The Fight for Health Care Has Always Been About Civil Rights

In 1965, just a week before also passing the Voting Rights Act, Congress passed the amendment to the Social Security Act that authorized Medicare and Medicaid, with Cobb as the witness to Lyndon B. Johnson’s signing ceremony. The law’s effects on segregation were felt immediately. Since Medicare’s universal coverage of elderly people brought federal funds to about every hospital in America, it also bound them by Title VI’s nondiscrimination clauses, which essentially ended segregation in those hospitals—some of the last public arenas in which Jim Crow legally held sway. Medicare was the final federal legal blow for de jure segregation, and without it, there would still be few legal mechanisms to force hospitals to integrate. It’s hard to overstate how much Medicare and Medicaid themselves did to end formal segregation.