Medicaid was enacted in 1965 under the Lyndon Johnson administration as a social insurance program to provide lower-income Americans with the health care they need. Since then it has been solidly supported by all subsequent administrations as a social contract within our society, as a matter of fairness and necessity. As poverty and inequality have increased in more recent years, it has become a mainstay assuring necessary medical care for some 74 million Americans, covering more than one in five Americans, almost one half of births, 39 percent of children, and about two-thirds of nursing home and long-term care, and more than one-quarter of mental health services. It has been described as “the backstop for America’s scattershot health care system.”
