It is means-tested, and while Medicare is administered by the federal government and so has uniform structure throughout the country, Medicaid is administered by the separate states, with resulting requirements and benefit levels varying significantly between states.Īfter Harry Truman failed to pass a universal health insurance scheme during his presidency, Medicare became a central goal of the Democratic party. Medicaid is health insurance for the poor. ![]() Medicare is health insurance for the elderly, a universal program for which all Americans become eligible when they reach retirement age. This is seen perhaps most clearly in differences between Medicare and Medicaid, in both how they are structured and are commonly understood. The US is unusual (perhaps unique) among wealthy democratic countries in having a two-tier public health insurance system. Both Medicare and Medicaid were enacted in the Medicare Act of 1965. Attempts to require welfare recipients to work draw on this reservoir of negative feeling, and more broadly on the notion of the “undeserving poor,” which can be traced back at least to the time of Justinian.īut perpetuation of these attitudes requires overlooking ways the not-poor are also supported by welfare programs. Decades of survey research have shown that Americans hold unusually negative attitudes towards “welfare,” generally viewing welfare recipients as slackers, who could find jobs if they really wanted to. ![]() These efforts mirror earlier attempts require work on the part of recipients of welfare (AFDC, Aid to Families with Dependent Children), which were eventually enacted in 1996 in the presidency of Bill Clinton. George Klosko deconstructs Medicare and Medicaid’s different histories and structures and misconceptions about the contributory nature of each.Īs Congress struggles to repeal and replace the Affordable Care Act, less attention is paid to efforts in several states to impose work requirements on Medicaid recipients. ![]() Medicare, health insurance for the elderly, a universal program for which all Americans become eligible when they reach retirement age and Medicaid, health insurance for the poor are two often conflated and misused concepts.
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