Trump Should Take Down The AMA’s Licensing Grift

In the labyrinthine world of American healthcare, few entities wield as much unchecked power as the American Medical Association (AMA). While the AMA positions itself as the voice of physicians, in reality it’s largely a government-sanctioned medical coding monopoly that extracts billions from the health care system and funnels it into leftist political advocacy supporting transgender pseudo-science, climate radicalism, and racial quotas in medical education and practice.

It’s an arrangement that is not only anti-competitive but profoundly unfair, compelling doctors and patients to subsidize agendas they may vehemently oppose. Now that the Department of Government Efficiency has taken a well-deserved axe to the leftist nonprofit network living off government largess and the Trump administration has brought corporate monopoly power into its focus, the government-generated monopoly providing AMA with its millions in advocacy dollars seems ripe for the picking.

AMA owns the rights to something called Current Procedural Terminology (CPT) codes — a standardized system of five-digit codes that describe every medical procedure from a routine check-up to complex surgeries. Developed and copyrighted by the AMA since the 1960s, these codes are mandatory for billing under the Health Insurance Portability and Accountability Act (more commonly known as HIPAA). No doctor, hospital, or insurer can process claims without them, creating a captive market where the AMA charges licensing fees to everyone in the chain — providers, software vendors, and payers.

Moreover, because the federal government mandates CPT use for Medicare and Medicaid, innovators and alternatives are effectively locked out. And being a government-granted monopoly is rich business. In 2023, the AMA raked in $308 million from CPT royalties — more than half its revenue — dwarfing membership dues, which now account for less than 10 percent of its income.

It would be one thing if the monopoly rents charged by the AMA added proportional value to the system. But it appears these revenues flow directly from America’s medical community into shameless left-wing advocacy. In 2023, the AMA passed resolutions denouncing state laws restricting the mutilation practices known as “gender affirming care” for children, framing such interventions as essential despite glaring evidence to the contrary. This is, of course, in keeping with its history of pushing a rabidly pro-abortion agenda.

The AMA — which holds enormous sway over medical school accreditation and curriculum — is also fully in favor of racial preferences in medical education and practice, coming out in “unequivocal opposition to legislation that would dissolve affirmative action or punish institutions for employing race-conscious admissions.” The organization has also labeled basic diagnostic tools like Body Mass Index to be tools of “racist exclusion.” In 2021 it issued a strategic plan to “embed racial justice and advance health equity” — rather than, say, address the opioid crisis killing all Americans at record levels, regardless of race — as a critical focus for American doctors.

While one in eight Americans suffer from high blood pressure, 38 million adults have diabetes, and 60 percent of Americans are afflicted with chronic and mental health conditions, the AMA has turned its efforts to decrying climate change as the most high-stakes health crisis facing the country. The AMA called for full divestment from fossil fuels by all health and life insurance companies, endorsed population control (and presumably all the abortion and eugenics that entails) to help solve climate change, advocated for “climate change education” as a key component of medical curriculums, and filed multiple amicus briefs arguing for federal regulation of greenhouse gases and motor vehicle emissions.

Leftist advocacy isn’t a fringe component of AMA’s mission; it’s central to the organization’s identity and funded directly by CPT royalties. And the AMA is keen on keeping it that way. As more and more voices call for breaking up AMA’s monopoly or propose that the government develop a free, open-source alternative, AMA’s lobbying muscle — ironically, funded by the very royalties being debated — fights to maintain the status quo. In 2024, the AMA spent $24.8 million on lobbying, outpacing many health care giants.

The AMA claims to advocate for all physicians, yet its membership has plummeted to less than 20 percent of practicing doctors. Meanwhile, the monopoly persists, driving up costs: Licensing fees add layers to billing software, electronic medical records systems, and claims processing. All of this leads to the inevitable question: Why should a private entity profit from public necessity while using the proceeds to advance the radical and niche agenda of the 1 percent?

This does not have to continue. The Trump administration has ended the government-funded left-wing nonprofit grift by effectively shutting down USAID and curtailing funding to National Public Radio and the Corporation for Public Broadcasting. It has also shown a renewed interest in taking on monopoly power across the spectrum.

As a government-backed, overtly left-wing monopoly, the AMA now sits squarely in the crosshairs. The organization no longer deserves a privileged role in the country’s health ecosystem. The Trump administration should end the grift and reform the medical billing system into a process that serves patients, not elite leftist cabals.

Rachel Bovard is the vice president of programs at the Conservative Partnership Institute. She served on Capitol Hill for over a decade, including as legislative director to Sen. Rand Paul and the executive director of the Senate Steering Committee.