph C. Morton is professor emeritus at Northeastern Illinois University and author of “The American Revolution” and “Shapers of the Great Debate at the Constitutional Convention of 1787.” He is available for tutoring, talks and workshops on American history. Email him at demjcm@com.cast.
