On this day in 1965, President Lyndon Johnson signed Medicare and Medicaid into law – ensuring our nation’s seniors and most vulnerable citizens have access to affordable health care for the very first time.
Johnson appealed to an American tradition that, in his words, “calls upon us never to be indifferent toward despair… commands us never to turn away from helplessness… directs us never to ignore…those who suffer untended in a land that is bursting with abundance.”
Over the last 60 years, Medicare and Medicaid have become lifelines for the health and financial security of tens of millions of Americans. Before Medicare, roughly half of older Americans had no health insurance, and one-third of seniors lived in poverty. Today, nearly all older people have coverage and only 10 percent are below the poverty line.
Medicaid, funded jointly by the federal government and the states, is now the largest health insurance program in America, covering one out of five people and 40 percent of all children nationwide. Medicaid also pays for nearly two thirds of nursing home care and over 40 percent of all births nationwide. And thanks to the Affordable Care Act, Medicaid expansion helped millions of low-wage workers finally secure health coverage.
But despite all the progress we’ve made through Medicare and Medicare, Congress and the president have crashed the programs’ 60th anniversary party with a slash-and-burn budget that threatens to throw our entire health care system into chaos. Under the so-called “big beautiful bill” signed into law earlier this month, the wealthiest earners in our society rake in huge new tax breaks while Medicaid is slashed by $1 trillion -- yes that’s trillion with a “T.”
These cuts, combined with reduced subsidies for buying private health insurance, will leave over 15 million people uninsured in the coming years – that’s roughly the populations of New York City, Los Angeles and Chicago combined. The human cost will be staggering, as millions of lower-income workers are once again left one illness away from bankruptcy. And as emergency rooms are flooded by patients who cannot afford care, hospital revenues will plummet, facilities will close, and premiums for employer-sponsored coverage will surge.
This big ugly bill has big ugly consequences for Medicare, too. Thanks to lobbying by Big Pharma, Congress and the President exempted some prescription drugs from price negotiation, hiking the cost of lifesaving medicines for seniors. And because this billionaire tax cut bonanza explodes the deficit, the law will trigger an automatic $500 billion across the board cut to Medicare.
These cuts, especially to Medicaid, won't just hurt people who rely on its coverage. They will hurt all of us. Medicaid is an economic engine. It keeps nurses and care workers on the job and our hospitals, clinics, and nursing homes running strong. It fuels our fight against the opioid epidemic. It helps schools support youth mental health. And for workers who earn a living doing this work, these Medicaid cuts will be a job killer.
Tens of thousands of AFSCME members, including nurses and direct care workers, depend on Medicaid for their livelihoods. Medicaid also helps millions of people access mental and behavioral health services, a field where many AFSCME members work.
With Medicaid being the largest source of federal funding that goes to states, these cuts also mean fewer resources for states and communities to fund education, infrastructure, corrections, and all essential services. This means all 1.4 million AFSCME members – not just those working in health care – will likely face new attacks on their jobs and a much tougher time at the bargaining table in the years ahead.
Meanwhile, the billionaires and big corporations pocketing these tax breaks will have more resources than ever to push privatization schemes that rip off taxpayers and strip workers of their voice.
AFSCME members mobilized like never before to fight this bill. Through our Get Organized campaign, we flooded congressional phone lines, packed town halls, and brought working and retired members to Washington to speak truth to power.
Now that these cuts are law, our focus must shift from fighting this bill in Congress to fighting its impact in our communities. That means growing the worker power we need to defend our jobs, our freedoms, and the essential services we provide. We will engage our members, coworkers and retiree activists in this fight. And we will build the muscle we need to hold Congress accountable in 2026.
Medicare and Medicaid are lynchpins for America’s working class. We will not sit idle while this morally bankrupt budget jeopardizes these time-tested programs. We will fight back. We will get organized. And we will do everything in our power to make the next 60 years of Medicare and Medicaid as successful as the first.