American Medical Association members vote to endorse individual mandate

The American Medical Association’s delegates held their annual meeting over the weekend, at which the most contested issue under discussion was the individual mandate to purchase health insurance or pay a fee, and whether the AMA should continue, as it has since 2006, to officially support such a mandate. The mandate is a crucial component of the Affordable Care Act passed by the Democratic Congress last year.

Despite the controversy, the delegates voted on Monday in favor of maintaining support for the mandate by a vote of 326-165. An alternative proposal, in favor of the government encouraging the purchase of insurance through tax credits but not requiring it, was supported by delegations from several more conservative states.

MedPage Today reports on a sense of increased controversy over the mandate at the meeting:

The AMA’s “individual responsibility” hasn’t been a point of contention at previous meetings. But that was before the national debate over healthcare reform divided the nation, and divided AMA members … During Sunday’s meeting of the Medical Services Committee where the issue was being discussed, lines of physicians eager to voice their opinions for or against the individual mandate snaked around the room and out the door.

This is not the first time that strong voices and politics have divided the AMA over mandates: In 1993, amid national discussion of President Clinton’s proposed health care reform, the AMA voted to neither reject nor endorse a mandate for employers to purchase insurance for their workers, despite having supported such a mandate in previous meetings.

The AMA has had no clear partisan allegiance over the past two decades, according to OpenSecrets. Although its campaign contributions have more often gone to Republicans, contributions to Democrats have been relatively higher in election years where Democrats had the majority in Congress. Among the most important issues to the AMA have been medical malpractice tort reform, primarily a Republican-supported issue, and protecting and expanding Medicare payments, which both parties have defended at various points in time.

The individual mandate to buy private insurance was first proposed as a Republican alternative to the single-payer health insurance system preferred by liberal Democrats under the first Bush administration in 1991. It has since become extremely unpopular among Republicans and the conservative movement, in large part because of its association with President Obama and the Democratic Party. National Review recently condemned Mitt Romney’s candidacy for president because of his involvement with the creation of a state-level individual mandate as governor of Massachusetts.