ABSTRACT
Even in the spring of 1966, when the majority of states were still only contemplating a Medicaid program, it was clear that the total costs of Medi-caid would be far greater than expected. While the language of Medicaid mouthed "comprehensive care," the ears of the legislators were attuned to the sterner issues of welfare spending. Thus, almost as soon as the first program began, a backlash set in. At first isolated voices in New York and California began a process of disparagement and dissent, but the sentiments voiced were soon reflected by critics on Congressional committees. Other states moved into Medicaid with more or less deliberation, and at vastly different speeds. By August, 1966, a full year after the signing of P.L. 89-97, there were 19 Medicaid programs in existence. Medicaid had begun with one set of philosophies for providing care to the "medically indigent.".
