More than 50 years ago, on July 30, 1965, President Lyndon Johnson signed Medicare into law, saying at the time, “I’ll spend the goddamn money,” he said. “I may cut back on tanks – but not on health.”
The story behind Medicare’s birth in Independence, Missouri, detailed here, reveals that LBJ called former President Harry Truman “The real daddy of Medicare.” (LBJ signed Medicare into law in Independence specifically to honor Truman’s effort to create national health insurance.) Truman became the first Medicare enrollee and Truman’s wife Bess got America’s second Medicare card – at the time, the monthly Part B premium was $3.
Quick facts about Medicare then…
- More than 50 percent of seniors had no health insurance prior to the establishment of Medicare, and 35 percent lived in poverty, according to the Center for Medicare Advocacy.
- Instant success Medicare went into effect in 1966, and more than 19 million people enrolled during its first year, increasing seniors’ access to physician and hospital care by a third.
- A model for universal healthcare Medicare was initially conceived as a stepping stone to universal national healthcare. The Vietnam War put an end to that idea by syphoning off federal funds such an initiative would have required.
- A catalyst for desegregation Medicare law required hospitals who wanted to accept Medicare patients to desegregate. More than one thousand integrated during the first four months.
- A plus for longevity According to the New York Times, in the 30 years between 1970 and 2010, life expectancy at age 65 went up by five years, even though coverage was even more restricted than it is now. Analysts attribute the increase in part to Medicare enabling people to get early treatment.
- A boon for all. Ever been treated in the ER even though you lacked insurance? A 1985 ruling required emergency rooms at any hospital participating in Medicare to provide basic treatment to everyone, insured or not.
- Growing, growing…What started as barebones insurance has grown into a robust program of coverage for seniors, with benefits added over the years: long-term disability insurance (1972), home health coverage (1980), hospice coverage (1982), prescription drug coverage (2006 – but initially only for those with private Medicare plans), expanded free wellness checkups and tests (2010, with the Affordable Care Act) and an end to the denial of coverage of skilled care for chronic diseases like Alzheimer’s based on a patient not improving (2012) and most recently, permanent repeal of Medicare’s annual physical therapy caps (2018).
- Grown More than 46 million seniors are now covered by Medicare – that’s almost every American senior. Another 9 million disabled are also covered by Medicare.
- Ratings Having recently introduced nursing home ratings, the Centers for Medicare and Medicaid is paying attention to the growing numbers of seniors who want to age in place and introduced a five-star ratings system for home health care on Medicare.gov. The ratings are based on patient surveys and let you search by zip or name.
- Some things still not covered While Medicare made great strides with adding Part D in 2006, most beneficiaries scratch their heads over why it doesn’t cover certain benefits that they are used to having covered while they were still in the workforce. Medicare still doesn’t cover hearing aids, dental care, vision care or long-term care. Millions of beneficiaries would love to see these benefits added to Medicare.
Medicare in its 54th year – what’s on the horizon?
- New Medicare cards with encrypted Member ID numbers – Medicare is rolling out new ID cards for all beneficiaries. It will take a full 12 months for everyone to receive their new card as the cards will roll out in stages across the nation. However, your Social Security number will no longer appear on your Medicare card, which will help to protect our nation’s seniors from ID theft.
- Part D Coverage Gap Closing in 2019 The recent budget deal effectively put an end to higher costs for brand-name drugs in the gaps. This was accomplished a year ahead of schedule by increasing the discount provided by manufacturers of brand name drugs in the gap from 50% to 70% beginning next year and reducing the percentage that beneficiaries pay for brand name medications in the gap from 30% to 25%.
- Medicare Plan F to Be Discontinued in 2020 – There are 10 standardized Medicare supplements and for decades the Plan F policy has been a top seller because it covers all of your Medicare Part A and B deductibles, copays and coinsurance. However, this plan will no longer be available to new enrollees beginning in 2020. Congressional leaders felt that “first dollar coverage” plans may encourage people to visit the doctor more often because they have no skin in the game. People already enrolled in Plan F will be grandfathered though.
- New benefits for Medicare Advantage plans. As of February 2018, 21 million seniors are enrolled in Medicare Advantage plans. (Here are some fast facts.) CMS will now allow “non-skilled home support” as a benefit. Non-medical services could include things like rides to the doctor, portable wheelchair ramps and other assistive devices. This measure, coupled with a 3.4% projected average increase in payments to MA plans, will likely make these plans more popular.
- Wealthier seniors will pay even more for Medicare The Bipartisan Budget Act will further increase Part B and D premiums for individuals earning over $500,000 (individual) or $750,000 (married). This will be equal to 85% of program costs (as opposed to 80%) in 2018.
- Will the Medicare eligibility age be raised? We have heard less about this but it still could happen. The Washington Post reported that Medicare’s hospital trust fund will run out of money in 2029. However, others (thankfully) disagree.
Happy birthday to Medicare!
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