I am very proud to say that I have been involved in health care law and policy for more than one-half of the lifetime of these important social programs. My first job out of college – right after the 15th anniversary of Medicare and Medicaid – was as a health care policy adviser to a member of Congress from Massachusetts.
Over that time, Medicare has grown from a little-understood health care program for the elderly to the second-largest health insurance program in the United States. It has expanded from a program that just covered individuals who are 65 years of age and older to one that now covers individuals with disabilities and individuals with chronic kidney failure. It provides health care security to society’s most vulnerable. From its very early days as a program that was modeled after the 1965 federal employee health insurance program, Medicare now covers outpatient prescription drugs; physician-administered drugs such as those used in cancer therapy; skilled nursing care; home health care; and many other benefits. Medicare beneficiaries can now choose to receive their care through private insurance plans known as “Medicare Advantage.” And, since the enactment of the Affordable Care Act in 2010, Medicare is experimenting with alternative payment models in an attempt to drive down health care costs.
Equally important is the Medicaid program, which many political observers viewed as merely an afterthought to Medicare when President Johnson signed both programs into law in July of 1965. But Medicaid has now evolved into the single largest health insurance program in the United States. Largely targeted to lower income Americans, it is now an integral part of the American social safety net.
One of the most rewarding parts of my job is working with a 50-year old statutory and regulatory framework and applying that framework to a 21st century health care system to find solutions for my clients. Foley Hoag’s health care team has, over the years, provided advice to our clients over virtually every single aspect of both programs. Health care changes very rapidly and we view it as our responsibility to stay on top of those changes to help our clients adapt for the challenges that they will face over the next 50 years.