When Social Security was first proposed, it was suggested that medical care be included. However, fear at the time that this addition might spark too much opposition, and that might kill the bill convinced Roosevelt not to include it in the original proposal. President Truman tried to pass legislation to provide medical care for the elderly but failed. It fell upon President Johnson to push it as part of the Great Society Plan.

Bill to provide both medical care for the elderly and insurance for the poor was introduced in the House of Representatives. After much debate and opposition from parts of the medical community, the House passed the bill and moved it to the Senate. The Senate expanded the coverage greatly. After House-Senate Conference Committee meetings the bill to emerge was close the House Bill. The bill to emerge created Title XVIII, known as Medicare, which includes Part A, which provides hospital insurance for the aged, and Part B, which provides supplementary medical insurance. Title XIX, which became known as Medicaid, provides for money to the states to finance health care for poor individuals.

The bill was signed on July 30, 1965, in Independence, Missouri with President Truman attending the signing ceremony.

he law would be small. They believed it would not have a significant impact on American demographics. They were wrong. Over the period of time, the bill changed the nature of immigration. As a result of the law, immigration from Asia and South America soon exceeded the immigrants from Western Europe. Over time the number of immigrants was also increased as well. The result over the decades was a significant change in American demography.