The Evolution of Medicare: Changes Over the Years

As a senior how much do you know about Medicare?

Medicare, a national health insurance program for the elderly and disabled, was signed into law in 1965 by President Lyndon B. Johnson as part of the Social Security Act. The history dates back further, with earlier proposals and discussions surrounding national health insurance going back to the early 20th century. The program was designed to tackle the lack of affordable healthcare options for older adults. Many of these individuals did not have adequate insurance coverage. They faced rising healthcare costs as they aged. 

• Medicare’s Enactment (1965):President Johnson’s “Great Society” initiative included the enactment of Medicare as Title XVIII of the Social Security Act, along with Medicaid (Title XIX). This landmark legislation provided health coverage to most Americans aged 65 and older. 
• Key Features of the Original Medicare:
  • Medicare Part A: Primarily covered hospital stays and related services. 
  • Medicare Part B: Offered optional, supplementary coverage for physician services. 
• Subsequent Expansions and Modifications:
  • 1972: Eligibility was extended to younger adults with disabilities and those with end-stage renal disease. 
  • Medicare Advantage (Part C): Established in 1997 (as Medicare+Choice) and later modified, allowing beneficiaries to enroll in private health plans. 
  • Medicare Part D: Added prescription drug coverage in 2003. 
  • Medicare Modernization Act of 2003: Made significant changes, including the introduction of Medicare Advantage plans and the prescription drug benefit. 
• Additional changes have continued with expansions for individuals with disabilities and prescription and vaccine drug coverage.
• Many states have expanded eligibility for specific types of care and drug treatments.

Congress and the President continue to look for savings by proposing potential changes which would negatively impact seniors and the disabled, including changing benefits and eligibility. When I turned 65, there was no choice. We had to sign up for Medicare in order to have access to our supplemental coverage.