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July 19, 1995

The Compromise and the Afterthought: Medicare and Medicaid After 30 Years

JAMA. 1995;274(3):278-282. doi:10.1001/jama.1995.03530030098045

IT HAS BEEN an eventful time since, on July 30,1965, then-President Lyndon Baines Johnson signed Public Law (PL) 89-97, the Social Security amendments that brought into being the Medicare and Medicaid programs. The legislation represented an unrivaled turning point in American health policy. It embroiled the American Medical Association (AMA) in the fight of its political life—which it lost. It changed how hospital, medical, and other health care services were financed; altered the shaky relationship between the federal government and the states; and spawned a long parade of political, financial, social, and moral events that continues to unfold today.

Deep Roots  Its roots ran deep.1-5 Politically, they reached back to the unsuccessful presidential campaign of Theodore Roosevelt in 1912; he included in his Progressive ("Bull Moose") platform a call for "health insurance for industry" that would guarantee coverage for working Americans. He lost the election to Woodrow Wilson.That