InsureWithTom.com, 2111 S. 67th Street Ste 300, Omaha, NE (2026)

(Or soon will be!)

Let me Fix it! 🤗 Slide into my DMs, Call me at 402.979.8648, or email [email protected] I’m a caregiver “in training” for my elderly mother, Joyce! I like reading personal development books and listening to podcasts, although I’ve collected far more books than I’ve gotten around to reading. And there are only so many great podcasts you can listen to and still have a life!

I’m a health insurance tele-broker from Nebraska focusing on health insurance plans, such as Medicare Supplement, Medicare Advantage, Prescription Drug Plans, and Dental Plans. I also help people who are not yet eligible for Medicare navigate the complexities of the Affordable Care Act, also known as ObamaCare. I’m licensed to sell health plans not only in Nebraska, but also South Dakota, Texas, Utah, and Washington. I have also networked and built relationships with other reputable health insurance brokers nationwide. So, if you’re looking for a health insurance plan for 2018 in your state, and need help, let me know! I can point you in the right direction! In the meantime, be sure to follow me online and subscribe to my blog to stay up to date on what’s happening with healthcare in America! https://insurewithtom.com/blog/

03/01/2026

Understanding ACA-Alternative Health Plans

We’re nearly three months into a new year, with a new reality of increased health insurance premiums costs.

Those with higher incomes who get their health insurance through the individual ACA marketplace saw their premiums spike considerably, mainly due to the enhanced premium tax credits expiring at the end of 2025.

Those enhanced premium subsidies passed in 2021, fueled the greatest surge of ACA Marketplace plan enrollments in history. But that party is now over.

So far, the data shows that around 1.2 million fewer people enrolled in plans for 2026 versus last year. But that could drop further as people struggle with budgeting their monthly premium payments.

What do you do if you can no longer afford individual Marketplace coverage?

First things first. It’s important to know why ACA health plan premiums are so costly in the first place. It’s because it’s the most comprehensive coverage you can buy outside of employer-based, or government health plans, that have no pre-existing health condition exclusions.

That was the biggest catalyst. (no pre-ex) the game changer.

Prior to the ACA, only employer based or government health plans accepted enrollees regardless of health.

Everything else in the individual private insurance market, except for some very limited benefits plans, require health underwriting prior to being accepted.

So, what do you do if you don’t have access to employer based or government health plans and have pre-existing conditions that may prevent you from buying health insurance?

If you can afford it, ACA is the only way if you want comprehensive health insurance without pre-existing health condition exclusions.

But what if you’re priced out of the ACA Marketplace?

There are more affordable non-insurance options such as Health Sharing plans that will accept you with a waiting period for certain pre-existing conditions.

During the waiting period, you’ll have to learn how to navigate and manage your conditions as an uninsured cash payer. Thankfully there are price transparency tools online that can help with this.

For example, FAIR Health has online tools that help you estimate your healthcare expenses by procedure with both out of network/uninsured and in-network/insured prices.

You can often save significantly on healthcare costs with a cash payer rate versus the inflated rates insurance carriers are forced to pay.

I recommend also joining a Direct Primary Care Clinic. These are membership-based practices that provide ongoing medical care for a flat monthly fee.

There are even Direct Specialty Care that focus on specific medical specialties rather than general primary care.

The Direct Primary & Specialty Care movement is growing in response to more people choosing not to participate in the traditional health insurance market or are forced out due to unaffordable premiums.

But for those who are relatively healthy, there are several options in the private insurance market that are often more affordable than ACA Marketplace plans.

Let’s dive into the most common type of ACA alternative health plans available in the private market.

Comprehensive Major Medical

Do you lead a healthy lifestyle? Are you open to a part time job or side hustle? If so, there are Comprehensive Major Medical health benefits available for individuals who qualify to become consumer data survey respondents for organizations involved in the population health management and data research field. By becoming an employee or working owner, who contributes by completing a few surveys a month about your healthy lifestyle, you get access to the organization's group health plan.

