AMA: Build On The ACA Rather Than Pursue Medicare For All

The American Medical Association isn’t ready to support a single payer version of “Medicare for All” and instead wants to strengthen the Affordable Care Act heading into the 2020 Presidential campaign.

The AMA‘s policy-making House of Delegates this week faced criticism from members within its annual meeting and non-member protesters outside the Hyatt Regency Chicago because the doctors group opposes a single payer version of “Medicare for All.”

On Tuesday morning, AMA delegates defeated an effort that would have ended the national doctor group's opposition to a single payer version of Medicare for All. The AMA did, however, agree to study a public option approach to expanding coverage and reiterated its support of the ACA.

“Since the ACA was enacted into law in 2010, millions of Americans have gained health insurance," AMA President Dr. Barbara L. McAneny said. “We need policies to make coverage more affordable for millions of Americans – both in the premiums they pay, as well as their cost-sharing responsibilities.” 

The single payer version of Medicare for All pushed by Sen. Bernie Sanders of Vermont and others running for the Democratic Party's nomination for President would eliminate co-payments, deductibles and premiums. Single payer would also bring an end to the private insurer's role in providing most benefits.

“The AMA is pursuing sustainable, practical solutions," AMA's McAneny said. "Building on the ACA would help cover the uninsured without disrupting the coverage of most of Americans. We will continue to put our patients first as we engage in these debates moving forward,”

The AMA has more than 200,000 physician members and, as the nation’s largest doctor group, has lobbying clout on U.S. health policy. A committee within the AMA took testimony over the weekend, hearing a range of new ideas that included asking the nation’s largest doctor group to drop “policy opposition to single-payer proposals.”

But amid mixed testimony, the AMA agreed to instead be open to different versions of coverage expansion. The AMA committee said the organization should support an effort to “thoughtfully engage in discussions of health reform proposals, which will vary greatly in their structure and scope.”

“Your Reference Committee heard testimony from members of the Board of Trustees and the Council on Legislation that even with policy opposition to single-payer proposals, our AMA will continue to thoughtfully engage in discussions of health reform proposals, which will vary greatly in their structure and scope,” the AMA reference committee said.

Prior to the annual meeting, the AMA released a 17-page report on the costs and impact of “Medicare for All” to doctors, their patients and taxpayers as well as a look at other health reform proposals.

The AMA is currently allied with other industry groups in the fight against Medicare for All as a part of a group called "Partnership for America's Health Care Future," which is spending millions of dollars and is backed by the American Hospital Association, the Blue Cross Blue Shield Association and America's Health Insurance Plans, which includes Cigna, Anthem, Centene and other health insurance giants.

The AMA has fought vigorously and successfully against the Donald Trump administration and Republican Congressional efforts to repeal the Affordable Care Act, which has increased coverage to more than 20 million Americans and included new patient protections, particularly for those with pre-existing medical conditions. “Expanding health insurance coverage and choice have been long-standing goals of the AMA,” the report of the AMA’s Council on Medical Services says.

As a supporter of the ACA signed into law by President Barack Obama in 2010, the AMA favors fixes to the law as well as approaches to expand coverage. And AMA delegates remain committed to improving the ACA based on delegates votes this week.

But doctors weren’t interested in a Medicare for All approach that uproots the existing private healthcare system. The AMA heard testimony recognizing that “almost 60 percent of nonelderly Americans (more than 156 million) are enrolled in employer sponsored insurance, and are generally satisfied with their coverage.”

The AMA resisted pressure from protesters outside the annual meeting that wanted the doctors to take a more progressive stance toward healthcare expansion.

“This weekend nurses marched with a progressive coalition of grassroots activists and members of the medical community demanding that the American Medical Association endorse Medicare for All,” said Martese Chism, a nurse in Cook County and a member of National Nurses United (NNU) said in a statement provided by the union. “The AMA has a long history of siding with the insurance industry and putting corporate profit above patient's health. As nurses committed to healing, we feel compelled to fix the system. Medicare for All is the cure to ensure our patients get the care they need.”