Happy Birthday, Medicaid and Medicare! Today is the 50th anniversary of the signing of Social Security Act of 1965 which created both programs. Massachusetts has had a particularly important role in influencing the evolution of Medicaid at the federal level and among the states. In honor of the day, the Blue Cross Blue Shield Foundation created a spectacular interactive timeline to showcase major milestones in Medicaid history in Massachusetts . Notably, many of the expansions and innovations of the past 30 years are the result of the advocacy legacy of HCFA.
Under Governor John Volpe and Lieutenant Governor Elliot Richardson, Massachusetts became the 23rd state to implement Medicaid in 1966, originally covering about 380,000 adults and children. In 1972, Massachusetts became one of 35 states to make all Supplemental Security Income (SSI) recipients eligible for Medicaid. In the 1980’s, Massachusetts Medicaid expanded to cover many services and groups including:
- medically necessary abortion services
- home and community-based long-term services and supports to residents who would otherwise require institutional care
- coverage at the maximum income level allowed under federal law for older people and people with disabilities with incomes up to the federal poverty level
- pregnant women and children under age 8 with income below 185 percent of the federal poverty level
The timeline also highlights Chapter 203 of 1996, which expanded Medicaid to serve all children under age 19 with family incomes below 133 percent of the federal poverty level and to cover children under 12 with family incomes up to 200 percent of the federal poverty level. Our leadership led directly to Senator Kennedy conceiving of and pushing the federal CHIP program, which now covers almost 6 million kids nationally. Chapter 203 also authorized coverage expansions for adults who were not parents, and officially renamed the Massachusetts Medicaid program to MassHealth. In the 2000s, new programs for seniors ("Senior Care Options") and people with disabilities took off, and then Chapter 58 in 2006 further expanded coverage and restored benefits which had been cut. HCFA was involved in all of these policy initiatives.
Of course, our pioneering 2006 innovations combined with the earlier expansions provided the test bed for the ACA.
The most recent entries in the timeline showcase the 2013 launch of One Care, which combines Medicaid and Medicare benefits and financing for disabled adults who are eligible for both programs. Additionally, but not the least important, Massachusetts implemented the Affordable Care Act in 2014 which includes the creation of MassHealth CarePlus for newly eligible adults with incomes below 133 percent of the federal poverty level. Today MassHealth covers around 1.8 million Bay Staters.
Many challenges remain. But we'd urge everyone to reflect on the inspiring history of Medicaid in Massachusetts, which can be explored on the very cool timeline on the Blue Cross Foundation website: bluecrossmafoundation.org/publications/ma-medicaid-50th.