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The First 30 Years of Medicare and Medicaid

Nancy De Lew, MA, MAPA
JAMA. 1995;274(3):262-267. doi:10.1001/jama.1995.03530030082040.
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Medicare is a uniform national health insurance program for the aged and certain disabled persons. Medicaid is administered by the states within broad federal guidelines and finances health services for certain low-income groups.

Trends in Enrollment, Spending, Health Status, and Managed Care 

Enrollment.  —The enactment of Medicare and Medicaid in 1965 provided health insurance coverage to millions of Americans. Medicare enrolled 19 million elderly in 1966. Medicaid was phased in by states, except Arizona, and by 1972 enrolled 18 million poor elderly, disabled, and families with dependent children. In 1972, Medicare was amended to include persons younger than 65 years with disabilities who were receiving Social Security disability benefits for 24 months or persons with end-stage renal disease (ESRD), nearly 2 million people.1Since the mid 1980s, Medicaid eligibility has been significantly expanded: enrollment increased 50% from 22 million in 1985 to 33 million in 1993. In recent years,


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