Short Term Medical

Short Term Medical plans offer temporary health coverage for up to twelve months depending on your state’s rules. These plans generally cost less than traditional health insurance, and coverage can begin as soon as the following day. Benefits may be more limited compared to major medical though, especially for preventative care, maternity, or mental health, so it’s important to understand what your policy covers, and what it excludes.

Fixed Indemnity Plans

Limited Benefit Fixed Indemnity plans pay a fixed dollar amount per day, service, or visit when you experience certain medical events that are specified in the policy. For example, you might receive a fixed payment for a doctor’s visit, a hospital stay, or a specific procedure. These payments go directly to you, not the provider, and you can use the money however you choose. Since benefits are fixed, you know exactly what the plan will pay for each covered event. These plans are typically more affordable than comprehensive health insurance, however, it’s important to know that the fixed payments rarely come close to covering the full cost of serious medical care. A major hospitalization, chronic condition, or emergency can still leave you with substantial expenses. That’s why these plans should be considered supplemental, and not primary health insurance. But if the price of primary health insurance is out of reach for you, what can you do?

Health Sharing Plans

As healthcare costs continue to rise, many individuals and families are exploring alternatives to traditional health insurance. One option gaining attention is health sharing plans which are community-based programs where members contribute monthly amounts to help cover one another’s medical expenses.

At their core, health sharing plans function as a cost-sharing arrangement. Members pay a monthly “share” into a collective pool. When someone has an eligible medical need, funds from other members are used to help pay the bill. Instead of insurance companies, most plans are run by nonprofit organizations guided by shared values or lifestyle commitments.

Many people find health-sharing plans more affordable than traditional premiums. Members often appreciate the sense of contributing directly to others in need. Some plans offer freedom in choosing healthcare providers.

It’s important to consider that health sharing plans are not insurance. They’re not legally required to cover pre-existing conditions, preventive care, or certain treatments. Because payments are voluntary contributions, and not legally guaranteed benefits, there’s always a degree of risk. Additionally, many plans require members to adhere to specific lifestyle or belief standards.

For people seeking lower monthly costs and who are comfortable with the structure and values of these programs, health-sharing plans can provide meaningful financial support. However, anyone considering them should read the guidelines carefully and understand what is and isn’t covered.

Well… there you have it. Outside of job-based coverage, and government, such as the ACA Marketplace, Medicare, or Medicaid, your options for individual health plans in the private market are going to be limited to the types of plans I just laid out for you.

I’ll be covering these options in more detail in future posts. In the meantime, if you have any questions, feel free to leave a comment or reach out to me directly.

11/05/2025

My Thoughts on The Precarious State of Medicare Plans

As of this time of post, we’re a little over a few weeks into the start of Medicare’s Annual Enrollment season for 2026 plans.

Have you notice less advertising for Medicare Advantage this year compared to previous years?

Sure, you still get a ton of telemarketer calls. That’s not going to stop anytime soon. But overall Medicare marketing spending is down.

Why is this? Well, it’s the usual suspects: Healthcare utilization and the costs that come with it are rising much faster than the government’s reimbursement rates paid to insurers.

And on top of that, there’s the impact of the Inflation Reduction Act which shifted the burden of paying the majority of the costs (60%) of covered prescription drugs above the $2000 out of pocket cap onto the insurance companies.

Prior to this change, the Government picked up most of the tab when you reached the Catastrophic stage of your prescription drug plan.

This is why you’re seeing less advertising. Insurers are cutting back. The extra benefits that Joe Namath, and Jimmy Walker used to tout will be skimpier next year on some plans,

And while $0 premium plans are still being offered the cost sharing on some of those plans have increased.

I’ve also noticed prescriptions like Ozempic and Trulicity will have Prior Authorization requirements with several plans next year.

That means if your current plan is covering these drugs and you switch plans; you’ll need to get a new prior authorization in a hurry in January. And hope and pray the plan accepts it. Otherwise, you’re going to have to find an alternative prescription that the plan will cover.

You might just be better off staying with the plan that’s already covering your prescriptions, if the costs aren’t changing significantly in 2026.

