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Upon its enactment in July 1988, the Medicare Catastrophic Coverage Act (MCCA) was hailed as the first major expansion of government health care since the creation of Medicare in 1965. Supported by President Reagan, majorities in both houses of Congress, and the nation's largest senior-citizen interest group, the American Association of Retired Persons (AARP), the legislation effectively plugged many of the holes in the existing Medicare system by providing protection against some but not all catastrophic health care expenses. Additionally, the consensus behind the MCCA appeared to...