In 1945, President Harry Truman proposed a national health insurance plan to be funded through a payroll tax. The plan won immediate support from liberal Democrats and unions, but met fierce resistance by conservative Republicans, who by 1946 controlled both houses of Congress, and by the American Medical Association. While President Truman used the issue to win re-election in 1948, his health care bill never came close to passage. Instead, employer-sponsored and union-negotiated plans became the model for health insurance until the passage of Medicare and Medicaid in 1965, and the Affordable Health Care Act in 2009.