Sixty-one years ago today, President Lyndon Johnson signed Medicare and Medicaid into law as an amendment to the Social Security Act.

Two years ago, President Trump promised that he would “never let anyone touch your Medicare.”

Yesterday, this Administration announced dramatic cuts to Medicare, spiking prescription drug costs for up to 25 million seniors.

That’s some lousy anniversary present!

Not to mention a horrific betrayal.

The road to get these public health insurance laws on the books was a long and rocky one, but it is one of America’s crowning achievements.

On July 30, 1965, President Lyndon Johnson traveled to the Truman Library in Independence, Missouri, to sign Medicare into law.

The location was very deliberate. It drew attention to the 20 years it had taken Congress to enact government health insurance for senior citizens after Harry Truman had proposed it.

As it had been for decades, it was a tough fight down to the wire. A look back is instructive, not only to show how long it can take to move a legislative dream to reality but also to illustrate how a president with a grasp of history and knowledge of how government works is crucial to making success possible.

In 1935, when President Franklin Roosevelt first tried and failed to get health insurance included as part of Social Security, Republicans, conservative Democrats, and the American Medical Association (AMA) were winning their fight to sink President Roosevelt’s proposal for health insurance. Congress was intimidated, and in August 1935, FDR gave up, signing the Social Security Act without health coverage.

Eight years later, in the midst of World War II, he once again called for social insurance “that will extend from the cradle to the grave.” And again, his proposal went nowhere.

On FDR’s death, Harry Truman became president. In his 1948 Message to Congress on the State of the Union, he said:

“Healthy citizens constitute our greatest national resource. In time of peace, as in time of war, our ultimate strength stems from the vigor of our people. ”

“This great nation cannot afford to allow its citizens to suffer needlessly from the lack of proper medical care. Our ultimate aim must be a comprehensive insurance system to protect all our people equally against insecurity and ill health.”

Congress still refused to budge.

Running for election in his own right that year, and trailing behind in the polls, Truman won an upset victory after demanding that healthcare insurance and civil rights be included in the Democratic Party platform.

That same year, Congressman Lyndon Johnson of Texas, whose home district was Democratic and liberal in a state turning increasingly Republican and conservative, was running for election to the US Senate.

He opposed Truman’s health care plan as socialistic and was elected. Socialized medicine or anything that even looked or smelled like socialized medicine gave members of Congress a chill.

I Like Ike. I Don’t Like Socialized Medicine

During Dwight Eisenhower’s presidency, Congress enacted the Kerr-Mills bill for cases of “medical indigency” to cover elderly individuals who needed help with their medical bills but who failed to qualify for welfare in their states. But reformers regarded Kerr-Mills as inadequate, given the rising number of elderly and the rising cost of hospital care.

It went nowhere.

Medicare Stalls Again

In 1961 President John F. Kennedy made Medicare a legislative priority and chose Clinton Anderson of New Mexico to manage his bill.

Though public opinion polls suggested strong support for the bill, Anderson faced powerful opponents, including the House Ways and Means chairman, the American Medical Association, and Senate Finance Committee chairman Harry Byrd of Virginia. The bill’s opponents prevailed, narrowly defeating the bill in 1962.

Again

It was reintroduced in 1963, and following Kennedy’s assassination, Anderson worked painstakingly to build solid, bipartisan Senate support.

Lyndon Johnson’s big win in the 1964 presidential contest increased support for these programs. Johnson coaxed, cajoled, badgered, buttonholed, and maneuvered Congress into enacting Medicare for the aging and Medicaid to help low-income people.

Finally, 62 years ago, on the morning of July 30, 1965. President Johnson loaded up two planeloads of dignitaries and headed toward Independence, Missouri, the hometown of former President Harry Truman.

He intended to sign the bill at the side of the man whose original proposal LBJ had dismissed as socialism. Now he revered Truman as “the real daddy of Medicare.”

At the bill-signing ceremony, President Johnson enrolled President Truman as the first Medicare beneficiary and presented him with the first Medicare card. This is President Truman’s application for the optional Part B medical care coverage, which President Johnson signed as a witness.

After signing the bill, Lyndon Johnson turned to Harry Truman and signed him up as Medicare’s first beneficiary. It was high drama, touched with history, politics, sentimentality, showmanship, and compromise.