For the past 50 years, senior citizens, people with disabilities and people with low incomes have been able to easily get health insurance thanks to Medicare and Medicaid.

President Lyndon Johnson on July 30, 1965, signed into law the Social Security Amendments which led to the creation of Medicare and Medicaid — the first public health insurance programs in the U.S.

“I like it,” said Harriet Melvin, 76, of Cranberry Township. “I’m pleased with (Medicare).”

Medicare — which is funded by the federal government — provides health coverage for senior citizens and people with disabilities, while Medicaid — which is funded both by Washington and by the state — provides coverage for people with low incomes.

Karen Rizzo, president of the Pennsylvania Medical Society, said that Medicare is not perfect, but does the job.

“Before Medicare, the financial burden of health care was significant for many of our elderly. They sometimes chose to go without care as they didn’t want the costs to create a hardship for their families. Medicare gave them and their families peace of mind, and today continues to play a vital role in the health of those who qualify,” Rizzo said.

Across the U.S., 55 million people get Medicare benefits and 69 million are signed up for Medicaid.

In Butler County for 2012, the most recent statistics available, there were 37,043 signed up for Medicare hospital and supplemental coverage. The county currently has 19,680 people signed up for Medicaid.

At Butler Memorial Hospital, revenue from Medicare makes up more than half of its annual revenue.

“So, obviously it’s important to us,” said Chief Financial Officer Anne Krebs.

Last year, Medicare made up 52 percent of the hospital’s $274.8 million revenue. Krebs said patients using Medicare made up 41 percent of their patients last year — with 186,000 patients using Medicare.

“It’s a big part of our business,” Krebs said.

She also said Medicaid makes up about 10 percent of the hospital’s business.

Thomas McGill, vice president for quality and safety for the hospital, said Medicare and Medicaid made it so that many people who were not insured could have insurance and not pay an outrageous amount.

“It’s been around so long, it’s hard to imagine (it not existing),” McGill said.

He noted that the existence of Medicare also made more research into ailments affecting older populations possible. Before, he said there was no money in doing that type of research. Now, Medicare makes the research more lucrative.

People age 65 or older qualify for Medicare if they or their spouse are U.S. citizens or permanent residents who have worked long enough to be eligible for Social Security benefits or railroad retirement benefits. Additionally, government employees who have not paid into Social Security but have paid Medicare payroll taxes are eligible.

People under the age of 65 are eligible if they are entitled to Social Security disability benefits for at least 24 months or have a disability pension from the Railroad Retirement Board and meet a few other requirements.

Additionally, people suffering from ALS qualify for Medicare immediately and people with end-stage renal disease requiring regular dialysis or kidney transplant qualify depending on their age and how long they or their spouse have paid Social Security taxes.

People who do not qualify for Medicare based on their or their spouse’s work record still can get Medicaid as long as they are over 65 years old and have been a citizen or legal resident for at least five years.

People who are age 65 and getting Social Security benefits or who are under 65 and getting Social Security disability benefits automatically get signed up for Medicare parts A and B, which cover hospital and medical insurance.

If you are not automatically enrolled you can enroll online at www.socialsecurity.gov/medicare/apply.html, call 800-772-1213 or visit the local Social Security office. In Butler, the office is located at 102 Woody Drive.

Brittany Buzzelli, community liaison and APPRISE coordinator for the county Area Agency on Aging, said her office does not deal with the enrollment of people in Medicare. However, she does provide assistance to people who have recently enrolled and do not know how to use it.

She said that Medicare is very helpful to the people who have it, who otherwise might not have health insurance.

“They definitely need it,” Buzzelli said. “It definitely helps people out.”

Carolyn Keefer, 76, of Cranberry Township has Medicare and supplemental insurance. She said Medicare is helpful for her diabetes care.

When her husband was suffering from cancer — he died in 2001 — she said that coverage from Medicare was extremely useful.

“It was very helpful for everything, except the prescriptions,” Keefer said.

Medicare Part D, which covers prescription drugs, did not go into effect until 2006.

For Medicaid, the Affordable Care Act created a national minimum income eligibility level of 133 percent of the federal poverty level — about $32,200 for a family of four.

People interested in enrolling in Medicaid can do it online at www.dhs.state.pa.us/applyforbenefits/index.htm or visit the local state county assistance office. In Butler, that office is located at 108 Woody Drive.

At Butler County’s human services department, revenue from Medicaid covers about $30 million of its $85 million budget.

Joyce Ainsworth, director of county human services, said the insurance has a great impact on the people who use it for the department’s services, such as mental health or drug and alcohol treatment.

“It’s huge,” Ainsworth said.

When the law was passed in 1965, Ainsworth said that pushed deinstitutionalization, moving chronically mentally ill or mentally disabled people from state institutions into more community-based care.

Ainsworth said this started the county-level human services system that exists today.

“That of course had a very significant impact,” Ainsworth said.

The system got waivers, which states use to deliver care using Medicaid.

“The waivers are in lieu of an institution,” Ainsworth said.

Because it is a federal program, Ainsworth said it can be difficult to deal with the large number of regulations, particularly with the changes over the years.

“The regulations are phenomenal,” Ainsworth said.