The Impact of Social Welfare Programs on Politics in Columbia, Maryland

In 1965, the Johnson administration was interested in a program to counter the risks of heart disease, cancer, and stroke. This was similar to the concept of health insurance that had been popular during the progressive era, but it only covered medical costs and did not reach the entire working class. The Welfare Administration of the Department of Health, Education and Social Welfare shared Mills' interest in expanding the Kerr-Mills program. This was inspired by the British National Insurance Act of 1911, which was similar to existing programs in Germany, Austria, Hungary, Scandinavia, and Eastern Europe. Mills proposed a voluntary health insurance program that would cover both medical and hospital expenses.

It would be funded partly by the beneficiaries themselves and partly by general income. Since universal health care became an important social policy ideal in the 1920s, reformists have been interested in what Derickson (200) called the supply-side solution to the problem of access to health care. They wanted to make sure children receiving social assistance had access to health care. Although Medicare was guaranteed approval in late 1964 and 1965, legislation remained fluid and important issues related to consumer choice and the basic design of the program were constantly changing. This tension summarized some of the issues of the historic transformation of health insurance in the 20th century and of the political debate over Medicare in the 1960s. In order to benefit those living in states with low TANF cash benefits, a redesigned TANF program was created.

This would benefit approximately 5 million black children, 7 million Latino children, and 13 million white children living there. In 1934, Falk and a colleague traveled to Washington to advise on drafting what became Social Security legislation on the subject of health insurance. Despite this initial absence of political conflict in the Medicare and Medicaid programs, a tension eventually emerged. In early 1964, I wanted to create provisions that would make Kerr-Mills more acceptable to states and cover gaps in health coverage for people receiving social assistance. For the past 40 years and especially since the 1980s, Medicaid has expanded beyond its roots as a social assistance program to cover more people who need medical services. Falk and his colleagues continued to push for national health insurance in the Social Security Act of 1935 and other legislation such as Senator Robert Wagner's bill introduced in 1939. Faced with political difficulties and opposition from the medical profession, reformers studied this measure for two decades. It was tempting for Social Security Board to recommend Congress exclude states from any national health insurance program Congress might decide to create.

Douglas Bigby
Douglas Bigby

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