How Gore and LBJ Won the War for Medicare

Written by Sarah Calise, Archivist

In my previous post, “Gore: Patients, Not Politics,” I outlined how Representative Albert Gore supported President Harry Truman’s five point proposal for a national health insurance program. Although their efforts failed, Gore continued the fight for health care for the poor and elderly as he entered the Senate in 1953.

Gore and Johnson 1965

Sen. Gore shaking hands with President Johnson on July 30, 1965 after the Social Security Amendments were signed at the Truman Library. Johnson is handing over a ceremonial pen. From the Albert Gore Papers Photograph Collection.

The battle for the passage of Medicare and Medicaid culminated in the 1960s, under President Lyndon B. Johnson. Gore and Johnson had a “complex relationship” in which they would “cooperate on issues such as Medicare, voting rights, and economic development,” but just as easily “clash over taxes, interest rates, and Vietnam.”[1] Gore and Johnson’s collaboration ultimately succeeded in 1965, but how did they get there?

On May 20, 1962, President John F. Kennedy addressed a large crowd at Madison Square Garden where he asserted his support for a medical care program for the elderly. You can watch the speech here, or read the transcript here. In the months before this speech, the Ways and Means Committee conducted hearings on the King-Anderson bill (S. 909 and H.R. 4222), a hospital insurance bill, but did not take any further action on it. Kennedy pushed for the passage of this legislation. In response to the opposition’s argument that national health insurance programs overstepped government boundaries, Kennedy said:

“This bill serves the public interest. It involves the Government because it involves the public welfare. The Constitution of the United States did not make the President or the Congress powerless. It gave them definite responsibilities to advance the general welfare–and that is what we’re attempting to do.”

Opponents, led by the American Medical Association (AMA), believed that such national programs made Americans too dependent and weakened an individual’s self-reliance. Kennedy countered that nothing sapped self-reliance like being “sick, alone, broke.” In the next few months, two more pieces of legislation entered the scene. Neither had enough support, and Kennedy’s assassination brought everything to a halt.

Senator Gore received hundreds of letters, telegrams, and pamphlets opposing the King-Anderson bill, while a small portion supported it. Below are a few examples of responses Gore received (Click the images to view larger):

Many constituents who urged Gore to vote no on the bill called it socialist. These responses were not unique. Opponents to national health care programs used anti-socialist rhetoric since President Franklin D. Roosevelt attempted his own initiatives in the 1930s. Additionally, some Tennesseans wrote Gore believing his support for such health care programs went against his “normal political philosophy.” This was not true. As explained in my previous blog post, Gore often fought for national health care measures that would help the poor, rural, and elderly receive adequate medical services. As many Tennesseans moved toward conservatism and the Republican Party, Gore increasingly supported key liberal efforts, such as Medicare and many of Johnson’s “Great Society” programs.

On February 10, 1964, President Johnson sent a special message to Congress on the nation’s health. He reiterated the messages of Kennedy and other presidents before him when he said, “In America, there is no need and no room for second-class health services.” Despite this speech, things got heated between Gore and Johnson at the Democratic National Convention (DNC) in Atlantic City in August.

1964 dnc.png

1964 Democratic National Convention. Courtesy of the Library of Congress.

In the summer of 1964, Medicare turned into a “severe political liability,” according to Gore.[2] In July, the House passed H.R. 11865. The bill would raise Social Security’s monthly cash benefits, but Gore did not think this plan was viable. This was the bill that the American Medical Association (AMA) and its conservative allies successfully pushed for instead of a national health care program for the elderly. Gore noted that Johnson was “strangely silent” on Medicare, and confronted his vice presidential candidate, Hubert Humphrey, at the convention. In Gore’s own recounting of events, he called the Democratic platform a “piece of namby-pamby” that made the convention look more like a meeting of the AMA.[3] Following this conversation, the updated Democratic platform had a much stronger statement on Medicare to the satisfaction of Gore.

In early September, in a telephone conversation between the two, Gore once again questioned Johnson’s support for Medicare. Specifically, they discussed Gore’s Medicare amendment added to H.R. 11865, which was under review in the Senate. In the telephone call, which you can listen to here, Johnson reassured Gore that he had his support and spent several minutes giving advice on how best to go about getting the amendment passed. Ultimately, however, H.R. 11865 died due to a deadlock in the House-Senate Conference Committee.

After another failed attempt at passing Medicare, Gore felt the political effects. He had little backing in the South among his colleagues and constituents. Yet, he carried on with Medicare as one of its only Southern proponents because “the people of no other region needed Medicare quite so badly.”[4]   In his weekly column from January 11, 1965, Gore presented his intentions to push for the health care measure in light of recent momentum. See below for his draft of the column:

Gore Medicare 1965098

In July 1965, the House-Senate Conference Committee reconciled the differences between their respective versions of H.R. 6675, or the Mills bill. In his column, Gore hoped “the President will be able to sign this measure into law before the end of the month.” And he did. President Johnson signed the Social Security Amendments, which included Medicare and Medicaid, on July 30, 1965.

34897-22_med_525px

Johnson signs the Social Security Amendments of 1965 with Harry S. Truman sitting to his left. Courtesy of the LBJ Presidential Library.

Johnson and Gore flew out to Independence, Missouri to sign the bill in the presence of Harry S. Truman, who began the battle for national health insurance programs decades before and inspired congressmen like Gore to continue the fight until he succeeded. Gore said he “was so pleased and honored to be asked to accompany President Johnson and to participate in this historic ceremony.”

Both Johnson and Gore returned to Washington at each other’s throats over Vietnam. Although their relationship was turbulent and deteriorated into the late 1960s, they both greatly aided the enactment of one of the most significant pieces of legislation in United States history. Against the wishes of many of his constituents and Southern colleagues, Gore persistently advocated for accessible, federal health care programs for elderly and poor Americans throughout his time in Congress–even when he knew it might (and it most likely did) result in him losing his Senate seat.

For another timely article with a great perspective, see: “The Fight for Health Care Has Always Been About Civil Rights,” by Vann R. Newkirk II.


Works Cited

[1] Kyle Longley, Senator Albert Gore, Sr.: Tennessee Maverick (Baton Rouge: Louisiana State University Press, 2004), 182.
[2]  Albert Gore, Let the Glory Out: My South and its Politics (New York: Viking Press, 1972), 177.
[3] Ibid., 179.
[4] Ibid., 180.

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