This fall is probably the most important time than ever before to study your Advantage or stand-alone Part D plan’s Annual Notice of Change booklet to learn what’s changing next year

You don’t want to wait until January to find out your most expensive prescription is no longer covered, or your doctor is no longer in network,

Take the time now to review what’s changing. If you don’t understand what’s changing, get with someone who can help explain it to you,

And if you don’t like what’s changing, now is the time to review your options.

If you’re healthy enough to qualify for a supplemental Medigap plan, one of your options is returning to Original Medicare, where things don’t change every year all that much, other than your annual Medigap plan premium increases.

And you won’t have to worry about whether your doctor, or hospital is in network, because there is no network. On Original Medicare you have the freedom to see any doctor or hospital anywhere in the U.S. that accepts Medicare.

Now you will still have to deal with the drama of standalone drug plans changing every year. There’s no escaping that. But there are tools online that make it very easy to compare and enroll in plans if you do need to make a change.

Bottom line, the way Medicare Advantage and Part D drug plans are currently designed are unsustainable under the Inflation Reduction Act.

Insurers may have to go back to the drawing board. $0 or very low premiums plans may have to go bye bye. They may have to introduce medical deductibles. Some plans are already doing that now.

And if you want a lower Maximum out of Pocket, you just might have to start paying a higher premium for it. It just makes sense.

But if you do have to pay a higher premium and you still have significant cost sharing, you might want to compare that to Original Medicare supplemented with a Medigap plan.

First, you’ll want to determine if the monthly premium for a Medigap plan is affordable for your budget.

And if it is, you’ll want to find out if you will medically qualify for underwriting, it only takes a few minutes to find out. Talk to a qualified agent who is proficient in underwriting. Not all are. Especially if they mainly sell Advantage plans where there is no underwriting involved.

Once you’re fairly confident you’ll qualify, here’s how the application process works:

You submit an application to the carrier, for a future effective date that you want the policy to begin, During the Annual Election Period, when you’re wanting to return to Original Medicare, that would be January 1st.

If approved, you can begin the process of returning to Original Medicare effective January 1st by selecting and enrolling in a Standalone Part D plan during the Annual Enrollment period between October 15th and December 7th.

It’s important to NOT do this prior to receiving an approval from the Medigap plan, because enrolling in a Standalone Part D drug plan is the trigger that notifies Medicare that you are returning to Original Medicare on the effective date.

If you do this prior to being approved for a Medigap plan, you’ll be returned to Original Medicare come January 1st without any supplemental coverage that picks up most of Medicare’s out of pocket cost sharing.

If you just have Part A and B only, you’re responsible for 20% of the Part B medical expenses with no maximum out of pocket limit. And a $1676 deductible for 2025 on Part A Hospitalization for the first 60 days. And beyond 60 days you have a significant daily copay to meet.

You don’t want to be on Original Medicare only unless you’re wealthy and can afford to self-insure the potential unlimited cost-sharing.

So, make sure you’re approved by underwriting with the Medigap plan before you enroll in a standalone Part D plan, if you are returning to Original Medicare next year.

I hope this helps someone. Let me know in the comments if you have any questions.

09/03/2025

If you've been paying attention this summer, there's been a lot of talk in the news about Obamacare (ACA) plan premiums spiking in 2026.

The median proposed increase among insurers nationwide is 18%.

"My health insurance premiums are going up? What else is new, right?"

But it's not just the rising costs of healthcare, and higher utilization that are causing rates to increase next year.

An even bigger impact is the temporary enhanced subsidies, that were implemented during the pandemic, are set to expire at the end of this year. (Unless extended.)

A little backstory on the ACA enhanced subsidies: how it fueled immense growth in ACA plan enrollments by opening the door to those previously locked out because of income, and how it's going to show them the door at the end of this year if/when the enhanced subsidy party ends.

Really, it's going back to the way it was before the party started.

The Affordable Care Act (ACA) has always had premium tax credits for households with income at or below the 400% federal poverty level threhold. If your income was above that level, you had to pay full price.

And full price is not cheap. The only thing that makes Affordable Care Act plans "affordable" are the subsidies that lower your premium cost.

Why? Because ACA plans are guaranteed issue. There are no pre-existing health condition exclusions. The insurance companies have to accept the sick among the healthy. They have to take the bad risk along with the good, with no underwriting mechanisms in place to balance it out and maintain manageable loss ratios.

