After two days of debate, the American Medical Association's House of Delegates Monday voted by two-thirds (326-165) to renew its support for the individual mandate, the embattled portion of the Affordable Care Act that requires people who can afford health coverage to purchase it.
"This is a contentious issue for this country," AMA president Cecil Wilson, MD, acknowledged at a news briefing after the vote, which took place at the AMA's annual meeting in Chicago. "It would be most surprising if we would not feel some of that challenge in terms of making decisions."
At the end of the debate, however, Wilson said an "overwhelming" majority of physician delegates voted to continue the stand the association took on the general issue in 2006. The issue was raised by some delegates in part because the constitutionality of that portion of healthcare reform legislation is being challenged in several courts in a number of states.
"Our concern is that if we are not able to have a requirement that people have an individual responsibility to purchase insurance, we're not aware of another solution, except something that would say that the government would make a requirement and tax the individuals for that," Wilson said at a news briefing announcing the delegates' vote.
"From our perspective, the concern would be raised that would take us down a path toward a government run system."
Wilson then had harsh words for people who can afford health insurance but don't buy it, "who then arrive in the emergency room having fallen off of their motorcycle – and they did not wear a helmet – and they end up with major life-threatening injuries, the treatment for which very few people could afford.
"And the result of that is that all of pay for that, private as well as taxpayers...
Those people, he said, cause those who have health coverage to pay premiums that are "$1,000 a year more than they otherwise would be."
The reaffirmation vote includes a stipulation that for individuals and families who cannot afford health coverage, there would be government tax subsidies or credits inversely proportional to the person or family's income.
Asked if the AMA might file an amicus brief in support of the Obama administration's fight to block challenges, Wilson said he didn't think so.
"Our posture related to this is that this will wind its way through the courts, and the Supreme Court will make that decision and we will leave that to the court to make that decision."
Wilson said the delegates' vote emphasized, in effect, that "We cannot walk away from the fact that some 32 million more Americans would be able to have insurance who do not have it now, and that as a result of not having insurance, would live sicker and die sooner. "
The AMA House of Delegates includes physicians representing state and medical specialty societies.
In a news release, the AMA said the delegates also reaffirmed support for health insurance tax credits and health insurance market regulation, health savings accounts, and direct subsidies for the coverage of high-risk patients.
The individual mandate has been repeatedly challenged in federal court.
See Also:
Behind the Waning Support for ACA's Individual Mandate
Could health law survive without the individual mandate?