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The Social Security Amendments of 1960: Completing the Foundation for Medicare and Medicaid

JHHSA, Vol. 26 No. 4, (2004)

The expansion of social security coverage enabled northern, industrial
states to transfer a larger share of their Old Age Assistance (OAA)
clients to the Social Security (OASDI) rolls at an earlier date than was
possible in southern, agricultural states. Due to the differential rate of
transferring clients, northern states could achieve a larger financial
return from the establishment of Medicare while an increase in federal
medical reimbursement for public assistance clients was more bene-
ficial to southern jurisdictions. Although public opinion over-
whelmingly supported the former option, partisan presidential politics
and a split in the Democratic ranks enabled southern Democrats to
thwart the will of the people by enacting legislation that significantly
expanded federal contributions for the health care of indigent, elderly
citizens. The evidence, therefore, indicates that regional differences in
the share of elderly citizens receiving OASDI and OAA benefits contri-
buted to the suppression of Medicare amendments. It is also evident
that, in the absence of a presidential veto threat, southern opposition to
Social Security health insurance would have been muted and Congress
may gave enacted Medicare legislation in 1960 instead of 1965.

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