AMA to reconsider support of health insurance requirement

A divided American Medical Association will consider withdrawing its support of a key tenet of the health overhaul law that requires Americans to purchase an insurance plan.

The Chicago-based national doctors group, which represents nearly a quarter-million physicians, is being asked by several medical societies within the organization to change its stance in favor of the  "individual mandate." A formal vote comes up at the AMA's annual policymaking House of Delegates meeting Saturday through Wednesday at the Hyatt Regency Chicago.


The AMA's support of the health care legislation, which was passed by Congress and then signed into law in March 2010 by President Barack Obama, was seen as critical at the time the controversial legislation was being debated.

The delegates' debate comes following the filing of federal lawsuits by several attorneys general challenging the individual mandate. Legal challenges in general are contending that the mandate requiring Americans buy health coverage is unconstitutional and exceeds Congress' power to regulate commerce. Legal analysts expect the challenge to be settled by the U.S. Supreme Court.

A resolution that will be introduced by three national surgery groups, including the American Society of General Surgeons and six largely southern state delegations of physicians, says the federal mandate "regulating the individual purchase of health insurance will likely undermine the innovations and improvements in health care financing that can evolve in a free market."

The AMA should "regard the purchase of health insurance to be a matter of individual responsibility to be encouraged by the use of tax incentives and other noncompulsory measures," those opposed to the mandate said in their resolution.

The groups represent less than 10 percent of the 512 doctor delegates who will vote among the AMA's policymaking House of Delegates, but resolutions can be amended and garner support of other groups during the meeting.

The opponents will face about 20 groups within the House of Delegates that remain in favor of an individual mandate.

Supporters of the individual mandate have argued a "guarantee-issue model" of insurance would provide insurers with a larger risk pool to pay claims, which helps them turn a profit and provide benefits and services to more people. It's one of the few key areas of the health law where doctors agree with the health insurance industry, which has long supported an individual mandate to purchase medical insurance.

An individual mandate was among the early principles promoted by America's Health Insurance Plans, the Washington-based lobby for such health insurance giants as UnitedHealth Group, Aetna Inc. and Chicago-based Health Care Service Corp., the parent of Blue Cross and Blue Shield of Illinois and three other Blues plans.

Without an individual mandate, the AMA, insurers and employer groups have said, people will wait to buy health insurance until they are sick, and that would lead to a spike in premiums for everybody.

"If large numbers of people wait to purchase health insurance until they are sick, these patient protections will drive up premiums for the insurance pool and force more people to drop coverage," said supporters of the individual mandate, including the American Academy of Family Physicians and at least eight state delegations. "Such cost shifting could lead to the collapse of private insurance markets, leaving government programs as the only recourse for many Americans."

bjapsen@tribune.com | Twitter @brucejapsen