This was a vote on a motion to recommit that would have required that medically underserved communities be given priority with respect to federal funding for graduate medical education. A motion to recommit with instructions is the minority's opportunity to torpedo or significantly change a bill before a final up-or-down vote on the measure. This motion to recommit was offered to legislation limiting federal funding for graduate medical education to $46 million per year.
Specifically, this underlying graduate medical education bill repealed a provision of a major health care reform law (that established near-universal health care coverage in the U.S., and was signed into law by President Obama in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 bill also limited federal funding for graduate medical education to $46 million per year.
Rep. Jim Clyburn (D-S.C.) urged support for this motion to recommit: “I oppose this [underlying] bill because we need to be training more primary care doctors, not fewer; but at a minimum, we must ensure that the nation's neediest areas have access to the doctors they need. This final amendment [motion to recommit] will ensure that training programs in the areas most in need of primary care doctors are to be prioritized for funding. This is common sense. My district, like so many others represented in this body, has some very rural communities. In many areas, families have to drive for dozens of miles to reach the nearest doctor. People who live in remote communities, like Brittons Neck and Salters, travel great distances in search of primary care, and many don't have public or private transportation. This is not just an abstract debate about compassion. For many people, it is literally a matter of life and death.”
Rep. Brett Guthrie (R-KY) opposed the motion to recommit: ”On the underlying bill, what's interesting is that this bill only takes this program back to the way it was passed out of the House in the health care bill. We are doing exactly what the [former Democratic] majority passed out of the House. It changed to a mandatory program in the Senate [health care bill], and was adopted when it came back from the Senate [for a final vote]. So, if this program is so important that it has to be mandatory funding as they say it has to be, why didn't they do it when they debated the health care bill before and include the provision that is in this motion to recommit? As a matter of fact…[the health care law] authorizes changes in medical education in hospitals, teaching hospitals, children's hospitals, nurses' programs, geriatric programs, pediatric programs. There are all sorts of them, and none of them have the provision that this motion to recommit wants to put on this program….I ask my colleagues to vote against this motion to recommit.”
The House rejected this motion to recommit by a vote of 184-236. Voting “yea” were 183 Democrats and 1 Republican. 234 Republicans and 2 Democrats voted “nay.” As a result, the House rejected a motion to recommit that would have required that medically underserved communities be given priority with respect to federal funding for graduate medical education.