Where Industry and Security Intersect
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The U.S. Government’s work in helping to create a healthcare system to address the needs of the disadvantaged and people with disabilities has steadily escalated since 1915, when public concern for disadvantaged Americans became an important issue.
Social Security provisions of the 1930s sought to support state activities relating to public health care services for mothers and children. By the late 1930s, many Americans were clamoring for some form of health insurance to provide protection against unpredictable and potentially catastrophic medical costs. A central issue of discussion was whether this service should be privately or publicly financed. In the end, private group insurance financed through employers prevailed for most of the population.
Private health insurance grew rapidly through the 1940s, as employee fringe benefits expanded because of limits placed on wages during World War II. At the same time, numerous bills were introduced in Congress proposing national health insurance financed through payroll taxes, but these measures were never brought to vote. In 1950, Congress sought to improve access to medical care for needy people who were receiving public assistance. This was the beginning of federal participation in financing state-government payments made to providers of medical care to recipients of public assistance.
In 1960, Congress introduced limited legislation, including the "Medical Assistance to the Aged Act," which provided medical assistance to individuals who were less poor, yet still needing assistance with medical expenses. Congress established the Medicare and Medicaid programs as Title XVIII and Title XIX, respectively, under the Social Security Act in 1965. Coverage for people with disabilities and certain types of kidney disease was added to Medicare in 1973.
The Social Security Administration managed the Medicare system, and the Social and Rehabilitation Service managed Medicaid until 1977. These duties were then transferred to the newly established Health Care Financing Administration, under the U.S. Department of Health and Human Services, formerly known as the Department of Health, Education and Welfare.
The laws supporting access for persons with disabilities help drive demand for the AT industry. These laws have resulted in modifications to existing facilities and products and the creation of entirely new families of AT devices. For example, the requirements of the Americans with Disabilities Act generated demand for architectural elements such as ramps and lifts.
The Television Decoder Circuitry Act increased sales of decoder circuitry and generated demand for closed-captioned programming. The Telecommunications Act of 1996 and related laws drove the development of new telecommunication devices and modifications to existing devices for people with disabilities.
Since then, the Congress has enacted at least three more pieces of legislation that will benefit persons with disabilities – and spur further development of AT products: The Individuals With Disabilities Education Act of 1997 (20 U.S.C. §§1400 et seq.); the Assistive Technology Act of 1998 (Pub. Law 105-394); and Section 508 of the Rehabilitation Act as amended in 1998 (29 U.S.C. §794d).