The American Medical Association (AMA) is the largest national association of physicians in the United States. In 2022, the AMA claimed 271,660 members, including non-dues-paying retired physicians. ¹ Though the AMA’s influence has waned since the middle of the 20th century, it remains one of the most powerful nonprofits in the American medical industry. Due to its influence and structure, critics allege that it functions as a self-interested government-backed cartel. ²

Through extensive lobbying, advertising, and advisory efforts, the AMA has played a key role in the crafting of American health care policy since its founding in 1847. The AMA was a strong supporter of the Affordable Care Act (also known as Obamacare) but continues its long-standing opposition to a single-payer health care system organized by the federal government. While the AMA’s political policy recommendations tend to be left-of-center, its views on race and gender have drifted further left since 2016. The AMA has officially declared racism to be a public health issue, blamed racial health outcome disparities on racism in the medical industry, and has encouraged the prohibition on using race as a biological proxy in medical settings. In 2021, the AMA published a guide recommending physicians align their language with social justice ideology; for instance, by rejecting the connection between personal health and individual decision-making. ^{3 4 5 6 7}

The AMA has opposed state and federal policies restricting gender reassignment surgeries and hormone treatments for minors, arguing, “It is imperative that transgender minors be given the opportunity to explore their gender identity under the safe and supportive care of a physician.” ⁸

History

In the mid-19th century, the American medical industry was lightly regulated; doctors often did not require medical school degrees to practice as long as they had state licenses. Faced with a glut of physicians, both doctor salaries and quality were considered low. In 1847, the American Medical Association (AMA) was formed as the first national physician association through the merger of numerous state associations. The goal of the AMA was to both raise physician quality and pay by pushing for government regulations to restrict the supply of American doctors. ⁹

The AMA soon “gained control over education and licensure. By the turn of the twentieth century, reformers had codified new requirements for medical schools, and the number of schools plummeted, along with the number of new doctors.” In the early 20th century, AMA membership exploded both due to the organization’s political influence and the protection from malpractice litigation it offered through insurance packages. The organization gained more political power and briefly supported a federal single-payer insurance system, but quickly reversed course and became an opponent. ⁹

The rise of the AMA was also fueled by widely recognized and generally successful national campaigns. In 1859, the AMA launched a campaign against abortion that encouraged its members to refuse to perform the practice. By 1900, the AMA had successfully pushed for anti-abortion laws in nearly every state. In 1917, the AMA declared support for prohibition of alcohol; under national Prohibition, only medical doctors could prescribe alcohol. ¹⁰

The AMA’s political power peaked in the 1940s through 1970s. Its influence reshaped the medical profession, shifting doctors from generalism to specialization, and away from being independent small-business owners to more commonly being employees in corporations within highly regulated environments. ⁹

At its peak in the early 1950s, 75 percent of American physicians were AMA members. By 1997, the AMA’s 300,000 members only represented 40 percent of doctors. The decline has been attributed to perceived conflicts of interest with major health care companies and political disagreements. Per capita physician membership declined until only 15 percent of doctors were AMA members in 2011. A steep decline in membership from 2008 to 2010 was partially attributed to members dissenting from the organization’s support for the Affordable Care Act and federally mandated health insurance. ^{11 10} Some doctors have expressed discontent that the AMA is still considered a leading representative of American physicians despite its relatively low membership. ¹²

A 2011 study found that “72% of surveyed physicians who left the AMA did so because the organization ‘does not speak for practicing physicians.’” The drop in the group’s membership as a share of the number of U.S. physicians has allegedly coincided with a decrease in the AMA’s reliance on membership dues as a primary revenue source, instead increasing reliance on royalties from its maintenance of the U.S. medical billing code system and other programs. ¹³

Funding

Overview

In 2022, the American Medical Association (AMA) generated about $493 million in revenue. Of that sum, less than $34 million came from membership dues. By far the largest revenue source was “royalties and credentialing products,” at over $293 million. Other significant revenue sources included insurance commissions ($33.2 million), journal revenues ($30.8 million), and advertising ($13.3 million). ¹⁴ The AMA’s reliance on commercial sources for revenue rather than membership dues has drawn criticism that the organization is beholden to business interests and does not adequately represent American physicians. ¹² Critics have alleged that the AMA has sold data harvested from its members to private companies. ¹⁵

Current Procedural Technology (CPT) Codes

A key source of funding for the AMA is the licensing of Current Procedural Technology (CPT) codes, a system for medical expenditure reimbursement to which the AMA has exclusive intellectual property rights. In 1983, the federal government declared that CPT would be the sole reimbursement system used for Medicare and Medicaid expenditures. Critics argue that this arrangement constitutes a government-backed private monopoly. ¹⁵

A June 2025 opinion piece by STAT News noted:

“CPT codes provide a standard way to document medical services for billing. The Centers for Medicare and Medicaid Services then assigns relative value units (RVUs) to each CPT code — largely based on annual recommendations from a multispecialty AMA advisory committee — to determine payment levels for each service. This reimbursement system often rewards specialty care and costly procedures like surgeries more generously than the primary care needed to improve population health. Many experts argue that Medicare’s current payment schedule inflates health care costs and steers would-be family physicians into higher-paying specialties by privileging procedures over preventative regimens, worsening the nation’s critical shortage of primary care doctors within an already widespread national physician shortage across all specialties.” ¹³

The AMA’s reliance on CPT royalties was highlighted amid plans announced by the U.S. Department of Health and Human Services (HHS) under Secretary Robert F. Kennedy Jr. to overhaul U.S. health spending priorities, including by targeting the CPT billing code system. ¹³

Health Care Policy Positions

Role of non-Physicians

The American Medical Association (AMA) supports measures to fight what it calls “scope creep,” or the expanded roles of non-physician medical workers such as nurses. According to the AMA, only physicians have the necessary training to perform high-level medical tasks and diagnostics effectively. Allowing nurses or physician assistants to, for instance, order tests or prescribe medicine, allegedly leads to lower quality care and increased costs as hospitals provide a greater quantity of lower value care. In addition to operating an advertising campaign against scope creep, the AMA fights state and federal legislation that expands the role of non-physicians, such as bills that permit physician assistants to operate without direct physician oversight. ¹⁶

The American Academy of Physician Associates (AAPA) criticized AMA’s “scope creep” campaign as “disparaging rhetoric” against the PA profession. ¹⁷ AAPA has previously supported expanding the number of responsibilities for PAs and similar professionals, arguing “Over the past few years, many states have attempted to address the ongoing shortage of healthcare workers by introducing new bills to increase the scope of practice for nurse practitioners and physician assistants (PAs). The goal of each bill was to improve access to care, particularly for patients who may live in areas where it’s difficult to find a doctor.” ¹⁷

Medicare and Medicaid

The AMA operates the Specialty Society Relative Value Scale Update Committee (RUC), a committee that serves in a key advisory capacity to the Centers for Medicare and Medicaid Services (CMS): “The RUC’s recommendations […] significantly influence the relative values assigned to physician services and, as a result, how much physicians are paid” by Medicare and Medicaid reimbursement. At least as of 2008, the CMS had accepted 90 percent of the RUC’s recommendations. ¹⁸

The AMA has pushed for steep increases in physician pay from Medicare. Physician payments were frozen in 2001, resulting in a 26 percent pay cut in real terms by 2021 due to inflation. ¹⁹

Single-Payer Health Care

The AMA has been described as “a relentless opponent of universal healthcare.” As early as 1949, the AMA opposed a single-payer health care system (as an extension of Social Security) proposed by President Harry Truman, calling it “socialized medicine.” In 1961, the AMA hired film actor and future President Ronald Reagan to work on an advertisement against Medicare. In 2019, the AMA joined “Partnership for America’s Health Care Future,” a group supportive of the Affordable Care Act but opposed to a single-payer system such as Medicare-for-All. ²⁰

However, a 2022 New Yorker report revealed that a single-payer health care system has support from a substantial minority of AMA members, particularly younger members. In 2019, the AMA House of Delegates voted on a proposal to end opposition to a single-payer health care system, which failed but earned support from 47 percent of delegates. ⁹

Affordable Care Act

The AMA supports reforming the Affordable Care Act (also known as Obamacare) to expand its coverage over the currently uninsured population by tweaking various subsidies and tax credits that primarily apply to low-income individuals. ²¹

In 2024, the AMA released a “Plan to Cover the Uninsured” that promoted expanding Medicaid coverage to those at 133% of the federal poverty line and to extend Medicaid coverage to immigrant communities, including illegal immigrants, arguing the plan “[r]ecognizes the potential for state and local initiatives to provide coverage to immigrants without regard to immigration status.” ²²

Other Policies

The AMA opposes prior authorization, a cost-control policy that requires physicians to attain authorization from health plans for specific treatments. The AMA argues that the policy is needlessly burdensome for physicians and administrators, thereby resulting in increased costs and abandoned care. ²³

The AMA supports federal and state policies that promote access to telehealth services, including covering telehealth under Medicare. ²⁴

The AMA supports combatting the ongoing opioid epidemic by funding treatment options, increasing access to naloxone, and supporting telehealth, among other policies. ²⁵

In 2025, according to a post on X (Formerly Twitter), the AMA hosted a discussion where a professor of Bioethics claimed that “every medical institution must” consider that the police be defunded and abolished and replaced by an increase in social services such as medical care, housing, and food programs. ²⁶