So higher income households were often priced out of the ACA marketplace, and had to look to alternative health plan options, or go without coverage entirely.

But during the pandemic, Congress temporarily expanded the subsidies for the years 2021 and 2022 with the American Rescue Plan Act, which was passed March 2021.

This is where the party started, because this act for the first time ever capped premiums at 8.5% of household income for the second lowest cost Silver plan no matter how high that income was!

That was a game changer!

And the Inflation Reduction Act passed in August of 2022 extended these enhanced subsidies through 2025.

Just like how economic growth was fueled by stimulus money during the pandemic, these enhanced subsidies created huge ACA plan enrollment numbers. (over 21 million in 2023 alone!)

But that growth may be subsiding (and reversing) soon for those above the 400% federal poverty level threshold if the enhanced subsidies aren't extended by the end of year.

They will be cut off. And premiums won't be capped at 8.5% anymore for them. The party will be over. And the hangover will begin.

So, what do you do when you are priced out of the ACA marketplace, and don't have access to a group health plan?

You look for alternatives in the private health plan marketplace to bridge the gap until you're eligible for Medicare, which is the Holy Grail of health insurance. (Original or Traditional Medicare at least.)

But caveat emptor! There's a lot a crap being peddled out there.

A "Nationwide PPO" won't do you any good if there's no (or very limited) coverage for chemo/radiation, outpatient services, etc.

There's a lot of options being marketed today. But do you know how to sort the good from the bad? (Comprehensive vs. Limited Benefit?)

That's where a good agent or broker like me can help. Before even making a plan recommendation we study your current policy to make sure you know what it covers and what it doesn't.

You know you've likely never read your policy entirely. Like most of us, you just took the word of your agent or the call center and stuck your policy in a drawer somewhere when it arrived along with your other insurance policies.

But on your worst day... when you get that bad news from the doctor, that you didn't want to hear... is that the time to be discovering what your plan covers and what it doesn't cover?

This will be the focus of my posts on this page going forward:
Explaining the good, the bad, and the ugly of the private health plan options currently being offered in the individual marketplace if you're priced out of ACA next year.

Before, when I focused solely on supplementing Original Medicare beneficiaries with Medigap plans, I didn't have to spend a lot of time explaining what's covered and what's not, because it's already spelled out for you in Section 2 of the Medicare & You handbook.

(Medicare Advantage and Part D drug plans are an exception as there's a lot of moving parts to it, and they change every year.)

But now that I'm focused more on serving the self-employed/small business owner, I see a greater need to educate on the pitfalls on picking the wrong plan and finding out after it's too late, and the medical and hospital bills are already piling up!

So stayed tuned for most posts from me on this (long neglected) page! Like or follow me on my InsureWithTom .com FB page to see more posts like this one in your feed.

If your self-employed or a small business owner with a higher income, now is the time to start reviewing your options for 2026 before those "enhanced" ACA premiums take effect, and you're potentially priced out! 😩

10/03/2024

The History and Regulatory Evolution of Medicare Supplement (Medigap) Plans

If you have what is known as Original Medicare, you probably have a supplemental Medigap plan.

I thought I’d take you back through time to explore the history and regulatory evolution of these secondary health plans, which are designed to supplement Original Medicare’s cost sharing.

Since Medicare went into effect on July 1, 1966, private insurance companies have offered plans designed to cover some of the out-of-pocket costs not covered by the national healthcare program.

Medicare was never designed to cover all a person’s medical costs. Like most plans at the time beneficiaries had cost-sharing typically in the form of deductibles, copays, and coinsurance.

One of the concerning issues of Original Medicare is that Maximum Out-of-Pocket Limits weren’t built into its original design.

Part A has cost sharing in the form of a deductible per benefit period and daily copay that begins after 60 days of continuous hospital stay.

For Part B, after you meet your deductible for the year, you generally pay 20% of the bill for most doctor services. No matter how high the bill is, you’re responsible for that 20% of cost-sharing!

Medicare supplement plans, also known as Medigap plans, were designed to help cover these deductibles and coinsurances among other things.

