Happy Birthday, Medicare! Celebrating 60 Years of Coverage

• Pages: 97-100
• Date: 01 May 2025
• Published date: 01 May 2025
• Author: Alexandra Glezer

Bifocal 46 Issue 5

97

As Medicare will mark its 60th anniversary this

July, COLA is taking a look back at how it

all began, what it covers today, and what lies

ahead for this vital program.

What is Medicare?

In response to the growing gap in health coverage for

older adults and individuals with limited incomes,

President Lyndon B. Johnson signed the Social Secu-

rity Amendments of 1965 into law (Social Security

Administration, n.d.). These amendments created

Medicare, a federal health insurance program for peo-

ple aged 65 and older, and Medicaid, a jointly-funded

federal-state program providing coverage for those

with limited incomes (National Archives, 2022).

Prior to Medicare, health insurance was largely tied to

employment or purchased through the private market,

options that often excluded older adults (Lankford,

2023). As people aged, their health needs increased

while their incomes typically declined, making pri-

vate insurance unaordable for many (Social Security

Administration, n.d.). By the mid-1960s, barely half

of the adults aged 65 and over maintained some form

of health insurance, and among those insured, few had

any coverage for surgical and out-of-hospital physi-

cian costs (Social Security Administration, n.d.). Addi-

tionally, many private insurers routinely dropped their

older, higher-risk policyholders (Social Security Ad-

ministration, n.d.). While there had been federal-state

programs of medical assistance to older adults prior to

the 1965 amendments, most proved unsuccessful due

to restrictive eligibility requirements and limited scope

of coverage (Social Security Administration, n.d.).

At the time of its enactment, Medicare was composed

of two parts: Hospital Insurance (Part A) and Sup-

plementary Medical Insurance (Part B) (Klees et al.,

2012). Part A covers inpatient hospital visits, home

health agencies, skilled nursing facilities, and hospice

care and is devoid of premiums to those eligible; those

who are interested in Part A yet ineligible for it have

the option to pay a monthly premium (Klees et al.,

2012). Part B provides coverage for physician visits,

outpatient hospital visits, home health agencies, and

more. Unlike Part A, Part B requires that eligible indi-

viduals pay a monthly premium (Klees et al., 2012).

Since then, Medicare has greatly expanded in scope.

Through the Balanced Budget Act of 1997, the Medi-

care Advantage program (Part C), formerly known

as Medicare+Choice, was established (Klees et al.,

2012). Part C allowed beneciaries to enroll in pri-

vate-sector health plans, oering more choice in how

they received their coverage (Klees et al., 2012). By

Happy Birthday, Medicare!

Celebrating 60 Years of Coverage

By Alexandra Glezer, Legal Intern for the

ABA Commission on Law and Aging