Republicans have never been fans of big government, but they weren’t in control when Democrats enacted three of the most costly and cherished social programs in this country’s history. Franklin D. Roosevelt was president when Social Security was approved in 1935. Lyndon B. Johnson was in office when Medicare and Medicaid came along 30 years later.

The GOP controls both chambers now, but the costly Medicaid program has become an albatross around their necks in efforts to repeal the Affordable Care Act known as Obamacare. Social Security and Medicare have also become costly programs, but they are pretty much considered untouchable at the moment.

In 1935, Democrats held 75 of the 96 seats in the U.S. Senate and 334 of the 435 seats in the U.S. House. There were 64 Democrats and 35 Republicans in the Senate in 1965 and one Senate seat was vacant. There were 247 Democrats and 187 Republicans in the House.

Harry Truman, another Democrat, on Nov. 19, 1945, had become the first president to propose a new national health care program. However, it never got off the ground. Former President Bill Clinton experienced the same result when he put his wife, Hillary, in charge of a 1993 national health care effort.

Early in 1965, the House and Senate approved different Medicare bills by wide margins. A compromise worked out later between the two chambers was approved 307-116 in the House and 70-24 in the Senate.

Johnson went to Independence, Mo., on July 30, 1965, to sign the 133-page bill with Truman at his side. Truman said the new law would mean dignity, not charity, “for those of us who have moved to the sidelines.”

Medicare had three parts — basic Medicare, supplemental coverage for doctor bills and health benefits for the needy and near needy. No one called the third stage Medicaid in the early days, but that is what it has become.

The federal and state governments financed the free care under Medicaid jointly. Eligibility rules differed from state to state. However, the benefits that were available to those past age 65 could be extended to individuals under 65 who would ordinarily qualify for the welfare rolls.

Every state by Jan. 1, 1970, under Medicaid had to offer some hospital benefits, nursing home care, some laboratory and X-ray services and some coverage of doctor bills.

Congress has made a number of changes to all three social programs over the years, and a major change for Medicaid came under Obamacare. It expanded the program to working adults who make less than 138 percent of the federal poverty level — about $33,500 a year for a family of four and $16,200 for a single adult.

Medicaid currently covers some 74 million people, one in five Americans.

Louisiana was late in expanding Medicaid, but is now one of 31 states that have expanded. Former GOP Gov. Bobby Jindal opposed expansion. Democratic Gov. John Bel Edwards expanded the program when he first took office in 2016, and 433,412 citizens are now covered. Many thousands of those have had serious illnesses discovered and been provided corrective and preventive care.

Republican governors control most of the 19 states that haven’t expanded Medicaid, but 11 GOP governors have expanded and want to protect the program.

Efforts of Republicans in Congress to repeal Obamacare have made proposals designed to do that heavily dependent on major changes and budget cuts in the Medicaid program. However, those who have benefited from the expansion have protested vigorously when members of Congress meet with their constituents.

Research conducted by the Harvard School of Public Health has shown that the uninsured rate among low-income adults in Louisiana has dropped from 42 to 15 percent because of the expansion. It said a proposed U.S. Senate health care bill would result in a $2.68 billion decline in federal funding to the state by 2022 and citizens currently benefiting would lose the coverage.

The Advocate in March interviewed Flora Guillory, a full-time day care worker, who has now qualified for Medicaid. The couple didn’t qualify before expansion, and her husband died about a year ago of liver cancer. She had severe health ailments, including lung and vein problems, high blood pressure and cholesterol and diabetes, which she calls “just the major things.”

Coverage was a godsend, she said, but is worried it could be taken away. She is healthier now but can only pay her bills. And Guillory is only one of over 433,000 Louisianans in pretty much the same situation.

Those who are concerned about the future of their health care coverage received a faint glimmer of hope last week. Senate Majority Leader Mitch McConnell, R-Ky., said the opposition of Republican senators to Medicaid changes in a Senate bill repealing Obamacare may force him to work with Democrats to reform the existing health care law.

Are such miracles really possible?Medicaid ExpansionMGNonline