Cultural Positions

Racism

Since at least 2018, when the American Medical Association (AMA) House of Delegates meeting presented the “Plan for Continued Progress Toward Health Equity,” the AMA has asserted that the American health care system is fundamentally racist and needs ardent reform. The AMA has asserted that differentials in health outcomes between white and non-white patients, like cancer survival rates and infant mortality rates, indicate racism by medical professionals against non-white patients. In 2020, AMA Board Member Willarda Edwards stated, “The AMA recognizes that racism negatively impacts and exacerbates health inequities among historically marginalized communities. Without systemic and structural-level change, health inequities will continue to exist, and the overall health of the nation will suffer.” ²⁷

In 2023, after the U.S. Supreme Court declared affirmative action in university admissions to be unconstitutional, the AMA declared support for affirmative action policies, particularly in medical school admissions. ²⁸

In 2021, the AMA announced that it was adopting a new set of guidelines “to dismantle racist policies and practices across all of health care.” ²⁹

A few months earlier, AMA chief health equity officer Aletha Maybank wrote an 83-page report arguing that the AMA is “rooted in white patriarchy and affluent supremacy” and must counteract its history with anti-racist policies. As evidence, Maybank pointed to instances of AMA-affiliated doctors practicing surgical procedures on black female slaves before the Civil War. She identified “colonization” and “capitalism” as other “root causes of oppression” in the United States. ³⁰

The AMA adopted guidelines that established definitions for “systemic racism, explicit and implicit bias and microaggressions” in health care settings and required health care providers to “actively […] prevent and address” these issues. Necessary measures include providing special antiracist training for personnel and establishing protocols for reporting and punishing infractions. Institutions are required to “[take] every complaint seriously.” ²⁹

In December 2020, the AMA declared racism to be a “public health threat.” ³¹ According to a June 2020 survey run by the AMA, “early in the [COVID-19] epidemic it became clear that Black, American Indian and Indigenous, Latino/Latina/Latinx and Hispanic and Pacific Islander communities, as well as historically marginalized and medically vulnerable populations, were disproportionately affected by COVID-19.” The disproportionate impact allegedly included an increase in racist sentiment toward racial minority physicians. ³²

Earlier in 2020, the AMA updated its “Civil and Human Rights” policies regarding the concept of “race.” The AMA declared that “race is a social construct” as opposed to being rooted in biological or genetic variables. Furthermore, the AMA encouraged doctors to ignore race as a risk factor for disease, and instead emphasize “the experience of racism, and social determinants of health.” ³³

Most controversially, the AMA endorsed a policy of prohibiting health care providers from “using race as a proxy for biology or genetics in medical education, research, and clinical practice,” and encouraged medical students to expunge race from their studies except to acknowledge how race as a concept can harm medical outcomes. This meant, for instance, that health care providers should no longer acknowledge African ancestry as a risk factor for sickle cell anemia, even though the disease almost entirely exists within African-descended populations. ³³

Gender and Sexuality

The American Medical Association (AMA) supports “gender-affirming care” for transgender individuals. ³⁴ In June 2023, the AMA officially announced its opposition to mandatory reporting of gender dysphoria or sexual orientation in children to their parents. ²⁸ As of 2025, the group has also filed a Supreme Court amicus brief in favor of supporting access to sex-change operations for minors and veterans. ³⁵

In 2021, the AMA sent a letter to the National Governors Association opposing state legislation limiting sex-change operations and hormone treatments for minors, arguing ““It is imperative that transgender minors be given the opportunity to explore their gender identity under the safe and supportive care of a physician.”  ⁸

In October 2022, the AMA sent a letter to the U.S. Department of Justice requesting a federal crackdown on “high-profile users on social media” who allegedly spread disinformation regarding transgender children. ³⁴

Language

In 2021, the American Medical Association (AMA) released “Advancing Health Equity: A Guide to Language, Narrative and Concepts,” which included recommendations to reform common medical language. For instance, the guide recommended replacing “vulnerable” with “oppressed” because the latter better highlights “the power relations that create vulnerability and poverty.” The guide states: “People are not vulnerable; they are made vulnerable.” ³⁶

Other suggestions include rejecting individualism, diminishing the importance of personal decision-making, replacing “equality” with “equity,” and highlighting “the political roots underlying apparently ‘natural’ economic arrangements, such as property rights.” ³⁶

Journalist Conor Friedersdorf criticized the guidelines as “rife with specious reasoning, questionable assumptions, and dubious judgments, all presented in an effort to get doctors talking like ideologues of the social-justice left.” For instance, he pointed out that “vulnerable” is not synonymous with “oppressed;” while women are generally considered oppressed within left-wing circles, men were more susceptible to severe cases of COVID-19. ³⁶

