A Brief History of Medicare Politics

a brief history of medicare politics over wood grain with image of capitol building

As of January 2018, there are 58.5 million people enrolled in Medicare which accounts for twenty percent of all healthcare spending. But how did this massive healthcare program start? Medicare was signed into law by Lyndon B. Johnson in 1965, but the fight for senior healthcare started almost a century ago.

The beginning

When Franklin D. Roosevelt passed the Social Security Act of 1935, he briefly considered including healthcare in the bill but elected not to because he deemed it too controversial and feared it would tank the bill. Harry Truman proposed universal healthcare in 1945 and again 1949, but the American Medical Association (AMA) lobbied hard against the movement, deeming universal healthcare “socialized medicine” that would remove the entrepreneurial spirit from American healthcare. They also feared universal healthcare would sever the intimate relationship between patient and doctor and put the government squarely in the middle of medicine.


One of Medicare’s most staunch opponents was an Arkansas Democratic House Representative, Wilbur Mills. Once deemed the “most powerful man in Washington,” Mills used his leverage as member of the influential House Ways and Means Committee to oppose the bill. Mills opposed the bill because he feared the cost would fall on the shoulders of working Americans and potentially draw money away from Social Security. Congress passed the Medical Assistance for the Aged Act (known as the Kerr-Mills Act) in 1960, but only 28 states adopted it as it was a voluntary measure.

Operation Coffeecup

When John F. Kennedy launched his presidential campaign against Richard Nixon in 1960 on a platform of civil rights and healthcare for seniors and low-income individuals, the AMA launched their own campaign along with the private insurance lobby. The AMA lobbied hard and hired then-movie star Ronald Reagan to record a long-playing record titled “Ronald Reagan Speaks Out Against Socialized Medicine” and distributed it to the wives of doctors (ladies’ auxiliary) across the country. The ladies’ auxiliary clubs were encouraged to have meetings with their friends over coffee, play Reagan’s record, and write to their Senators and Congressmen to speak out against senior healthcare. The campaign was called Operation Coffeecup. This is considered the first viral marketing campaign and Reagan’s first venture into politics.

Passing the bill

Kennedy was unable to pass a Medicare bill before he was assassinated in 1963, but Lyndon B. Johnson made it his personal mission to pass the bill once he took over the Oval Office. Because the AMA’s campaign against Medicare worked so well, senior healthcare became entangled with the Cold War and Communist influence in America. In order to pass the bill, Johnson attached it to the Social Security Act Amendments of 1965 and signed it into law on July 30th, 1965 after 20 years of political debate. Johnson called the bill provision “the most revolutionary and most beneficial measure for older Americans since we passed Social Security itself back in 1935.”

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