This was a procedural vote on a resolution setting a time limit for debate and determining which amendments could be offered to legislation limiting federal funding for graduate medical education to $46 million per year, as well as a separate bill that provided annual funding for Defense Department programs. If passed, this particular procedural motion--known as the “previous question"--effectively ends debate and brings the pending legislation to an immediate vote.

The underlying graduate medical education bill repealed a provision of a major health care reform law (that established near-universal health care coverage in the U.S., and was signed into law by President Obama in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 bill limited federal funding for graduate medical education to $46 million per year.

In addition to providing for House consideration of the medical education bill and the Defense bill, this resolution also provided for a “same-day rule” (see explanation of a “same-day rule” below) that allowed for expedited consideration of legislation extending the controversial government surveillance law known as the “Patriot Act.”

Rep. Virginia Foxx (R-NC) urged support for the resolution and the underlying graduate education measure: “H.R. 1216 restores congressional oversight to federal spending by ending the autopilot spending for physician residency programs at teaching health centers and restoring it to the annual appropriations process. When a program is put on autopilot, Congress abdicates its authority to unelected bureaucrats and takes a hands-off approach. House Republicans are committed to ending that approach to federal spending and ensuring that government programs are accountable for how they are spending money. No longer will we accept politically popular excuses. Each program must prove that it is a wise steward of taxpayer dollars. If Congress will not address out-of-control spending now, we are passing the buck to our children and grandchildren.”

Rep. Jim McGovern (D-MA) opposed the resolution and the underlying bills. With respect to the underlying graduate medical education measure, he said: “Now, everyone knows there is a shortage of primary care physicians in this country. Why, then, do Republicans want to undercut efforts to bring physicians into areas of desperate need?...Making these funds discretionary does nothing to help our constituents who are struggling to obtain primary care. Making this program discretionary will deter other entities from making business decisions necessary to expand residency training…”

Foxx also praised the underlying Defense bill: “One need not look too far back in history to find words that remind us of our responsibility to provide for the common defense. President Ronald Reagan, in his first inaugural address, promised to `check and reverse the growth of government,' but also to `maintain sufficient strength to prevail if need be, knowing that if we do so we will have the best chance of never having to use that strength.' That message… still holds true today.”

McGovern opposed the underlying Defense measure: “All Members of this House are strongly committed to protecting our national security--regardless of party, region, or political point of view. It has been the tradition of the House Armed Services Committee, at the staff and member level, to work in a bipartisan way to carefully craft the annual defense authorizations bill…But given such a tradition, it comes as a surprise to see so many…that attempt to repudiate and attack several of the president's national security policies. From warehousing low-level detainees [terrorism suspects] for an indeterminate amount of time, to delaying the implementation of the repeal of Don't Ask, Don't Tell [which banned gays from serving openly in the military, to hamstringing the implementation of the bipartisan-supported New START Treaty [a nuclear weapons reduction agreement between the U.S. and Russia]…such changes have all the appearance of a partisan agenda.”

McGovern also opposed the portion of the resolution which provided for expedited consideration of legislation extending the Patriot Act: “The Senate is currently debating this reauthorization, and the Republicans feel it necessary to…jam this bill through this House as soon as the Senate is done with it. This is no way to debate legislation dealing with our homeland security and basic civil rights and civil liberties. This is an important issue. Members need time to be able to understand all of the implications of the Patriot Act.”

[Normally, the House Rules Committee passes a resolution setting a time limit for debate and determining which amendments may be offered to bills. The full House then votes on that resolution. Following passage of the resolution, the chamber begins debate on the underlying bill. House rules, however, prohibit the full House from voting on such a resolution until the day after it passes the Rules Committee. In order for the House to pass a resolution on the same day it was passed by the committee, it must receive a two-thirds majority vote.

Occasionally, the House circumvents this requirement by passing what is known as a “same-day rule.”  A same-day rule is a resolution that waives the two-thirds majority vote requirement, and allows for passage with a simple majority vote. Under this procedure, the House first passes the same-day rule (which waives the two-thirds majority vote requirement). Following the vote on the same day rule, the House then passes the resolution setting a time limit for debate and determining which amendments to the underlying bill. After passing that resolution, the House can begin debate on the underlying bill. Republican leaders used this “same-day rule” procedure for legislation extending the Patriot Act.]


The House agreed to the previous question motion by a vote of 233-179. All 230 Republicans present and 3 Democrats voted “yea.” 179 Democrats voted “nay.” As a result the House proceeded to a final vote on a resolution setting a time limit for debate and determining which amendments could be offered to legislation limiting federal funding for graduate medical education to $46 million per year, as well as a separate bill that provided annual funding for Defense Department programs. (This resolution also provided for expedited consideration of the government surveillance law known as the Patriot Act.)