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Medicare at 50 Years: The Series

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The Commonwealth Fund’s Medicare at 50 Years series traces the evolution of Medicare and its major accomplishments over the past 50 years, examines how the Affordable Care Act is helping to reform Medicare, and explores the key issues confronting the program and policy options for addressing them.

The Commonwealth Fund’s Medicare at 50 Years series is now available in its entirety for viewing and download as an e-book.


Medicare: 50 Years of Ensuring Coverage and Care. How Medicare has helped transform health care in the United States—and even stimulated broader social change. 

50 Years of Medicare: How Did We Get Here? How has Medicare evolved since it began in 1965? Take a look at our Medicare timeline to find out. 

The Affordable Care Act and Medicare: How the Law Is Changing the Program and the Challenges That Remain. How the law is strengthening the program for current and future beneficiaries and the major challenges that policymakers have yet to confront. 

Medicare Payment Reform: Aligning Incentives for Better Care. Explores the key issues facing Medicare’s future, including the potential of value-based payment to improve care for beneficiaries and achieve savings, and strategies for accelerating its adoption.

Modernizing Medicare's Benefit Design and Low-Income Subsidies to Ensure Access and Affordability. Presents options for an integrated benefit for enrollees in traditional Medicare that would not only reduce cost burdens but also could potentially strengthen the Medicare program.

Predictable Unpredictability: The Problem with Basing Medicare Policy on Long-Term Financial Forecasting. Why policymakers should focus on Medicare’s immediate needs instead of long-term forecasts, by maintaining the program’s fiscal solvency while improving its ability to meet the needs of beneficiaries.

Serving Older Adults with Complex Care Needs: A New Benefit Option for Medicare. To improve Medicare’s capacity to serve beneficiaries with complex care needs, and to prevent unnecessary institutionalization, this issue brief proposes a complex care benefit option that would include home and community services, and describes how it might be structured to balance the goals of improving care for beneficiaries and ensuring affordability.

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