On July 30, 1965, President Lyndon B. Johnson signed Medicare and Medicaid into law as an amendment to the Social Security Act. Most people who will become eligible for Medicare this year were in high school when this legislation was authorized. Today’s seniors were young adults busy with their lives and families.

In 1965, almost half of those 65 and older had no health insurance, living in fear that the high cost of health care could propel them, and their families, into poverty. Today only two percent of seniors have no access to health insurance. This has led to a five-year increase in life expectancy for those over 65.

Today, 55 million Americans rely on Medicare to provide needed care, including preventive services, hospital stays, lab tests, critical supplies, and prescription drugs.

It’s hard to remember that in 1965 many disabled people, families with children, pregnant women and low-income working Americans were unable to afford the medical care they needed to stay healthy and productive. When the legislation was passed, many thought Medicaid would never last, yet today Medicaid provides comprehensive coverage for almost 72 million eligible children, pregnant women, low-income adults, and people living with disabilities.

Almost one out of three Americans depends on Medicare and Medicaid for needed health care. Here in Region 10, which includes Alaska, Idaho, Oregon, and Washington, there are over 3 million Medicaid/CHIP enrollees and over 2 million Medicare enrollees, covering about 41% of our population’s healthcare needs. In Alaska, there are almost 122,000 Medicaid or CHIP enrollees in addition to almost 83,000 Medicare beneficiaries, covering approximately 28% of the state’s population. Without Medicare and Medicaid, both the quality of life and the length of life expectancy in this country would be diminished. These programs improve health and save lives every day by providing access to those who wouldn’t otherwise have health coverage.

Medicare and Medicaid are also driving innovation. These programs have become the standard bearers for coverage, quality, and innovation in American healthcare. The Center for Medicare & Medicaid Innovation funds transformative developments in payment and delivery models to simultaneously improve population health, improve the patient experience of care, and reduce per capita cost. Paying for value, not volume, will be key for the future.

More Americans have access to affordable health care now than at any point in our history. That number will continue to grow as more states expand Medicaid. Estimates show that in 2016 there will be 20,000 new Medicaid enrollees in Alaska and at least $18 to $27 million less in uncompensated care annually. The Affordable Care Act has ensured that Essential Health Benefits are offered in Qualified Health Plans. No one should have to choose between needed healthcare or food and shelter. Medicare, Medicaid, and affordable health insurance all work together to eliminate that hard choice.

By improving access to needed care, having health insurance improves mental and physical health and provides protection from financial hardship due to sickness. As we look ahead to the next 50 years, we can celebrate that what was put in place in 1965 has given us the foundation for a healthy future for all Americans.

Susan Johnson is Regional Director, US Department of Health and Human Services, Region 10. John T. Hammarlund, is Regional Administrator, CMS Region 10.