This was a vote on an amendment by Rep. Dennis Cardoza (D-CA) that would have required the Government Accountability Office (GAO, which conducts studies and investigations on behalf of Congress) to conduct a study on the impact of federal funding for graduate medical education on physician shortages. This amendment was offered to legislation limiting federal funding for graduate medical education to $46 million per year.
[Specifically, the underlying graduate medical education bill repealed a provision of a major health care reform law (that established near-universal health care coverage in the U.S., and was signed into law by President Obama in 2010) that provided “mandatory” federal funding for programs that provide training to medical residents. Mandatory funding is not subject to any limitations set by Congress. (Social Security and Medicare are prime examples of programs that operate on mandatory funding.) This bill would have converted the medical education initiative to a “discretionary,” program—meaning it would be subject to limits imposed by annual spending bills. The underlying bill also limited federal funding for graduate medical education to $46 million per year.]
Cardoza urged support for his amendment: “Countless studies have demonstrated a serious and growing shortage of health professionals facing the United States--most critically a shortage of primary care physicians and dentists. However, where I come from, there is a shortage of specialties as well. With an existing shortage well established and an aging population increasing, our country desperately needs investments in the health care workforce, not rescissions. In my home state of California alone there are 567 designated health professional shortage areas, which include a population of more than 3.8 million medically underserved individuals. In California's San Joaquin Valley, there are already fewer than 87 primary care physicians for 100,000 patients of population. The doctor/patient ratio in my region is not getting better; it is getting significantly worse. That is why I have consistently advocated for the need to improve access to care and address this vital shortage.”
Rep. Brett Guthrie (R-KY) opposed Cardoza’s amendment: “…I don't think that moving an authorized and mandatory spending program to an authorized and discretionary spending program renders that program meaningless. If it does do that, then all the other programs that I have listed earlier in the debate--training in general hospitals, training in children's hospitals, training in behavioral education and health, training in nurse retention, training in nurse practitioners--that means that those programs that were in the health care act would not have as much strength as well. And so the comment that by moving this from one part of the budget to the other makes it meaningless, to me, is just not accurate.”
The House rejected Cardoza’s amendment by a vote of 182-232. Voting “yea” were 180 Democrats and 2 Republicans. 229 Republicans and 3 Democrats voted “nay.” As a result, the House rejected an amendment that would have required the Government Accountability Office to conduct a study on the impact of federal funding for graduate medical education on physician shortages.