The early Medigap plans weren’t the federally standardized plans we have now. They lacked much oversight, even at the state level. There were many different plans with various competing benefits, and it was hard to compare the differences between them.

A lot of seniors were concerned about out-of-pocket costs creating a financial hardship. Certain unethical agents took advantage of this and oversold plans that often overlapped or duplicated benefits. These additional policies in many cases provided very little value in return for the premiums paid.

Some of these rouge insurance agents didn’t even bother to deliver the policies they’ve written, and some even went as far as committing fraud by forging signatures on additional policies to receive bigger commissions! Complaints began to pile up at the state level through the Department of Insurance offices.

Several Committee hearings took place in the mid to late 1970’s that led to developing federal oversight of Medigap plans.

New York was one of the first states to crack down on these abuses, first from changing how insurance companies could do business in that state.

In most states, an insurance company could file and start accepting applications for a new policy right away. This is what insurance companies call a “file and use” state.

New York changed this to a process that needed pre-approval before business could be conducted. They required Medigap policies and brochures to have “easier to read” language and clearer benefits.

California soon made similar changes soon after.

The National Association of Insurance Commissioners (NAIC) developed model standards for Medigap plans around this time as well.

It’s important to note form the 1970’s well into the early 1980’s, employers were rapidly expanding benefits for retirees which included group health coverage that coordinated with Medicare.

Individually purchased Medigap coverage, however, remained and still is the most common way to supplement Original Medicare.

For the rest of this post, I’ll briefly cover the various federal legislative changes that have impacted Medigap plans beginning in 1980 all the way to the most recent legislation impacting Plan C & Plan F that became effective in 2020.

-The Social Security Disability Amendments of 1980-

Also known as the Baucus Amendments, for the first time established a voluntary certification option for Medigap issuers to follow. These minimum standards included meeting or exceeding the NAIC model standards and required medical loss ratios, which meant the percentage of premiums paid out as benefits had to be at least 60% (75% for group policies)

A rule was also established that new Medigap policies becoming effective in 1982 could no longer exclude preexisting conditions from coverage for more than 6 months after the policy takes effect.

The Secretary of Health, Education & Welfare, now called Health & Human Services was required to produce educational information on Medigap policies, examine the methods states were using to regulate Medigap plans, and keep Congress addressed on the effectiveness of this certification procedure at least once every two years.

-The Omnibus Budget Reconciliation Act of 1987-

This act permitted participating physicians and suppliers to be paid directly by the Medigap plans. This eventually led to the coordination of Medicare & Medigap plans with claims being paid automatically through the “crossover” system.

Today in most cases, when a beneficiary receives care that is covered by Part B of Medicare, the Medicare contractor pays the provider its portion of the bill, then the remaining portion is automatically forward to the Medigap issuer to be paid.

This results in virtually a “hands-off” claim experience for the beneficiary! Prior to this convenience, you had to file a paper claim to the Medigap issuer to receive your benefits!

-The Medicare and Medicaid Patient and Program Protection Act of 1987-

This act mainly covered amendments to anti-kickback legislation, but it also included a provision that makes individuals who knowingly and willfully provide false statements or misrepresent a medical fact in the sale of a Medigap policy guilty of a felony.

-The Medicare Catastrophic Coverage Act of 1988-

Most of this act’s provisions were repealed only a year later in the Medicare Catastrophic Coverage Repeal Act of 1989, but one provision that stuck made the voluntary certification of meeting or exceeding NAIC model standards for Medigap issuers now mandatory.

It also improved consumer protection by requiring the Secretary of Health & Human Services to inform beneficiaries of sales abuses, provide a toll-free number where such abuses can be reported, and publish the addresses and phone numbers of state and federal offices providing information and assistance.

-Omnibus Budget Reconciliation Act (OBRA) of 1990-

This act further changed all the voluntary requirements to now mandatory requirements of Medigap policies including standardizing benefits, limiting pre-existing conditions to six months, and minimum loss ratios.

It established 10 standardized plans, (A through J) in all but three states. Massachusetts, Minnesota, and Wisconsin had their own Medigap model standards established at the time and were granted waivers.

