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ed its qualified support for the health care overhaul before final passage last spring, named the Medicare board at the top of its list of "needed changes" in the law.  As early as 2015, the 15-member board is supposed to develop proposals for holding down Medicare costs if they exceed certain thresholds. The AMA in the past has complained that the board's work could lead to excessive payment cuts.  At the annual meeting, the AMA's House of Delegates also called for medical liability reform and other changes in the context of the health care law.  The Coalition to Protect Patients' Rights hailed the move, saying the board would "be given unprecedented power to cut billions of dollars from the Medicare program and has virtually no oversight."  But the AMA stopped far short of calling for a repeal of the health care law as a whole. In fact, the group reaffirmed its support for the law's controversial "individual mandate" requiring Americans to obtain health insurance.  "The AMA's policy supporting individual responsibility has bipartisan roots, helps Americans get the care they need when they need it and ends cost shifting from those who are uninsured to those who are insured," AMA President Cecil B. Wilson said in a statement.  The gsevere malformations of the brain and spine. They include spina bifida, where the spine fails to close during early fetal development, and anencephaly, a usually fatal defect where much of the brain never forms. And the current findings should not deter women from taking supplements to get the recommended amount of folic acid, according to a researcher not involved in the study. "I hope women realize that until more work is done, they should continue to follow this important recommendation to reduce their risk of having a baby with a neural tube defect," Dr. Deborah L. O'Connor, of the University of Toronto and Hospital for Sick Children in Ontario, Canada, said in an email. In a recent study, O'Connor and her colleagues found that less than 1 percent of Canadian women were able to get the recommended 400 micrograms of folic acid from food alone.  (Canada also requires that folic acid be added to grain products.) A number of studies have found that since the U.S. began requiring folic acid fortification of flours, breads, cereals, pasta and other grain products, rates of neural tube defects have waned. In 2005, according to the Centers for Disease Control and Prevention, about 18 per 100,000 live newborns had spina bifida, the lowest rate ever reported. For the new study, Werler's team wanted to know whether, in the era of fortified grains, additional folic acid from supplements seems to further cut the risk. They compared 205 mothers who gave birth to a baby with spina bifida between 1998 and 2008, with 6,357 mothers who had a healthy baby. All of the women were asked whether they had used folic acid supplements in the two months before and after conception. They also completed questionnaires on what their diet habits had been before pregnancy. Overall, the researchers found that for every 100 micrograms of folic acid that women consumed from food each day, the risk of having a baby with spina bifida dipped by 13 percent. That included folic acid in fortified grains, as well as folate (the natural form of the B vitamin) in foods like spinach, asparagus, dried beans and peas, and orange juice. However, folic acid from pills was not linked to a benefit. Overall, 41 percent of the women said they'd used folic acid supplements at least four days per week around the time of conception. But their risk of having a baby with spina bifida was the same as that of women who hadn't used supplements. "Our study findings raise the possibility that supplementation with folic acid during the months immediately preceding neural tube closure does not offer further benefit in reducing the risk of a spina-bifida-affected pregnancy," Werler and her colleagues conclude. There are