Did You Know? – Medicare and Medicaid were initially managed by separate agencies

It may be hard to believe, but Medicare and Medicaid are already 60 years old! Initially, these programs were managed by different agencies. Medicare was established through the Social Security Amendments of 1965, which President Lyndon B. Johnson signed into law. The Social Security Administration (SSA) managed the program, along with overseeing the Social Security program itself.

Conversely, Medicaid was also a product of the same legislation but was administered by a different agency—the Department of Health, Education, and Welfare (HEW). At that time, HEW was a cabinet-level department responsible for a wide array of health, education, and welfare initiatives.

The choice to manage Medicare and Medicaid separately was primarily influenced by political factors. Medicare was viewed as an extension of the existing Social Security program, making its administration by the SSA logical. In contrast, Medicaid was a new initiative designed to provide health coverage to low-income individuals and families, which aligned more closely with the mission of HEW.

Over the years, the administration of both Medicare and Medicaid has evolved. In 1977, HEW was divided into two distinct departments—the Department of Education and the Department of Health and Human Services (HHS). Today, the Centers for Medicare & Medicaid Services (CMS) administers Medicare, as well as Medicaid, which operates at the state level under federal guidelines. Some states even assign their own names to Medicaid; for instance, California refers to it as Medi-Cal.