Rep. Wilbur Mills (D-Ark.), chairman of the House Ways & Means Committee, led the complex political efforts to craft the Medicare and Medicaid compromise legislation in 1965, after opposing national health insurance for years.
In the early 1960s, Ronald Reagan, then a private citizen, was a prominent AMA spokesman opposing a national health program for seniors. Later, as president, Reagan signed legislation creating a new Medicare prospective payment system based on DRGs, which established set medical prices for the first time.
Joseph Califano Jr., helped launch Medicare and Medicaid as President Johnson's chief domestic policy aide from 1965 to 1969; later, as Health, Education and Welfare secretary under President Jimmy Carter, he consolidated oversight of the two programs under the new Health Care Financing Administration (which became the CMS in 2001).
Rep. John Byrnes (R-Wis.) in 1965 drafted an alternative to Johnson's Medicare bill to make coverage for physician services voluntary; it was incorporated into the final legislation as Medicare Part B.
William Hsiao of Harvard University published studies of resource-based relative values for medical services that were used in developing Medicare's DRG-based prospective payment system implemented in 1983.
In 1985, members of congress held a 20th anniversary party for Medicare and Medicaid. Sen. Ted Kennedy (D-Mass.), far right, and Sen. Orrin Hatch (R-Utah) spearheaded creation of the Children's Health Insurance Program, which built on Medicaid to expand children's coverage, in 1997.
Bruce Vladeck, HCFA administrator from 1993 to 1997, oversaw the introduction of Medicaid's Section 1115 waiver program, expansion of the prospective payment system, and early experimentation with Medicare HMOs.
President Barack Obama advocated for and signed the Affordable Care Act in 2010, which expanded Medicare benefits; extended Medicaid to low-income adults; cut Medicare spending; and established the CMS Innovation Center to test reforms to improve quality and reduce costs.
Kathleen Sebelius, HHS secretary from 2009 to 2014, and Marilyn Tavenner, CMS administrator from 2011 to 2015, supervised implementation and administration of the ACA's Medicare and Medicaid benefit expansions and changes.