- 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.
- 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.
- 2010: President Barack Obama on March 23, 2010 signed the Patient Protection and Affordable Care Act into law. Along with the Health Care and Education Reconciliation Act, “Obamacare” represents the most significant government expansion and regulatory overhaul of the U.S. healthcare system since 1965 with the passage of Medicare and Medicaid.
Some of the new medical benefits now available to not only Medicare and Medicare recipients, but also to other Americans in the Patient Protection and Affordable Care Act usually referred to as President Obama’s health care reform bill include:
-Providing access to insurance, as well as other new coverage options for uninsured Americans with pre-existing conditions. Fortunately such a seemingly simple benefit such as buying human hair wigs for medical purposes will now be available for cancer patients undergoing chemotherapy or who have other medical conditions causing the loss of hair with this important provision.
– Extending coverage for young adults who can stay on their parents’ plan until 26 years old. Many young people who were formally uninsured will benefit.
– Preserving employer coverage for early retirees before they are eligible for Medicare,
until more affordable coverage is available through the new Exchanges by 2014.
– States will receive federal matching funds for covering some additional low-income individuals and families under Medicaid.
– Providing increased payment to rural health care providers to help them continue to serve their communities.
- 2011: Additional benefits from the Patient Protection and Affordable Care Act that directly impacted Medicare and Medicaid were initiated in this year including:
-Providing certain free preventive services, such as annual wellness visits and personalized prevention plans for seniors on Medicare.
-Offering prescription drug discounts to seniors who reach the coverage gap. They will receive a 50% discount when buying Medicare Part D covered brand-name prescription drugs.
– The establishment of new Center for Medicare & Medicaid Innovation that will test new ways of delivering care to patients to improve the quality of care, and reduce the rate of growth in health care costs for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP).
– The establishment of the Community Care Transitions Program thta helps high risk Medicare beneficiaries avoid unnecessary readmissions after a hospitalization.
- 2012: The United States Supreme Court’s decision in the case of the National Federation of Independent Business v. Sebelius upheld the constitutionality of most of the Patient Protection and Affordable Care Act.
- 2013: A Health Insurance Marketplace with open enrollment starting in the fall will be implemented so that small businesses and individuals can buy affordable and qualified health benefit plans in a supposedly more transparent and competitive insurance marketplace. There are some exceptions for some kinds of businesses. For example, businesses that require certain kinds of specialized licensing may have restrictions. Websites that offer games of chance like online slots US players can access & play – even if they are legally able to offer games to US players need to check with their secretary of state and possibly get clearance from the Federal Health & Human Services office. There may be significant tax penalties for non-compliance.
- 2014: Tax credits will become available to help the middle class families, who are not eligible for other affordable coverage, afford medical insurance. Income must be between 100% and 400% of the poverty line.