On July 30, 1965, President Lyndon B. Johnson signed the Medicare and Medicaid Act, also known as the Social Security Amendments of 1965, into law. It established Medicare, a health insurance program for the elderly and disabled funded through a payroll tax, and Medicaid, a health insurance program for people with limited income, particularly women and children, funded jointly by the federal and state governments (Medicaid is called MaineCare in our state). For 58 years, these programs have been protecting the health and well-being of thousands of Mainers, saving lives, preventing illness and improving the economic security of Maine families. As of 2023, approximately 340,000 Maine seniors are enrolled in Medicare and about 400,000 Maine residents are receiving Medicaid benefits. This means that about 50% of Maine people benefit from these two programs.
As the U.S. Centers for Disease Control and Prevention states: “Public health is the science of protecting and improving the health of people and their communities. Overall, public health is concerned with protecting the health of entire populations.” Access to health care is at the core of this definition and we can celebrate what Medicare and Medicaid have achieved as public health victories.
On this anniversary, it is important that we recognize the value of these public programs, which give life-saving services to so many vulnerable people. The benefits have been well documented for Medicaid. Research at the national level has shown that Medicaid expansion in states that chose to do that under the Affordable Care Act saved 19,000 lives, while the decision in other states to not expand led to 15,000 premature deaths (Center for Budget and Policy Priorities, November 2019; study based on 2014-2017 data). This data is compelling, and our governor made the prudent decision to expand MaineCare in 2019 because it improved access to health care in Maine for thousands and generated federal money to support increased access. Many lives were saved in our state, and our experience with the Medicaid expansion opportunity under the ACA is one demonstration of the pivotal nature of access to health care for the health of the entire community.
Unfortunately, though Maine has been a real leader in helping people to get access to health care, there are still too many of our neighbors who have no access or very limited access. Too many people are dying, becoming disabled or being driven into bankruptcy because of our failure as a nation to have a health care system that is accessible to all. In addition, physicians are struggling with the many inefficiencies that characterize the administration of our current health care system.
Despite the benefits afforded by Medicare and Medicaid, we still have work to do to improve our overall health as a nation, including improvements in life expectancy, preventable hospitalizations, infant mortality and reducing costs. The Maine Medical Association Annual Session in September will focus on opportunities to change the health care system to serve all people in a way that will make us proud. We also expect to release at that time our revised policy statement on the need for health care reform as well as our expectations of how our health care system should support patients and clinicians alike. We must do more, and we believe doing more is both possible and essential.
Finally, Medicare and Medicaid are not perfect programs – they both have flaws that are deeply frustrating for patients and clinicians alike. But the MMA feels strongly that the focus should be on fixing the flaws while preserving these life-saving programs that have done so much for so many. We celebrate their creation on July 30.
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