Medicare Turns 50

An Open Letter to My Daughter on Medicare’s 50th Anniversary: Before Medicare, one out of three people 65 and over lived in poverty. Fifty years later, fewer than 10 percent do. Today, people who reach 65 are living six years longer on average than before Medicare. Through the power of one woman’s experience, we are reminded of why health security is so important to every generation. Learn more from AARP's Medicare Q&A Tool.

President Johnson signing the Medicare program into law, July 30, 1965.

Courtesy of LBJ Presidential Library

Fifty years ago, on July 30, 1965, President Lyndon B. Johnson signed Medicare — and its sister program Medicaid — into law in the presence of former President Harry Truman in Independence, Mo. Eleven months later, both programs went into effect, with Truman and his wife, Bess, receiving the first two Medicare cards. (Truman was the first president to endorse the idea of a national health insurance program.)

Before Medicare's passage, only about half of American seniors had any kind of health insurance, and much of what they did have was inadequate. So it was with genuine trepidation that Johnson and his administration looked to the day when Medicare was to begin. Would seniors put off seeking treatment until coverage started? Would the hospitals be stormed by patients brandishing their new Medicare cards, only to be turned away? Alarmed by that prospect, Johnson personally ordered military helicopters to be on standby, ready to whisk patients to Army hospitals if any civilian ones became overwhelmed. It never happened. The helicopters were never needed, and the rollout ran smoothly.

Thirty years later, in 1995, Social Security commissioner Robert Ball, who was responsible for getting Medicare up and running, noted that the program had amply succeeded. "Because of Medicare, hundreds of millions of older people and their sons and daughters have been better off," Ball wrote. Plus, he added, their quality of life had been greatly improved "because of the availability of many modern medical techniques that otherwise might have been affordable only for the affluent."

Before Medicare, many seniors without insurance or financial help from their children received hospital treatment in charity wards, cared for by medical students. Medicare changed that forever. Right from the beginning, Medicare required a standard of care equivalent to paying customers, Ball recalled. This "meant being cared for in the relative luxury of a two-bed semiprivate room. It meant being treated with respect."

It also meant the end of racial segregation in hospitals after Johnson, who had signed the Civil Rights Act into law one year earlier, ordered that any hospitals continuing to segregate black and white patients would not be eligible for Medicare payments. The hospitals integrated almost overnight.