Also added was a 15-state demonstration plan option called Medicare SELECT, which offers a limited provider network. Medicare SELECT became a nationwide plan in 1995.

These standardized plans went into effect in 1992 for new purchasers. Existing policyholders could keep their pre-standardized plans.

-The Social Security Act Amendments of 1994-

Amended the anti-duplication provision to further clarify the situations a Medigap carrier could sell health insurance policies with duplicative (non-Medigap) coverage.

An unintended consequence of earlier legislation resulted in Medigap carriers refusing to sell Medigap policies to beneficiaries that had any other type of private coverage.

-The Balanced Budget Act (BBA) of 1997-

A high deductible option for Plans F & J were added, and restrictions on pre-existing conditions exclusions during the initial Medigap open enrollment were added for those aged 65 or older with previous health insurance.

It’s important to note that in 1972 the social security act extended Medicare to people under age 65 with long-term disabilities and those with End-Stage Renal Disease.

However, there has been no federal requirement that Medigap issuers have to offer plans for people under 65 that otherwise qualify for Medicare.

Some states guarantee that applicants under age 65 will have access to at least one plan, but others don’t.

Unfortunately, the Medigap 6-month open enrollment period did not give beneficiaries under 65 the same protection as those aged 65 and over.

-The Ticket to Work & Work Incentives Act of 1999-

This act permitted disabled Medicare beneficiaries to suspend their Medigap coverage when they were covered under a major medical group health policy.

-The Omnibus Consolidation and Emergency Supplemental Appropriation Act of 1999-

This act enforced penalties for providers or facilities that paid beneficiaries Medigap premiums. This was an attempt to avoid conflicts of interest created when providers or facilities first paid premiums and then self-referred patients.

-The Consolidated Appropriations Act of 2001-

This act gave guaranteed rights to purchase a new Medigap plan free from pre-existing conditions exclusions when individuals experienced certain changes in their health insurance, such as an involuntary termination of a group health or Medigap plan.

-Medicare Prescription Drug Improvement and Moderation Act of 2003-

Since this act added the Part D Drug provision, Medigap plans selling drug benefits could no longer be sold to those who didn’t already have them beginning June 1st, 2010.

The dropped plans were E, H, I, and J including the high deductible option.

People who already had these plans could keep them if they wanted to but were also given a guaranteed option to purchase plans A, B, C, and F with the same insurance carrier.

The Home Recovery and Preventative Care benefits were removed from all Medigap plans.

The Home Recovery benefit was very seldom used and actually required the tedious process of manually filing a claim to receive benefits!

The Preventative Care benefits became redundant because Medicare now covered many of the benefits that were covered under this benefit.

The Excess Charges benefit for Plan G was increased to 100% and a Hospice Benefit was added to the basic benefits of Plans A through G. Plans K, L, M & N were created as well.

-The Medicare Improvements for Patients and Providers Act of 2008-

This act set standards for which plans Medigap insurance carriers could offer. Insurers who wanted to offer plans beyond the least comprehensive Plan A had to at least offer one of the most comprehensive plans such as Plan C or F.

-The Genetic Information Nondiscrimination Act of 2008-

This act prohibited discrimination by health insurers and employees based on genetic information.

-The Patient Protection and Affordable Care Act of 2008-

This act required that the Secretary of Health & Human Services request that the NAIC review and revise cost sharing in Plans C & F.

The “first dollar” coverage benefit of these two plans had been linked to higher use costs for the Medicare program, which explains why they were considering revising the cost-sharing provisions of these two plans.

-The Medicare Access and CHIP Reauthorization Act of 2015-

This act brought an end to the popular “First Dollar Coverage” plans Plan C and Plan F as an enrollment option to those newly eligible for Medicare in 2020.

These two plans pay the Part B deductible which is specifically what the new legislation prohibits.

People who joined Part A before January 1st, 2020, are still able to purchase or switch plans C and F from any insurance company that offers them today. (But I typically don’t recommend you do that. Ask me why, and I’ll explain.)

But newly eligible Medicare beneficiaries can’t enroll in Plan F or C Medigap plans. They’ll have to pick one of the other standardized letter plans.

