An Unhappy Birthday for Medicare and Medicaid

July 30 marks a very important anniversary in our modern political history.

Fifty-three years ago in 1965, President Lyndon Johnson signed Medicare and Medicaid into law, creating two programs that would disproportionately improve the lives of older and low-income Americans -- especially women.

Fast-forward to 2018, and both programs are very much under siege. Nowhere is the struggle starker than in the House Republican budget -- titled "A Brighter American Future" -- now on Capitol Hill.

The importance of Medicare as a source of women's health coverage can't be over-emphasized.

Older and disabled women make up more than half the total beneficiaries, and two-thirds of those 85 and over. This budget from hell takes a giant step toward privatizing the program by allowing insurance companies into the Medicare marketplace, which means benefits could be caught in a race to the bottom and become too paltry to cover all but the barest of medical needs.

Medicaid is the joint federal-state program that provides low-income people with health care. The proposed Republican budget repeals the Medicaid expansion that came with Obamacare, which will cause 14 to 17 million people to lose coverage.

The Medicaid remnants that survive would be turned into block grants, allowing states to pick and choose who gets covered and what kind of benefits they get -- no doubt with little or no federal oversight. That approach makes it easier to cut the program without saying how many people would be dropped, or how much benefits would be lowered.

Since poor women under retirement age and their children are the biggest group of beneficiaries, it stands to reason they'd also be the biggest losers.

But there's more. Because women have more chronic health conditions like arthritis, hypertension, and osteoporosis, they're more likely to need institutional care. Since Medicare generally doesn't cover nursing home care, Medicaid provides such care for those with disabilities and/or very low incomes -- and 60 percent of those folks are women.

What's not in the budget? Long gone is the Obama-era effort close the Gingrich-Edwards tax loophole that allows some high-income individuals (possibly including Donald Trump) to avoid Medicare and Social Security payroll taxes altogether, resulting in billions of lost revenue for both programs.

The House Republican budget probably won't pass in its present form. But with Republican majorities in both houses of Congress, even compromises are sure to favor more cuts.

"A Brighter American Future?" Hardly. This summer's 53^rd anniversary of Medicare and Medicaid looks like a less than happy one for those that depend on them most -- namely women, but really anyone counting on growing older.