The American Medical Association (AMA), the nation’s most powerful doctors’ lobbying group, faces a Declining Influence: confront Health Secretary Robert F. Kennedy Jr. or seek collaboration. The stakes are high, as the group weighs protecting public health against maintaining influence over Medicare payments and other critical policies.
For many AMA members, publicly opposing Kennedy seems the ethical choice. Policies ranging from proposed vaccine guidance changes to Medicaid cuts are viewed as threats to public health. Yet a direct confrontation risks undermining long-standing relationships with Republican lawmakers and potentially losing leverage on key issues such as physician reimbursements.
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Striking a Delicate Balance
AMA President Dr. Bobby Mukkamala is tasked with navigating these competing pressures. “On Monday, we might say, ‘We disagree. They shouldn’t be doing this,’ and on Tuesday, ‘We love this and congratulations,’” Mukkamala told POLITICO. “That’s what I think the year is going to be like.”
After AMA members criticized leadership for perceived inaction at a June summit, the association has become more vocal in its critiques of both Kennedy and President Donald Trump. Yet this outspoken stance could jeopardize policy negotiations on Capitol Hill, where billions in Medicare reimbursements and the physician vote in midterms are at stake.
Mukkamala is currently advocating to reverse a 3 percent Medicare pay cut that took effect in January. While Congressional Republicans previously floated a solution, no legislation has yet passed.
Meet the AMA President
Dr. Bobby Mukkamala, an ear, nose, and throat specialist from Flint, Michigan, became AMA president in June. His personal journey—from surviving a brain tumor to leading one of the country’s largest medical organizations—shapes his perspective on public health and advocacy.
Described by former AMA board member Dr. Mario Motta as a “storyteller and natural-born activist,” Mukkamala balances personal experience with professional strategy. His advocacy extends beyond traditional channels; he has previously taken attention-grabbing steps, such as purchasing an AR-15, to highlight public health concerns.
Mukkamala also emphasizes the importance of federal research funding, noting the role of National Institutes of Health cuts in limiting access to life-saving medications he depends on to manage his cancer.
Building Bridges with the Administration
Despite Kennedy’s criticism of doctors and his proposals to change how government sets medical service rates, Mukkamala sees potential areas of cooperation. He has reached out to Kennedy, suggesting collaboration on preventive care initiatives aligned with his expertise in lifestyle medicine. While Kennedy has not responded, Mukkamala remains open to engagement.
“I don’t know if I’d ever get a hug from the HHS secretary. I’d take it if I got it,” he said, reflecting the complex dynamic between the AMA and the Trump administration.
A Political Shift for the AMA
Historically, the AMA wielded significant influence in Republican politics. The organization opposed President Harry Truman’s national health care proposal, the creation of Medicare, and President Bill Clinton’s 1993 health plan. Over time, however, the AMA has shifted left, particularly when Democrats supported doctors in disputes with insurers during the 1990s.
Since 2018, the AMA has increasingly supported Democratic candidates, reflecting broader political realignment along education lines. This shift has prompted internal friction, as some members believe leadership has been too cautious in responding to Trump-era policies.
Rising Discontent Among Members
Tensions came to a head in March, when physicians submitted a letter urging the AMA board to publicly oppose Medicaid cuts. Critics described the board’s response as “tepid,” arguing that the organization failed to speak out against major threats to public health.
By June, dissatisfaction erupted at the AMA annual summit in Chicago. Delegates voted to rebuke an outside panel dismissed by Kennedy, uniting physicians in public opposition to administration policies. Following this, the AMA adopted a more assertive public stance, issuing statements against both Trump and Kennedy.
Yet challenges remain. Even after rapid public responses, including condemning the White House’s ouster of CDC Director Dr. Susan Monarez, some AMA physicians believe the group still falls short of adequately countering public health threats.
Generational and Strategic Divides
The AMA faces internal tension between older members focused on Medicare reimbursement reform and younger physicians advocating for a stronger public health voice. Dr. Laurie Lapp, who served on an AMA federal legislation committee, supports Mukkamala’s bridge-building but emphasizes the need to push back on administration policies.
Mukkamala defends the AMA’s “quiet advocacy” approach, arguing that open opposition to Kennedy might risk sidelining the organization. “If we rallied against Kennedy, we would be looking through a window as opposed to being in the room,” he explained.
Frequently Asked Questions
Why is the influence of American doctors declining in Washington?
The American Medical Association (AMA) and other physician groups are facing reduced influence due to shifts in political priorities, changes in healthcare policy, and a more cautious approach in dealing with the Trump administration. Public disagreements with policies like Medicaid cuts and vaccine guidance have created tension between advocacy and maintaining political relationships.
Who is Dr. Bobby Mukkamala and what role does he play?
Dr. Bobby Mukkamala is the president of the AMA. He is responsible for balancing advocacy for physicians with engaging the Trump administration on public health issues. His leadership focuses on negotiating Medicare payments, preventive care initiatives, and building strategic relationships with policymakers.
What conflicts does the AMA face with Health Secretary Robert F. Kennedy Jr.?
Kennedy has criticized doctors for failing to address the root causes of disease and for being aligned with pharmaceutical interests. He has also proposed changes to how government sets rates for medical services, reducing the AMA’s influence. This creates a tension between confrontation and cooperation.
How has the AMA’s political alignment changed over time?
Historically, the AMA was influential with Republicans, opposing initiatives like Medicare and President Clinton’s health plan. Since the late 1990s, the group has shifted left, giving more campaign contributions to Democrats, partly due to changing alliances in healthcare disputes and evolving member demographics.
What internal challenges does the AMA face among its members?
The AMA experiences a generational divide: older physicians prioritize Medicare reimbursement reform, while younger physicians emphasize public health advocacy. Members have also criticized the leadership for previous inaction on controversial Trump administration policies.
How has the AMA responded to recent Medicaid and Medicare policy changes?
The AMA has publicly criticized Medicaid cuts and advocated to reverse a 3 percent Medicare pay reduction. Leadership has also issued statements condemning administrative actions that threaten public health, though some members argue these efforts are insufficient.
What strategies is the AMA using to maintain influence?
The AMA uses “quiet advocacy,” strategic negotiation, and selective public statements to remain engaged with policymakers. Leadership believes this approach helps the organization stay at the table and shape policy decisions, even in a politically challenging environment.
Conclusion
The American Medical Association stands at a pivotal moment in its history. Facing a politically charged environment under the Trump administration, the AMA must balance advocating for physicians, protecting public health, and maintaining influence in Washington. Leadership under Dr. Bobby Mukkamala aims to navigate this delicate path—pushing back against policies that threaten healthcare while seeking collaboration where possible.