The History of US Healthcare

Open Enrollment for Marketplace insurance plans is currently in full swing. But it hasn’t always been this way; There was a long and storied history that that led to OE as we know it today. Read on to see just how we got here: 

A Brief History of Healthcare:

A timeline history of healthcare in the US



1929: The story starts with the Great Depression. 1 in 4 people can’t find work and can’t afford to go to the doctor. So, for the first time, companies started offering insurance plans that covered hospital stays and doctor visits. 

1943: WWII is in full swing and every resource in the United States is dedicated to the war effort. A labor shortage caused by the war stoked fear of rapid inflation causing another depression. So, the federal government issued a freeze on all wages to try and keep workers where they were. However, companies found another way to compete for labor: they began offering employer-sponsored health insurance for the first time. The practice would prove so successful that, nowadays, there is an expectation that companies will provide some sort of insurance benefits for their employees. 

1946: The Hill-Burton act is passed, requiring hospitals across the nation to provide a reasonable amount of charitable care. 



1956: The Military Medical Care Act establishes a healthcare program for military members, retired personnel, and their dependents. The success of the program would lay the foundation for Medicare and Medicaid, as well as eventual evolutions to military healthcare like TRICARE. 

1965: President Lyndon B. Johnson signs Medicare and Medicaid into law as a part of his Great Society plan for the United States. Both programs continue to provide medical coverage to people that would not otherwise have it to this very day. 

1974: The Hawaii Prepaid Health Care Act requires Hawaiian businesses to offer insurance benefits to full-time employees. Ever since its introduction during WWII, employee-sponsored health insurance had become more and more widespread. By the mid-1970's, it had become an expectation that employers would provide insurance benefits for their full-time employees. In 1974, Hawaii became the first state to make it a legal requirement. 



1986: The Consolidate Omnibus Budget Reconciliation Act, or COBRA, is signed into law. Under COBRA, you can stay on your employer-sponsored health plan for 18 months after you stop working for the employer in question. However, you are responsible for the full cost of any premiums.  

1997: Medicare Advantage, originally called Medicare+Choice, is signed into law. Under Medicare Advantage, Medicare recipients can opt for a version of Medicare offered by a private company instead of the original version of Medicare. They may also sign up for Medicare supplement plans. Since their inception, these plans have proved popular: today, 43% of all Medicare enrollees are enrolled in a Medicare Advantage plan. 



2006: Massachusetts and Vermont pass state health marketplace laws, the first of their kind. They include coverage requirements for all eligible citizens and provide public options to people that need them. In a few years, these laws will serve as a blueprint for the Affordable Care Act. 

February 22, 2010 – The White House unveils President Obama’s proposal for the Affordable Care Act. Healthcare was a major issue early in 2008 presidential race before the housing crisis took over national attention. Still, both Democrats and Republicans were committed to creating a new healthcare law. The ACA drew heavy inspiration from the state marketplace plans in Massachusetts and Vermont. 

March 23, 2010 – After a major back-and-forth between the House, the Senate, Democrats, and Republicans, President Obama signed a version of the ACA that all parties could agree on. The ACA would go through one more revision in the Senate, but by this point it was basically finalized. 

2011 – Colorado and Connecticut create their own state marketplaces separate from the federal ones. They joined Massachusetts and Vermont, who never dropped their own marketplaces. They will eventually be followed by 13 other states and the District of Columbia. 

2013 – launches, creating an online federal marketplace for every state that does not opt for their own state exchange. 

2017 – The individual mandate of the ACA, which requires all citizens to have healthcare coverage if they do not want to receive a tax penalty, is set to stop in 2019. The federal government also shortens the Open Enrollment period for the federal marketplace from 92 to 45 days. 

2020 – The worldwide pandemic rocks the United States and changes daily life for everybody. In response to the crisis, the federal government expands Open Enrollment periods. The government also launches a special enrollment period with the pandemic as a qualifying life event. 

Healthcare Help for You

If you need help finding the right healthcare or health insurance plan for your life, then contact the brokers at Apollo Insurance Group today.

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