By Ar’Sheill Monsanto, Regina Agyemang
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Black History Month is a time to reflect on the resilience, achievements, and ongoing struggles of Black Americans throughout history. One of the most enduring fights that still occurs today is for equal access to healthcare. The legacy of Medicaid, a program rooted in the Civil Rights Movement, is a testament to how healthcare access remains a key civil rights issue.
When President Lyndon B. Johnson signed the Civil Rights Act of 1964, it wasn’t just about desegregating lunch counters and schools. The landmark legislation also laid the groundwork for healthcare equality by prohibiting discrimination in any program receiving federal funds. One year later, Medicare and Medicaid were born, fundamentally transforming healthcare access for millions of Americans, including many Black families who had long been denied adequate, quality medical care.
Dr. Martin Luther King Jr., one of the most prominent leaders in the civil rights movement, understood that racial and economic justice were inseparable from healthcare justice. Dr. King frequently spoke about how segregated healthcare facilities and lack of access to medical care were devastating Black communities, leading to his efforts to make healthcare reform a key civil rights priority (1). His collaboration with President Johnson was critical to creating Medicaid. While their relationship was complex, both men saw Medicaid as a tool for racial and economic justice.
President Johnson’s Great Society vision fundamentally transformed American healthcare by creating Medicaid in 1965. As part of his broader “War on Poverty,” President Johnson saw services like Medicare and Medicaid as essential to his vision of building a more equitable society. Medicaid, in particular, was considered a civil rights victory as it ensured that low-income Americans, many of them Black, had access to healthcare. While more limited than today’s version, the original Medicaid program represented a revolutionary concept: that healthcare for low-income Americans should be a right, not a privilege.
Yet, 60 years later, as a society, we find ourselves at another critical moment in the fight for healthcare justice, particularly around funding for clinics, federally qualified health centers, and community-based services that serve predominantly Black communities.
Medicaid is the largest funding source for home and community-based services, allowing people with disabilities and older Americans to live independently in their communities rather than institutions. (2). This represents a profound shift from the civil rights era when institutionalization, like nursing homes, was often the only option for those needing long-term care. The world has evolved, and through the work of Community Health Workers and Certified Patient Navigators, there is more opportunity to provide healthcare services right where the people are when healthcare facilities aren’t an available option.
The numbers tell a powerful story!
In 2022, more than 91 million older adults, children, military families, pregnant women, and people with disabilities were covered by Medicaid. Yet approximately 710,000 Americans are currently on waiting lists for Medicaid services. Proposed cuts to Medicaid threaten to turn back the clock, potentially forcing people back into institutions – the very outcome the disability rights and civil rights movement have fought against.
Both President Johnson’s and Dr. King’s shared vision of healthcare justice lives on in Medicaid’s structure and mission. The program remains one of the most essential tools for addressing racial and economic disparities in healthcare access.
At Link Health, this mission is at the heart of our work. We serve those who need access to resources like Medicaid, ensuring that they receive the care and support that they deserve. At Link Health, we share the vision that Medicaid has a role in supporting independent living for disabled and older Americans. This isn’t just about healthcare – it’s about civil rights, dignity, and the fundamental American promise of equality and justice for all despite race, gender, or disability.
Medicaid supports jobs in the healthcare sector, contributes to the state’s economy, and helps maintain the health and well-being of the population. It often supports over 50% of total federal funding allocated to states. For example, the federal government provides 60.8% and 65.3% in Massachusetts and Texas, respectively, while the state covers the remainder of the cost for coverage for its residents. (3). Moreover, Medicaid patients are the target demographic for our work with Link Health. We know these families are eligible for more resources that can empower them economically and address the non-medical drivers of health.
Medicaid is part of a broader civil rights agenda, and today’s debates about Medicaid expansion and funding reflect ongoing struggles for healthcare equity and social justice. The question before us today echoes the challenges of 1964: Will we move forward toward greater equality and inclusion, or will we allow progress to be reversed?
The answer lies in protecting Medicaid funding and recognizing that healthcare access remains a vital civil rights issue of our time. Join Link Health in this fight. Advocate and take action because healthcare justice is civil rights justice.
Sources:
1: U.S. Department of the Interior. (n.d.). Lyndon B Johnson’s relationship with MLK. National Parks Service. https://www.nps.gov/gwmp/learn/historyculture/lbjandmlk.htm
2. Nacdd, Author: NACDD, & Author: (2025, February 5). NACDD Medicaid fact sheet. NACDD. https://nacdd.org/nacdd-medicaid-fact-sheet/
3. Federal and state share of Medicaid spending. KFF. (2024, October 30). https://www.kff.org/medicaid/state-indicator/federalstate-share-of-spending/?currentTimeframe=0&sortModel=%7B%22colId%22%3A%22Location%22%2C%22sort%22%3A%22asc%22%7D
Author: Ar’Sheill Monsanto, Regina Agyemang
