Medicare, the federal entitlement program for the elderly and disabled, was signed into law by President Lyndon Johnson 46 years ago this week. Changes to the program, such as raising its eligibility age or requiring wealthier seniors to pay more for coverage, have been discussed in the debate over raising the federal debt ceiling and also by several commissions charged with finding ways to reduce federal spending, including on entitlement programs.

It remains unclear what role, if any, Medicare will play in the debt ceiling talks. The two proposals currently being considered  - from House Speaker John Boehner and Senate Majority Leader Harry Reid - do not include significant changes to Medicare.

Kaiser Health News asked experts to give us their thoughts on what would have to happen for Washington to decide if – or when – the time is right to revamp a popular program like Medicare. Here are edited excerpts of those interviews.

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Brian D. Smedley, vice president and director of the Health Policy Institute of the Joint Center for Political and Economic Studies:

I’m not a Medicare expert but clearly I think the budget conversation has identified the battle lines politically. I think Medicaid is much more vulnerable in this situation, because the population, which is mostly people of color, is less likely to vote. The health of the communities of color are going to define the economy. We need to invest in preventative care to create healthy communities -- these are the things we have to do to reduce health care costs and there are ways to structure programs like Medicare and Medicaid to keep that in mind.

I think there is a strong case to be made to restructure these programs. We need to forecast what our nation will look like in 20, 30 years and consider a major structural change. For example, if Medicaid were to be turned into a block-grant program many of the benefits that are offered right now to patients would not be there – it would be up to the states if they wanted to keep them or not. Things like periodic screenings and other services for young people who need these services. If we can ensure that Medicaid rates are closer to Medicare reimbursement rates then more providers will be willing to accept Medicaid patients.

Read the full story on Kaiser Health News, All Headline News.