Passage of the Medicare and Medicaid laws in 1965 drastically altered health care for older Americans. As the results of a study for the Senate Committee on Aging were reported in 1964, “only two-fifths of the insured aged [had] policies which [would] cover three-fourths of the hospital bill.” Those unable to afford insurance relied on family or on state and local programs, charities, and hospitals.7 With the addition of Medicare and Medicaid to the Social Security Act, people over 65—even poor Americans—could be ensured access to health care. And the government’s commitment to meeting the needs of older adults grew that year with the creation of the Older Americans Act of 1965. Upon signing the bill, President Lyndon Johnson said that it “clearly affirms our nation’s sense of responsibility toward the well-being of all of our older citizens.”8 The Older Americans Act established the Administration on Aging, the first federal resource dedicated solely to the needs of older adults. It also established local centers that would provide older adults with food, employment, and transportation services. Quietly, responsibility for the care of older adults was shifting from the family to the federal government