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Gainesville Florida Estate Planning & Elder Law Blog

Monday, July 4, 2016

Medicare Celebrates 50 Years

We hit a Medicare milestone last Friday, July 1, as the program hit 50. Medicare first started covering Americans who were 65 or over on July 1, 1966.

Just getting everyone enrolled in 1966 was a monumental task since half the people in that age group had no insurance at all. But since that time the program has been providing outstanding service for older Americans.

The Center for Medicare Advocacy recognized Medicare’s 50 years with a list of 10 great accomplishments – some well-known and others more obscure.

Starting with #10. In 1966, 19 million people ages 65 or older were enrolled in Medicare – just one year after the program was enacted in 1965. Consider what an accomplishment this was, especially in a world with no internet or social media.

9. In 1973, Medicare began covering people with disabilities – as a result, 2.2 million more people received coverage that year.

8. Medicare hospice coverage was added in 1982 – most people now get some hospice care before they die.

7. In 1980, Congress removed the prior hospital/nursing home stay requirement for Medicare home health coverage and repealed the 100-visit limit – making care at home more available for people with long-term and chronic conditions. To date, if coverage criteria are met, there is no duration of time limitation for Medicare home health coverage.

6. To keep up with increasing enrollment and benefits, Congress increased the Medicare payroll tax almost annually until 1991. Declared "off the table" since then, Medicare has struggled with ever-increasing enrollment and no matching source of increased revenue.

5. In 2006, Medicare prescription drug coverage began, but only available through private plans. While providing an important new benefit, this delivery model also created additional incentives for beneficiaries to join private "Medicare Advantage" plans.

4. The Affordable Care Act passed in 2010, significantly increasing Medicare preventive benefits, improving Part D prescription drug coverage and adding to Medicare's long-term solvency.

3. Medicare has enhanced social justice in America in ways that are often not recognized. For example, in order to receive Medicare payments when the program began in 1965, hospitals were required to desegregate, increasing civil rights, health equity and access to care, particularly in southern states.

In 1987, Congress passed the Nursing Home Reform Law, which amended Medicare (and Medicaid). Effective in 1990, the Reform Law mandated that all nursing home residents receive the care they need to attain and maintain their highest practical physical, mental, and psychological well-being. As a result, the quality of care and life, protections from involuntary transfers and discharges and other resident rights were advanced nationwide.

2.  The Jimmo v. Sebelius case was settled in January, 2013. Applicable nationally, the Settlement acknowledged that patients are not required to improve in order to obtain Medicare for skilled nursing and therapy. The Settlement required CMS to review and rewrite coverage policy and provide education explaining that Medicare can be available for skilled care to maintain one's condition or slow deterioration.

1. 50 years later, in 2016, almost 60 million Americans have access to health care as a result of Medicare!     

We need to help Medicare grow, with renewed revenue and updated benefits. Coverage should be added for oral health and dental care, audiology and hearing aids, vision care, and prescription drug coverage in the traditional Medicare program.

It's our turn to have the vision and fortitude Americans had in 1965 – to keep Medicare viable, accessible and relevant for generations to come.


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