Signed by Lyndon Johnson at the Truman Library on July 30, 1965 — with Harry Truman himself receiving the first Medicare card — the Social Security Amendments of 1965 created Medicare, a federal insurance program for Americans 65 and older, and Medicaid, a joint federal-state program covering low-income Americans. Medicare has since been expanded to cover people with disabilities (1972), end-stage renal disease patients, and, through Medicare Part D (2003), outpatient prescription drugs. Medicaid expansion under the Affordable Care Act became optional after NFIB v. Sebelius (2012).