On July 30, 1965, President Lyndon Johnson traveled to the Truman Library in Independence, Missouri, to sign Medicare into law. His gesture drew attention to the 20 years it had taken Congress to enact government health insurance for senior citizens after Harry Truman had proposed it. In fact, Medicare’s history dated back even further. Show Congress held its first hearings on government health insurance in 1916 during the Progressive Era. During the New Deal, health coverage became part of the deliberations over the Social Security program, but President Franklin Roosevelt decided it was better strategy to pass the old-age pension provisions first. In 1939 Senator Robert Wagner introduced national health legislation and held hearings, but the outbreak of World War II caused his bill to be shelved. It was not until after the war, in November 1945, that Harry Truman sent Congress the first comprehensive federal health insurance proposal. That bill went nowhere. During Dwight Eisenhower’s presidency Congress enacted the Kerr-Mills bill for cases of “medical indigency,” to cover elderly individuals who needed help with their medical bills but who failed to qualify for welfare in their states. But reformers regarded Kerr-Mills as inadequate, given the rising number of elderly and the rising cost of hospital care. In 1961 President John F. Kennedy made Medicare a legislative priority and recruited Clinton Anderson of New Mexico to manage his bill. Anderson, a pragmatic and effective legislator, had suffered frequent bouts of illness throughout his life. “Perhaps a man who has spent much of his life fighting off the effects of illness,” he once wrote, “acquires…an understanding of the importance of professional health care to all people.” Though public opinion polls suggested strong support for the bill, Anderson faced powerful opponents, including the House Ways and Means chairman, the American Medical Association, and Senate Finance Committee chairman Harry Byrd of Virginia. The bill’s opponents prevailed, narrowly defeating the bill in 1962. It was reintroduced in 1963, and following Kennedy’s assassination, Anderson worked painstakingly to build solid, bipartisan Senate support. Under intense pressure Anderson’s own health faltered, forcing him to manage portions of the bill from a hospital bed at Walter Reed. In 1964 the House and Senate passed alternative versions of the bill but failed to resolve those differences in conference. Lyndon Johnson’s long coattails in the 1964 presidential contest increased support for Medicare in both chambers of Congress. Anderson seized the moment, working closely with House members to expand the scope of the original bill. On July 27 and 28, 1965, the House and the Senate agreed to the conference report on the final bill, which offered a “three layer cake” of coverage: hospital insurance for the aged, physicians’ insurance for the elderly, and expanded federal assistance to supplement state medical payments for the poor. In recognition of Anderson’s efforts, President Johnson invited him to attend the Medicare signing ceremony in Independence, Missouri, with former president Harry Truman. Health Care Reform and History
Class 3: The Battle over National Health InsuranceIntroduction:After World War Two, Harry Truman was the first U.S. president to propose a comprehensive system of national health insurance. The American Medical Association launched the first professional public relations campaign in history to oppose the president’s plan, which was defeated by 1950. Following the failure of national health insurance, employers bargained with labor unions to establish health insurance coverage for employees. Private, employer-based health insurance came to define the U.S. health system. However, the limitations of this type of health insurance, which did not cover the poor or senior citizens, would lead to demands for Medicare and Medicaid in the 1960s. Class ResourcesPrimary Sources
Discussion Questions:
Back to top Which president started health insurance?President Harry S.
Harry Truman, who became President upon FDR's death in 1945, considered it his duty to perpetuate Roosevelt's legacy. In 1945, he became the first president to propose national health insurance legislation.
Which president supported plans for health insurance and a national health program in the 1930s?In 1933, Franklin D. Roosevelt, a Democrat, included a publicly funded health care program while drafting provisions to Social Security legislation, which was eliminated from the final legislation.
Which president focused on health care?Lyndon B. Johnson – 1965 was a significant year for health reform, as both the Medicare and Medicaid programs were signed into law. He made health reform and expansion his number one priority, noting throughout the 1964 election that it would be his first initiative after his inauguration in January of 1965.
Which was considered the first national health insurance plan in the United States?Late 18th century. On July 16, 1798, President John Adams signed the first Federal public health law, "An act for the relief of sick and disabled Seamen." This assessed every seaman at American ports 20 cents a month. This was the first prepaid medical care plan in the United States.
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Which of the post World War II presidents proposed a national health insurance plan?
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