President Lyndon B. Johnson characterized his administration as an effort to create a "Great Society." He used the phrase as the theme of his domestic policy, as Franklin D. Roosevelt had used New Deal and John F. Kennedy used New Frontier.

Johnson's Great Society sought to redress matters of poverty and racial injustice, and its War on Poverty in particular quickly became important in West Virginia. Projects offered through the Office of Economic Opportunity, as well as other Great Society programs, brought measurable benefits. In 1965, per capita personal income in West Virginia was 76 percent of the national average, and in 1986 it had risen to 86 percent.

In 1965, Johnson traveled to Independence, Missouri, to sign the landmark Medicare legislation in the presence of former President Harry Truman, who had first advocated universal health care tied to the social security system as early as 1945.

Johnson peppered Congress with 113 major measures to implement other aspects of the Great Society, and before the 89th Congress finally adjourned on October 22, 1966, 97 bills had been passed to provide education for underprivileged children; immigration reform; expansion of research for cancer, stroke, and heart disease; aid for the arts and humanities; protection of air and water quality; creation of a "model cities" program; consumer protection and "truth-in-packaging" laws; fish and wildlife preservation; highway and tire safety; and major strides in civil rights.

One of the major measures benefiting West Virginia was the Appalachian Regional Development Act of 1965, funneling federal funds to support a new network of four-lane highways, health clinics, airport construction, water and sewer systems, libraries, and aid for colleges and universities. The Appalachian Regional Commission created under the act reflected what President Johnson labeled "creative federalism," involving shared decision-making by state governors and the federal co-chairman. This mechanism bypassed traditional pork barrel legislation to benefit the pet projects of congressmen, while unfortunately opening the pork barrel to governors.

America pulled back from Great Society activism during the conservative era of the 1980s and 1990s, with President Ronald Reagan and House Speaker Newt Gingrich both critical of Johnson's dream. But like the social security program initiated by FDR, Great Society programs such as Medicare, Head Start, Job Corps, and community action programs now operating throughout West Virginia, are alive, prospering, effective, and popular. Although the Vietnam War crippled budgetary support for Great Society programs, increased deficits, and fueled inflation, the programs themselves have survived and are widely supported.