ABSTRACT
By most accounts, two of the most significant congressional enactments since World War II were both attempts to guarantee that Americans would have adequate access to quality health care-the 1965 legislation that established the Medicare and Medicaid programs and passage in 2010 of comprehensive health care reform. Superficially, there are certain similarities across the two legislative episodes. For one, both measures were championed by newly elected Democratic Presidents-Lyndon Johnson and Barack Obama-who were deeply committed to making major changes in the health care systems of their day. In 1965 and again in 2010, Democrats were able to rely on huge partisan majorities in the House and Senate to help them achieve victory on the floor. And in keeping with the enduring importance of the political parties in American electoral and legislative politics, both enactments were characterized by major ideological and political differences between Democrats and Republicans.
