July 30, 1965, found President Johnson experiencing the heat of a Missouri summer. He had traveled from Washington to Independence to meet with Harry Truman at the Truman Library to honor the many years the former president had invested in bringing to fruition two landmark federal programs. He wanted President Truman on hand to witness the birth of Medicaid and Medicare.
I am not sure President Johnson would recognize today's Medicaid program in the seeds that he and President Truman planted that long ago summer day, but I know he would celebrate it. A federal-state partnership that provides quality, affordable health care to more than 60 million Americans each year, Medicaid is a force that keeps expecting mothers healthy, keeps ailing family members out of institutions, keeps chronic conditions under control, and ensures that children have the chance to grow up strong.
Just consider these facts:
- Medicaid covers 1 in 5 adults and, along with the companion Children's Health Insurance Program (CHIP), 1 in 3 children.
- Medicaid provides the funding for vital maternal and infant health services in 40% of all the births in the country.
- Medicaid is a long-term care program -- covering long-term home and community base care for 3.25 million people and 60 percent of those in nursing homes.
- The uninsurance rate of low-income children plummeted after Medicaid coverage was expanded through CHIP in the 1990s.
- Thanks to the expansion of Medicaid to low-income pregnant women, infant mortality rates fell by more than 8 percent and low birth weight by nearly as much.
This is all before one considers what we have learned through administration of Medicaid. Because systemic problems need systemic solutions, Medicaid has helped policy makers address pernicious issues in health care delivery, such as racial disparities in treatment, the costs of prescription drugs, the benefits of community-based care, and the need for early screenings and preventive treatment.
Medicaid has also given states the latitude to experiment for themselves with health care delivery systems and to tailor their programs to meet the needs of their residents. Like its sister program Medicare, Medicaid encourages states to develop innovative programs and to identify best practices.
With the passage of the Affordable Care Act, Medicaid now has the potential to reach uninsured adults making less than roughly $16,000 a year -- up to 17 million more than are currently eligible. This will not just result in healthier people living longer; studies show that people in poor health tend to earn less than their healthy peers and struggle more for academic success and attainment.
Medicaid Expansion will bring us closer to the vision that animated Presidents Roosevelt, Truman, Kennedy, and Johnson and all those who worked with them on the law's original passage. When he signed the law that created both the Medicaid and Medicare programs nearly 50 years ago, President Johnson spoke of a tradition that we share in this country:
"It calls upon us never to be indifferent toward despair. It commands us never to turn away from helplessness. It directs us never to ignore or to spurn those who suffer untended in a land that is bursting with abundance."
We can aspire for no more than to honor and uphold these traditions. The Medicaid program, in intent and action, continues to do just that.