Medicaid Timeline

  • 1935: President Roosevelt signs the original Social Security Act — one of the few still-active portions of the “New Deal”. Relief was provided to specific low-income recipients, though health care occupied very little of the focus.
  • 1965: Title XIX of the Social Security Act created the Medicaid and Medicare programs, part of President Johnson’s “Great Society” reform plan. Whereas Medicare primarily addressed the health care needs of seniors, Medicaid specifically focused on low-income needs.
  • 1982: Arizona becomes the 50th state to utilize Medicaid. At this point, Medicaid resources are mainly administered by state agencies under various names (Arizona’s is “AHCCCS”, California has “Medi-Cal”, Massachusetts has “MassHealth”, etc.).
  • 1990: the Omnibus Reconciliation Act (OBRA 90) added the Medicaid Drug Rebate Program to assist with the rising costs of outpatient drugs. Managed plans are not covered, as they affect only a small portion of the population as yet. Further refinement of the Drug Rebate Program would continue in OBRA 93.
  • 1990’s: Federal waivers were offered to states to subcontract to private health insurance companies (usually health maintenance organizations or HMOs). By 2007, about two-thirds of Medicaid recipients will be under some form of managed care. And right around this time, we also saw the very first no deposit bonus.
  • 1997: the Balanced Budget Act reduced Medicaid payments to providers; the 1999 Balanced Budget Refinement Act and the 2000 Budget Improvement and Protection Act restored some of these payments. SCHIP (State Children’s Health Insurance Program) was signed, often accompanying Medicaid to provide health services to a wider range of recipients under one bundled state agency.
  • 2001: 46 Million people enrolled in Medicaid
  • In 2005, the Deficit Reduction Act (DRA) significantly changed specific elements of the Medicare and Medicaid programs, largely (but not exclusively) reducing funds. States given generally far more leeway regarding enrollment requirements and plan details.
  • 2008: 49 Million people enrolled. In November, a Federal rule is passed allowing states to charge premiums and higher co-pays to Medicaid recipients.
  • 2009: Medicaid and Medicare take center stage in President Obama’s call for health care reform.