Congressman Wilbur Mills of Searcy was one of the most prominent Arkansans in Congress for decades. He served from 1939 until 1977, and was a force to be reckoned with. One of his most important achievements was the passage of Medicare in 1965, which today provides healthcare for tens of millions of older Americans – an achievement that almost did not happen.
Prominent Americans had called for providing support for medical costs for decades. Former President Theodore Roosevelt made a national health care system an important part of his presidential campaign in 1912. In the 1930s, President Franklin D. Roosevelt considered such a system but could not find enough support for such a program. President Harry S. Truman twice initiated major campaigns for national health care in the 1940s.
Despite these failures, the federal government started subsidizing some limited medical care by 1950. Later in the decade, more studies emerged showing the need to help the neediest in society with high medical costs. The inability to afford care clearly cost lives and only increased costs in the long run. Several members of Congress came forward with different proposals, all of which failed to pass. In the meantime, Mills became chairman of the House Ways and Means Committee by 1958, where he commanded all the bills regarding taxation and federal spending. It was a position he held until 1974.
In 1960, then-Senator John F. Kennedy campaigned for an expanded health care system similar to the Medicare plan that emerged. Sen. Robert Kerr of Oklahoma teamed up with Mills that year to pass the Kerr-Mills Act, an early forerunner of Medicare. This bill partnered with the states to provide medical coverage to individuals aged 65 and over. However, the bill only helped the impoverished. States had to judge the assets of the elderly to see if they would qualify. By the end of 1961, the three states California, Massachusetts, and New York had most of the enrollees in the system and accounted for 90% of the program’s costs. In fact, by 1965, only 40 states participated in the Kerr-Mills program, with just 264,000 enrollees.
After Kennedy’s inauguration as president in 1961, he pressed Congress to pass a more thorough national medical plan for all Americans or at least a Medicare bill for the elderly. Mills did not think there was enough support for the bill and did not take up the bill in his committee. Even after Kennedy made a nationwide address calling for Medicare in 1962, Mills still declined.
Lyndon B. Johnson immediately took up Kennedy’s extensive domestic proposals after his assassination in 1963. Though Kennedy and Johnson did not always agree, the two had a grudging respect for one another, and Johnson believed in Kennedy’s goals. Johnson understood that Mills was the key to any Medicare bill passing. He pressed Mills to craft an efficient and reasonable program. In many of their conversations, Johnson often invoked Kennedy’s memory to push bills like Medicare forward.
In 1964, Johnson announced his unequivocal support for Medicare. “No longer will older Americans be denied the healing power of modern medicine,” Johnson declared. At Johnson’s urging, Mills began holding hearings on different Medicare proposals. Weeks of hearings ensued, with hundreds of witnesses coming forward and explaining in intricate detail the strengths and weaknesses of possible programs. Though support for medical care for the elderly was increasing, Mills and his counterparts in the Senate decided to hold off on voting until after the general election. With Johnson’s landslide victory in the presidential election that fall, along with increased majorities for Democrats in both houses of Congress, Mills saw the new political landscape and now threw his support into a comprehensive Medicare bill.
Once Congress came back into session in January 1965, Mills threw all his legislative skill into creating a bill that would pass. He worked carefully in committee to gain as much support as possible, gaining support from Democrats and reformist Republicans alike. Part A covered hospital services. Mills decided that more had to be covered as not all necessary medical care took place at hospitals and most specialists did not work for hospitals. As a result, Mills added Part B to the program to cover non-hospital care by doctors and technicians. A payroll tax financed it, similar to Social Security. He also inserted language that let doctors decide reasonable costs for services rather than government oversight boards. Mills carefully worked with the Senate on amendments to the bill, ensuring that any late additions would not derail their progress or sabotage the final product.
With the support of Mills, Medicare passed the House of Representatives by a margin of 313-115 on April 8. The bill passed the Senate by a similar lopsided margin.
Johnson signed Medicare into law on July 30, 1965, at the Truman Presidential Library in Independence, Missouri, with former President Truman and his wife, Bess, in attendance as the first recipients of Medicare. Mills was present at the signing ceremony. Today, the program provides health coverage for nearly 60 million Americans.