The NMA's mission is to protect and promote the interests of doctors and patients of African-American descent, and the association was a big contributor to the formation of national health insurance initiatives from 1900-1950. It was a small body at first, but it was among the first to recommend mandatory health coverage and it strongly advocated fairness in medical care for African-Americans. The association's focus grew to include the interests of African-American physicians, amid the segregated nature of medical facilities during the Jim Crow era.

From the 1910s to the end of the 1940s, the AMA (American Medical Association) was the voice of the mainstream medical profession. However, most African-American doctors could not join the AMA because of a dearth of local medical societies and the prejudicial practices of the time. To make matters worse, the NMA leaders kept on supporting mandatory health coverage, while the AMA tried to distance itself from the practice. This happened for two reasons- the communist scare of the time, and a strong belief in the superiority of the United States' health care system. The AMA also beleived that a national health insurance program would mar the sacred relationship between doctor and patient. The NMA was divided on these issues from the end of the 1930s through the beginning of the 1950s.

During that time, the National Medical Association on many occasions showed their support for a national health insurance plan, through the JAMA and various newspapers. Ordinary members, wanting to practice medicine, supported the proposals set forth by the AMA. During the health coverage debate that spanned from 1946-1950, the American Medical Association sent guest speakers to NMA conferences; these speakers promised NMA members AMA membership and the privilege to practice medicine. However, the NMA resisted the AMA's efforts at inclusion. By the beginning of the 1950s, the NMA still didn't have a unified front on health insurance, and continued to resist the AMA's promotion of non-compulsory coverage.