They will have to meet the annual Part B deductible (currently $240 in 2024) before the Medigap plan’s Part B supplemental benefits kick in.

Thanks for making it all the way to the end of this post!

I hope you found it enlightening!

09/27/2024

A Look Back on The Road to Medicare.

As we approach another Medicare Open Enrollment season, I thought it would be appropriate to look back on how it all began, and the steps it took to get there!

Over 50 years ago, in Independence Missouri, President Lyndon B Johnson signed the bill that became Medicare & Medicaid. The date was July 30th, 1965.

Prior to this landmark national health care legislation, people over the age of 65 had limited options available for private health insurance.

According to one report, by 1965 well over half of the general population had some form of hospital insurance as well as surgical insurance, and the market for major medical which includes primary or out of hospital care was rapidly growing.

Unfortunately, those numbers were closer to less than one half for the elderly population.

The first generation eligible for this new Medicare program had been through two world wars with the Great Depression in-between. They also were among the first beneficiaries of the Social Security legislation in 1935.

But there were limited options for health insurance for the elderly which meant unplanned hospital and doctors’ bills could cause extreme hardship.

This economic threat from unplanned healthcare costs didn’t go unnoticed by our government leaders over the years.

As early as 1912 Teddy Roosevelt’s platform for the Progressive Party was social insurance for sickness. In 1915, a labor group proposed a medical insurance bill to certain state legislatures, but opposition by special interests led to its failure.

When FDR signed the Social Security Act in 1935, he wanted to include a health care bill. But the committee was afraid that this inclusion would lead to the entire bill’s demise.

In 1945, President Harrison S Truman proposed a national health care program. It made its way to Congress through a Social Security Expansion bill known as the W-M-D bill.

Special interest groups again rallied against it, fearing socialized medicine would lead to Communism and by the Korean War, this bill was also abandoned.

Although his bill never saw the light of day either, he did a good job of bringing the issue of health care in America to light on a national level. It’s been noted that Blue Cross-Blue Shield, the non-profit health insurance fund, gained over 33 million policies during his presidency.

Truman was also considered the “Daddy” of Medicare by Lyndon B. Johnson and was the first beneficiary to be enrolled into the program after the signing of the bill at the Harry S. Truman Library & Museum in Independence Missouri.

In 1958 a Rhode Island Congressman by the name of Aime Forand proposed a bill to cover hospital costs for the elderly on Social Security.

Of course, there was swift opposition from special interests for this bill too, mainly the American Medical Association who at the time was against any notion of government interference of the patient-doctor relationship.

At this time though there was a growing grassroots support from seniors that brought the issue of health care to a national level, and it became harder for opponents to sway the debate.

The Kerrs-Mill Act of 1960 sought to address the issues of healthcare by initiating federal grants to individual states to help the medically indigent elderly pay for medical services.

But it didn’t solve a lot of issues because state adoption was voluntary, and it was only available to people who could pass a stringent means test. This act was really the precursor to what became Medicaid.

Another bill was proposed called the King-Anderson bill in 1962 which included covering not only the hospital but nursing home costs for people ages 65 and older. This bill too was defeated, but by a very narrow margin.

The American Medical Association later proposed an expansion of the Kerrs-Mill Act called Eldercare which included broader benefits that included doctor services, which through a series of compromises became Medicare and Medicaid.

Fun Fact: If you ever wondered why Hospital Insurance and Medical Insurance is split up into two parts, it’s because of a compromise.

The original Medicare proposal was really just hospital insurance, but as the debate went on, it became clear that hospital insurance only would be inadequate.

The comprise was to add a voluntary plan that covered doctor services, modeled after an Aetna health insurance policy.

It couldn’t be combined because the Hospital Insurance plan was to be compulsory, and the Medical Insurance plan had to be voluntary in getting enough votes to pass.

So that’s why your old Red, White, & Blue Medicare card has two separate parts, Part A which covers Hospital Insurance and Part B which covers Medical Insurance.

Over 19 million Medicare cards were issued the first year Medicare began.

To see more of my Medicare content, like this one, on your newsfeed, please like or follow this page.

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