AMA to Continue to Explore Ways to Fund Coverage for All

"We've moved the AMA a long way," Joseph Zebley, M.D., of Baltimore, an AAFP delegate to the AMA, said in an interview after testifying before an AMA reference committee on the issue of providing health services to the uninsured and underinsured.

The reference committee -- convened during the interim meeting of the AMA House of Delegates Nov. 5 - 8 in Dallas -- was considering a report that recommended federal tax credits for covering the uninsured. The report asked AMA "to continue to explore and support alternative means of covering the uninsured in the short term." Zebley and others succeeded in having "in the short term" removed from the recommendation. And they got the report broadened: The revised report calls for AMA "to continue to place a high priority on expanding health insurance coverage for all" -- both the uninsured and underinsured.

"There will always be highly vulnerable populations, people working in the service sector, just above minimum wage," Zebley told the reference committee. "They live on $900 or $1,200 a month and use half of that for rent and one-fourth of it for food. They don't have money out-of-pocket for health savings accounts. They don't have taxable income to 'credit' for the purchase of health insurance. They need alternative methods of coverage," such as extending Medicaid.

"This report is really about the maids in the hotels where AMA meets -- people who make $6 or $7 an hour and may be living out of trucks," said Zebley in the interview.

Dale Moquist, M.D., of Houston, chair of the AAFP delegation, agreed with Zebley. "We've seen a major shift," said Moquist. "The AMA is starting to realize a tax credit is just one of the many ways we need to use to try to get health care coverage for all."

Daniel Ostergaard, M.D., AAFP vice president for international and interprofessional activities, called the change in the report's wording "a major win." The AAFP worked closely with the American Academy of Pediatrics, American College of Physicians, and American College of Obstetricians and Gynecologists to urge AMA to pursue alternatives to tax credits for funding insurance for all.