ABSTRACT
The Medicaid program began in the last two years of the Lyndon B. Johnson administration: writing regulations, developing and approving state plans, certifying providers, determining eligibility, enrolling recipients, paying claims and reviewing reports and monitoring procedures. As applied to Medicaid there were two important gaps or thin patches in the state plan process: the lack of expertise to develop an adequate state plan, and a low level of aspiration in many states with respect to programmatic goals. Supplement D, issued on June 17, 1966, with additions to follow, was a manual that addressed both of these deficiencies and served over the next decade as a primary guide available both to federal and state officials. It does an admirable job of laying out the general principles and specific details of initial implementation. The Social Security Amendments of 1967 provided for an across-the-board 13 percent increase in Social Security payments, which was a major triumph for the Lyndon B. Johnson administration.
