Medicare & Medicaid Act

1965

42 U.S.C. § 1395 et seq. (Medicare); 42 U.S.C. § 1396 et seq. (Medicaid)

📌 Link to the Text of the Act

Read historical signing statement and statute (SSA.gov)

📌 Why It Was Done

The Act was passed to provide health insurance for two vulnerable groups:

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

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

📌 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.

📌 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.

📌 Who or What It Controls

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

📌 Key Sections / Citations

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

📌 Recent Changes or Live Controversies

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