This week marks the 49th anniversary of two of the most important “big government” programs ever — Medicare and Medicaid.

On July 30, 1965, President Lyndon B. Johnson signed these two critical health care programs into law. At the signing ceremony, LBJ handed the first two Medicare cards to former President Harry Truman, who had called for the program years before, and his wife, former first lady Bess Truman.

Contradicting the conservative fable that “big government” programs never work, Medicare has made the lives of millions of American senior citizens more secure and healthier. Medicaid has improved the lives of millions more poor Americans, by giving them access to health care at a fair price.

These programs are among the most important legislation passed during LBJ’s Great Society, and are so popular that Republicans spend every election cycle pretending that they really support expanding coverage, while spending a lot of their legislative time in the House and Senate trying to whittle down both programs.

Today is no different. Conservatives on the Supreme Court have just ruled that a key provision of the Affordable Care Act is invalid, putting an important national law in jeopardy — on a technicality! This law was argued and debated over two long, arduous years. Everyone voiced their opinion, and still does. Lies were told about what “Obamacare” would supposedly do. Dire predictions of failure were made by conservative pundits — too few people would sign up; too few young people would sign up, it would kill millions of jobs.

None of that proved true. Poor and middle-class Americans have signed up for the Affordable Care Act at rates higher than expected, among them millions of the young. No death panels have emerged, despite the predictions of Sarah Palin and Michele Bachmann. And the economy has continued to grow, despite right-wing attempts to obstruct progress.

Yet far too many Republican governors and legislatures, especially across the South, continue to prevent the expansion of Medicaid to their own citizens. Medicaid expansion is a key part of the Affordable Care Act, an opportunity for millions of “near-poor” Americans to gain access to health care at a low cost. Yet despite demonstrated need, despite dire health problems, despite the negative impact this denial of Medicaid is having on both individual families and many existing hospitals, the fear of reprisals from Tea Party voters has made GOP governors afraid to help their own citizens.

So they block Medicaid expansion to their own people, even though the federal government will pay almost all the costs, and even though there is demonstrated need. This is just wrong.

In 22 states, many of them among our nation’s poorest states, Republican governors and state legislatures are refusing to expand Medicaid. Almost half of those refusals come from the states that made up the old Confederacy (10 out of 11, with only Arkansas, headed by a Democratic governor, attempting to find an alternative solution to expansion). Wisconsin and Maine and Alaska, along with another nine states across the Midwest and in the Upper Rockies, are also refusing to expand Medicaid — almost all of them headed by Republican governors. This is just wrong. Their constituents need access to health care, too.

As we mark the 49th anniversary of the signing of Medicare and Medicaid programs into law, we should consider that poor families today also need health care, just as seniors did in 1965, just as poor people did in 1965.

Medicare and Medicaid were two of the greatest accomplishments of President Johnson’s Great Society. If Republican governors would set aside their partisan hostility toward President Obama and the Affordable Care Act, they could ease the worries of millions of their constituents, and make their lives both healthier and more secure.

It’s the right thing to do. It’s the moral thing to do. The 49th anniversary of Medicare and Medicaid this week reminds us that an expansion of Medicaid everywhere could help America be a better, healthier nation.

I call on the GOP to keep hope alive for all their constituents, even their less affluent constituents, and their minority constituents. I call on them to stop blocking access to Medicaid. It’s time to do the right thing, and end their partisan obstruction.