How old is the Medicare program?
Discussions about a national health insurance program go back more than 100 years; Teddy Roosevelt included the concept in his 1912 presidential campaign platform. It was a bold idea at a time when health care itself was simpler and less expensive than today.
Some 30 years later, President Harry Truman called on Congress to create such a program for every American. He envisioned an insurance option through which any person could get help paying for doctor visits, hospital care, dental services and more.
Truman’s idea proved too radical. The universal health insurance he imagined in 1945 remained nothing but an idea until 1965, when President Lyndon Johnson signed into law a version of Medicare for elderly Americans.
President Johnson’s Medicare had less complete coverage than what it now covers. It’s been incrementally expanded by several presidents, including Richard Nixon (1972, expanding eligibility), Bill Clinton (1997, Medicare Part C), and George W. Bush (2003, Medicare Part D).
1965: President Lyndon Johnson signs H.R. 6675, making Medicare law. He signed the bill at a ceremony in Independence, Missouri, the hometown of former President Harry Truman. It was during that event that President Truman became Medicare's very first enrollee.
1966: Americans ages 65 and older were enrolled in Medicare Part A, millions of whom also signed up for the optional Medicare Part B.
1972: President Richard Nixon signed into law the first major change to Medicare. As a result, Medicare coverage was expanded to certain individuals under the age of 65, including people having kidney failure requiring dialysis.
1982: After having recently expanding Medicare's coverage of home health care, a hospice benefit was added for terminally ill seniors.
1988: Congress passed a new law to limit enrollees' Medicare Part A and Part B out of pocket expenses. Although most of the law was repealed soon thereafter (today, there is no cap on Original Medicare's out of pocket costs) states are still required to use a portion of their Medicaid funding to limit cost-sharing for enrollees living in extreme poverty.
1997: President Bill Clinton signed into law a new form of Medicare coverage called Part C. Originally known by the shorthand "Medicare + Choice" and today called "Medicare Advantage", Part C plans are administered by managed care companies having a Medicare contract.
Medicare Advantage plans have become increasingly popular in the last 10 years because their coverage is typically more generous or complete than what is provided by Original Medicare.
2001: Medicare coverage was expanded to include Americans of any age having been diagnosed with amyotrophic lateral sclerosis (ALS, more commonly known as Lou Gherig's Disease), an incurable and fatal neurodegenerative disease.
2003: President George W. Bush signed a law adding Medicare coverage for prescription drugs. Medicare Part D, which went into effect in 2006, is considered the largest and most consequential expansion of benefits in the program's 55 year history.
2020: The Medicare Part D "donut hole" was fully eliminated as part of the Affordable Care Act signed into law by President Barack Obama in 2010.
Today, anyone with standard Part D coverage pays 25% of drug costs after they and their insurance plan have together paid $4,130 in drug costs. When an enrollee pays more than $6,550 out of their own pocket, they enter a catastrophic phase where Medicare pays about 95% of costs for the remainder of the year.