The Centers for Medicare and Medicaid Services estimate that before Medicare, about ½ of people aged 65+ did not have hospital insurance. Plus, it is estimated that 1 of 4 older individuals would go without medical care entirely due to budget restrictions. Medicare history and milestones have changed the way beneficiaries receive healthcare.
National health coverage wasn’t even discussed before President Roosevelt in 1912. He ran on a platform that included providing health coverage to anyone who needed it. Flash forward to 1945 when President Truman took office. Within seven months, he called for a national health fund that would be available to all Americans. Truman fought hard, but it took over twenty more years until anything went into effect.
1960’s: President Lyndon B Johnson’s first legislative speech discussed hospital and medical insurance for older individuals and children in need. Shortly after, in 1965, the Senate and House of Representatives passed the Social Security Amendments of 1965 (H.R. 6675) and was later signed into law by President Johnson. Medicare coverage went into effect in 1966.
1970’s: The Social Security Amendment of 1972 was signed by President Nixon. This extended Medicare eligibility to those under 65 with long-term disabilities. These amendments established Professional Standards Review Organizations (PSROs), encouraged enrollment in a health maintenance organization (HMO), and gave Medicare the authority to conduct demonstration programs. Additionally, the benefits provided by Medicare were extended and included chiropractors, speech therapy, and physical therapy.
1980’s: In 1980, President Carter signed the Social Security Disability Act of 1980 into law. This created what we know today as “Medigap.” Additionally, President Carter signed into law the Omnibus Reconciliation Act of 1980 which eliminated the number of home health visits, the prior hospitalization requirement to obtain home health, and Part B benefits deductible.
1990’s: The Omnibus Budget Reconciliation Act (OBRA) of 1990 created a Specified Low-Income Medicare Beneficiary eligibility group. This required the state Medicaid programs to cover premiums for beneficiaries with incomes between 100% and 120% of the federal poverty level. Additionally, Medicare benefits were extended and started covering mammograms and services in mental health centers. In 1993, President Clinton signed the Omnibus Budget Reconciliation Act (OBRA) of 1993 which modified payments to Medicare providers as part of a deficit reduction focus. It also lifted the caps on wages subject to Medicare Part A payroll tax. Plus, in order to help prevent Medicare fraud, waste, abuse, the Medicare Integrity Program was created through the Health Insurance Portability and Accountability Act (HIPAA) of 1996.
2000’s: On June 14, 2001, HCFA was renamed to the “Centers for Medicare and Medicaid Services (CMS)” by Tommy Thompson, Secretary of Health and Human Services. In 2003, the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 was signed by President George W. Bush. This created a prescription drug benefit, Part D, starting in 2006. Additionally, MMA established a new Part B premium for Medicare-eligible beneficiaries and created what we know as “Medicare Advantage.”
2010’s: The Affordable Care Act gradually started to close the “donut hole.” It also created a new income-based Part D (drug coverage) premium. As of 2015, Medicare continues to play a vital role in America’s health. Over 54 million beneficiaries are accounted for, reaching close to 20% of national health spending.
Medicare will continue to evolve – the rise in popularity for Medicare Advantage plans is a perfect example. Seniors are trusting you to provide them with the best coverage possible. At Senior Market Advisors, we give you the tools to do just that! Ready to contract? Visit agentcontract.com to start digitally contracting, or click here to get in touch with one of our agent advisors.