Social Security Amendments of 1965
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Long title | An Act to provide a hospital insurance program for the aged under the Social Security Act with a supplementary health benefits program and an expanded program of medical assistance, to increase benefits under the Old-Age, Survivors, and Disability Insurance System, to improve the Federal-State public assistance programs, and for other purposes. |
Enacted by | the 89th United States Congress |
Effective | July 30, 1965 |
Citations | |
Public law | 89-97 |
Statutes at Large | 79 Stat. 286 |
Codification | |
Acts amended | Social Security Act |
Legislative history | |
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The Social Security Amendments of 1965,
History
In 1912,
The concept of national health insurance began in the early 20th century in the United States and then came to prominence during the Truman administration following World War II. Between 1958 and 1964, controversy grew and a bill was drafted. The signing of the act, as part of Johnson's Great Society, began an era with a greater emphasis on public health issues. Medicare and Medicaid became the country's first public health insurance programs. The legislation was vigorously opposed by the American Medical Association until it had been enacted, but the AMA obtained concessions and later co-operated in its implementation.
Many politicians were involved in drafting the final bill that was introduced to the United States Congress in March 1965. On July 30, 1965 President Lyndon B. Johnson signed the bill into law.
Previous administrations
In 1935, when President
Once the targeted age was decided, a lengthy debate began over presenting a coherent medical care bill to Congress. The
In 1960, the Kerr–Mills Act created the Medical Assistance for the Aged (MAA), a program that gave states the power to decide which patients needed financial assistance. The federal government would provide matching funds to the states for the program. Some states did not participate in or abide by the Act.[2] Another preliminary bill, the King–Anderson Bill, was introduced in 1962. Under it, some hospital and nursing home costs for patients 65 and older would have been covered. Although the bill was defeated in committee, the vote was narrow (12–11), signaling a shift in attitudes.
Johnson administration
With the election of Lyndon B. Johnson in 1964, Democrats controlled both the presidency and the Congress, claiming a 2:1 ratio to Republicans in the House and 32 more seats in the Senate. The Democrats in the House Ways and Means Committee shifted away from Southern Democrats, making the committee more sympathetic towards health insurance reform.
Those who had worked on the King-Anderson Bill drafted a new bill providing coverage of the aged, limited hospitalization and nursing home insurance benefits, and
House of Representatives
The groups previously opposed to the legislation switched their focus from opposing the bill to creating new versions of it. As a result, three forms of the bill emerged: John Byrnes's, the American Medical Association's, and the administration's bill (known as Medicare). Byrnes was a Republican committee member who proposed for doctors' services and drugs to be financed; participation in coverage would be voluntary for the aged. An elderly patient who needed the help would have financing "scaled to the amounts of the participant's Social Security cash benefits," and the financing would come from the government's revenues. The AMA proposed Eldercare, which provided government financing for physician's services, surgical charges, drugs, nursing home costs, X-ray and lab services. When brought back to the Ways and Means committee, three bills were presented: Byrnes's, Eldercare, and Medicare.
When deliberations began in 1965, both AMA members and their suggestions were rejected. Wilbur Mills, the chair of the Ways and Means committee, suggested combining Byrnes's ideas and Medicare. His committee took on the task of drafting H.R. 6675, the bill that ultimately became law. In combining the two bills, Byrnes's suggestion, which included lower taxes, had to be altered as higher taxes were necessary for the program's predicted costs. The Ways and Means Committee reported favorably on the new bill to the full House of Representatives on March 29 after a straight-party committee vote of 17 to 8.[4]
During debate on the House floor, Republicans offered a substitute bill that would have made participation fully voluntary. It was narrowly defeated 236 to 191, with 128 of 138 Republicans in favor of the substitute. H.R. 6675 was passed in the House on April 8, 1965, by a vote of 313 to 115.[4]
Senate
The biggest threat to the passage of H.R. 6675 in the Senate came from liberal Democrats who were eager to expand coverage of the bill. As amended and passed in the Senate on July 19 by a vote of 68 to 21, H.R. 6675 would have cost approximately $800 million more than the House bill.[4]
Final passage
The bill went to a
The legislation made two amendments to the Social Security Act of 1935. Title XVIII, which became known as Medicare, includes Part A, which provides hospital insurance for the aged, and Part B, which provides supplementary medical insurance. Title XIX, which became known as Medicaid, provides for the states to finance health care for individuals who were at or close to the public assistance level with federal matching funds.
On July 30, 1965, Johnson signed the bill, making it Public Law 89–97. The signing took place in Independence, Missouri and was attended by Truman. Johnson credited Truman with "planting the seeds of compassion and duty which have today flowered into care for the sick and serenity for the fearful." Implementation of the amendments required extensive data processing and the re-configuration of hospital policies nationwide.[6]
Effects
In the late 1960s and the early 1970s, the federal government doubled the number of physicians trained in the US from 8,000 to 16,000 a year. There was a hospital building boom that moved from inpatient wards to one- and two-patient hospital rooms.[7]
References
- ^ LaTour, K. (2013). Health Information Management: Concepts, Principles, and Practice (4th ed). AHIMA Press. Retrieved from "Bookshelf : Link to "Health Information Management: Concepts, Principles, and Practice"". Archived from the original on 2014-03-10. Retrieved 2013-09-13.
- ^ Marmor, T. R. (2000). The Politics of Medicare: Second Edition (Social Institutions and Social Change).
- ^ "companion bill or measure glossary term". www.senate.gov. Retrieved 2016-04-06.
- ^ a b c "Social Security Act Amendments · The Legislation". acsc.lib.udel.edu. Retrieved 2016-04-06.
- ^ "Social Security History". www.ssa.gov.
- ^ "Social Security Act Amendments (1965)". Our Documents. National Archives and Records Administration. Retrieved 6 April 2016.
- ^ Sternberg, Steve (2015-07-30). "In 1965, Experts Warned of Medicare-Induced Crisis". U.S. News.