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Health Care: Starting A Conversation Between Millennials and Baby Boomers

“When I was your age” is a phrase that Millennials say they’ve grown tired of hearing from Boomers on almost every subject, including how our health care system has changed over the years. Millennials didn’t live the before and after of many health care measures, so they may think it’s no big deal that we have the benefits we have. On the other hand, Boomers remember how unfair the system used to be. To spark a dialogue between the two generations, here are five especially groundbreaking developments in American health care since the 1960s:

NOW: Medicaid and Medicare provide insurance for the elderly and poor

THEN: It used to be extremely difficult for older and low-income Americans to obtain private health insurance—until 1965, when President Lyndon B. Johnson signed a bill establishing the U.S.’s first-ever national insurance programs: Medicare would provide hospital and supplementary medical insurance for millions of Americans 65 and older, while Medicaid would finance healthcare for the impoverished.

NOW: Abortion is legal nationwide

THEN: Before 1973, 30 states outlawed abortion without exception, while 16 prohibited the procedure except under special circumstances (rape, incest, or danger to the mother’s health). Then, the breakthrough court case Roe v. Wade declared that forbidding a woman from having an abortion was unconstitutional. Today, “pro-life” versus “pro-choice” is still a flashpoint for controversy.

NOW: Pregnant women can’t be expelled from the workplace

THEN: Just 40 years ago, expectant mothers could be fired. But in 1978, The Pregnancy Discrimination Act (PDA) became law, banning employment discrimination against pregnant women. Employers were required to give pregnant women (and women recovering from abortions) “reasonable accommodations,” including modified duties, continued medical benefits, and/or disability leave.

NOW: Insurance companies treat mental health and physical health issues equally

THEN: Substance abuse and mental health conditions did not always receive the same insurance coverage as surgical and medical needs. Signed in 2008, the Mental Health Parity and Addiction Equity Act (MHPAEA) mandated that insurance companies and group health plans must treat mental health conditions the same as physical health conditions, meaning that copays and deductibles would be available for both categories. The law also says that insurers provide detailed reasoning in the event of denying coverage.

NOW: Everyone can get health insurance

THEN: Enrolling in health insurance for yourself and your family used to come with an especially hefty price tag if you were sick, unemployed, or low-income; thus, many Americans took a gamble and opted out of coverage. To help close this gap, President Barack Obama established the Patient Protection and Affordable Care Act (ACA, or “Obamacare”), requiring that all individuals have health care insurance beginning in 2014. Millennials specifically benefited from the provision that allowed dependents to stay on their parents’ health insurance plan until they turned 26. By 2016, the uninsured population was reduced by half, covering about 20-to-24 million additional Americans. In 2017, President Donald Trump tried unsuccessfully to repeal the act.

For more on health care issues and their social context through the decades, click here for a helpful resource sent to thirdAGE from MPH@GW, the online MPH program from the Milken Institute School of Public Health at the George Washington University. For more information on the program, click here.

To read more of Brooke L. Sager’s articles, click on her byline (above).