July 30 marks the 50th anniversary of Medicare and Medicaid, the two essential pillars of public health insurance in America. Medicare, for all of its shortcomings and enormous costs, has become politically unassailable—as dear to Tea Party Republicans as it is to single-payer Democrats. Medicaid has also steadily grown. Including the closely related Children’s Health Insurance Program, Medicaid now covers more than 70 million people. Yet it has never attained the same popularity or political security as Medicare or shed the stigma of “welfare medicine” that it acquired at its founding.
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