Physicians will keep fighting on these 6 key issues in 2020

Health care policy debates must include the trusted voices of doctors advocating for their patients, says AMA President Patrice A. Harris, MD, MA.

When most people hear the word AMA they often think of it as a doctor lobbying group and compare it with all other lobbying groups.  That is a misperception, perhaps fostered by the government and the media at times.  What is often overlooked by physicians and patients alike are it's two primary goals, physician education, and patient advocacy. It is not a union nor a trade association.  Because of these issues, many physicians no longer belong to the AMA.  Competing medical associations compete for membership.  They use an argument the AMA does not represent all physicians. 

A confounding fact is AMA dues are small compared to the fees charged by licensing authorities, state and local societies, specialty membership groups, medico-legal premiums and other essential overhead. The AMA has no enforcement nor legal authority to regulate physicians. The AMA has a code of ethics for membership. AMA membership terms and conditions. The AMA functions as an educational tool, financially it derives income from licensing CPT codes to insurers, advertising, and promoting a number of insurance programs to doctors,  It has a diverse source of income which some physicians consider unethical for a lofty group such as the American Medical Association.

Prior authorization

“We fight back against prior-authorization requirements because we see the negative impact on our patients and we know these requirements create unnecessary headaches and burdens for our practices,” Dr. Harris said. Payers continue to implement harmful policies that delay patient care and interfere with physicians’ ability to practice medicine.

The AMA has supported federal legislation to streamline prior authorization in Medicare Advantage plans and to improve the process in states across the country. Efforts include using the FixPriorAuth.org website to capture hundreds of patient and physician stories that bring home the negative impact prior authorization has on patient care.

Surprise medical bills

“We work toward reasonable legislation and regulation on surprise billing because we don’t want our patients stuck with bills that are unexpected and they cannot afford,” Dr. Harris said. The AMA believes patients should only be accountable for normal in-network cost-sharing amounts and supports an independent resolution system for settling payment disputes between physicians and insurers.

The AMA has worked with state medical associations and national specialty societies to:

Craft principles to guide surprise-billing legislation and policymaking.
Work closely with members of Congress to develop legislation that adheres to those principles.
Prevent an objectionable congressional bill from being passed.
Stop numerous state bills that would reduce the adequacy of provider networks.
Learn more about how the AMA’s work to prevent surprise medical bills.

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Health insurance coverage

“We continue our call for Medicaid expansion because we know it improves access to care and the health of our patients,” Dr. Harris said. The AMA promotes Medicaid expansion to cover the uninsured in all 50 states and has opposed Medicaid work requirements in state legislatures and in the courts.

The AMA continues to seek opportunities to improve the Affordable Care Act and expand options to those who do not qualify for subsidized coverage. Learn more about the AMA vision of health care reform.

The opioid epidemic


Dr. Harris, who chairs the AMA Opioid Task Force, also touched on AMA advocacy efforts to help end the opioid epidemic while ensuring that patients in pain maintain access to the medications they need. “We speak up for our patients in chronic pain and who have substance-use disorders because they deserve the same care and compassion as anyone with any other chronic disease,” she said, adding that the AMA also advocates for “policymakers to enforce mental health parity laws.”

The AMA has released an in-depth analysis of the opioid epidemic response by four states: Colorado, Mississippi, North Carolina, and Pennsylvania. The report, “National Roadmap on State-Level Efforts to End the Opioid Epidemic; Leading-edge Practices and Next Steps,” analyzes successful strategies used and lessons learned to guide policymakers and others in the months ahead.

E-cigarettes and vaping

When it comes to the dangers of e-cigarettes and vaping, Dr. Harris said “half measures are never acceptable,” echoing her recent comments on how a new Trump administration policy to limit flavors in some vaping products was “a step in the right direction, but does not go far enough.”

At a minimum, a total ban on all flavored e-cigarettes, “in all forms and at all locations,” is prudent and urgently needed, she said.

Gun violence

Dr. Harris also noted the AMA’s advocacy for common-sense gun laws. The AMA supports the Bipartisan Background Checks Act of 2019, which the U.S. House of Representatives passed in February but has been stalled in the Senate. AMA advocacy efforts helped secure long-sought funding for gun-violence research by the National Institutes of Health and the Centers for Disease Control and Prevention.

“Everyone benefits when health care and our health system is affordable, accessible and responsive to the unique needs of individual needs,” Dr. Harris said. “That is the goal, and certainly advocacy is how we get there.”


The AMA also has a Foundation, charitable arm that provides scholarships to offset student loans, improve community health, to train physician leaders, awards for excellence.















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