Obesity

In June 2023, the AMA criticized the use of the body mass index (BMI) to assess obesity and general health. The organization claimed that BMI is associated with “racist exclusion” and “historical harm” because the measurement was formulated primarily with data from white populations that do not properly apply to non-white populations. In its decision, the AMA cited data showing that non-white populations were at higher risk of some diseases at lower BMI levels than white populations. ³⁷

Lobbying and Political Spending

The American Medical Association (AMA) is one of the largest sources of lobbying expenditure in the United States. Since 1998, the AMA has spent between just under $15 million and almost $23 million annually on federal lobbying. ³⁸ In 2022, the AMA spent over $21 million on federal lobbying, the seventh most of any organization in the U.S. ³⁹ In 2024, the group remained the seventh-highest lobbying spender with $24.7 million in lobbying expenses. ⁴⁰

American Medical Association PAC

In the 2022 election cycle, the American Medical Association PAC (AMA PAC) spent $1.8 million, a standard amount for the past decade. During the 2010s, expenditures typically ranged around $5 million. ⁴¹

During the 2022 cycle, the AMA PAC slightly favored Democratic candidates as it has since the 2018 cycle. Prior to 2018, the AMA PAC had contributed more to Republicans in all but two election cycles dating to 1990. ⁴¹

In the 2024, election cycle, the AMA PAC contributed $649,000 to the campaigns of Democratic candidates and $524,000 to Republican candidates. 87% of its PAC funds went to incumbents. ⁴² The group contributed over $50,000 to then-Vice President Kamala Harris’s 2024 presidential campaign, its largest contribution in 2024. ⁴⁰

COVID-19

Throughout the COVID-19 pandemic, the American Medical Association (AMA) supported the implementation of stricter lockdown rules by the federal government. For instance, in January 2022, the AMA criticized a new policy recommendation from the U.S. Centers for Disease Control and Prevention (CDC) for having insufficiently strict COVID-19 quarantine guidelines. ⁴³

According to its 2023 nonprofit tax return, that year AMA received over $284 million in royalties due to the licensing of its Current Procedural Terminology (CPT). A July 2025 article by the Washington Reporter reported that the CPT code is embedded “in nearly every health insurance billing system in the United States” and is managed by the Centers for Medicare and Medicaid Services (CMS) within the “private insurance market.” ³⁵ The article by the Washington Reporter continued by listing several amicus briefings the AMA filed on court cases that took place during the COVID-19 Pandemic on topics such as defending eviction moratoriums as well as government restrictions on the closings of religious services and private schools. According to the report, the AMA has also previously filed briefings on non-COVID related cases such as supporting access to sex-change operations for minors and veterans, using gender identify to justify competing in sports, opposing attempts by the Trump Administration to revoke the Deferred Action for Childhood Arrivals (DACA) program, and attempting to block federal rules that expand the detention of unaccompanied migrant youth. ³⁵

Criticism

The American Medical Association (AMA) has been criticized by left-of-center and right-leaning sources for operating as a cartel. ²⁰

In 2019, the Guardian published a piece by four medical students from the left-of-center Physicians for a National Health Program that stated: “The AMA claims to represent the interests and values of our nation’s doctors. But it has long been the public relations face of America’s private health insurance system, which treats healthcare as a commodity” and has created an unfair system with inferior patient outcomes, including high costs and high infant mortality rates. The authors claim that the AMA’s influence has prevented the United States from establishing a government-based single-payer health care system, and thus has left almost 30 million Americans uninsured. ²⁰

Right-wing and libertarian critics accuse the AMA of using government power to manipulate free markets for the benefit of its members and at the expense of the general population. Libertarian economist Milton Friedman’s views of the AMA have been summarized as “a government-sanctioned guild or trade cartel that would raise health care costs and diminish quality.” Libertarian magazine Reason furthered the summary: “That’s because the costs of AMA’s aggressive tactics to keep physician wages up by, among other things, imposing onerous licensure rules, capping the number of new doctors, and harassing nurses, midwives etc. who can treat certain routine conditions more cheaply than doctors have become painfully obvious.” ⁴⁴

Leadership

As of 2025, Bobby Mukkamala, MD is the president of the American Medical Association (AMA), being sworn in as the 180th president of the AMA in June of that year. He previously worked as an otolaryngologist based in Flint, Michigan and is the chair of the AMA’s Substance Use and Pain Care Task Force. He also served as chair of the Community Foundation of Greater Flint during the Flint water crisis. In addition, he was a member of the AMA Council on Science and Public Health starting in 2009 and served as chair from 2016 to 2017. He later became a member of the AMA’s Board of Trustees in 2017 and 2021 and is a member of the Michigan State Medical Society Board of Directors since 2011 while serving as both board chair and later as president. He was previously the president of the Genesee County Medical Society (GCMS) and is a member of the GCMS Board of Directors as of 2025. ⁴⁵

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