If you look at AMA's IRS 990 forms from the last three years published, which actually go back to 2007 data since each one has current year and three prior, you see that in constant 2014 dollars the AMA's membership revenue has dropped each year since 2007. Since those same forms say that 93% or more of their revenue comes from membership dues, I think you ask a valid question.

The revenue decrease is either a result of fewer paying members, or more members moving from higher dollar open memberships to reduced dollar other types (senior discount?) or a combination of both. Either way, there does appear to be a financial incentive that may play here.

Now that AMA has said they are working to get the registration fee paid as part of AMA benefit, then suddenly all of those 30,000 "free" youth memberships just resulted in a big bill to the rest of us. $5 x 30,000 is a significant line item.