This was a 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.

The underlying graduate medical education bill repealed a provision of a major health care reform law (that established near-universal health care coverage in the U.S., and was signed into law by President Obama in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 also 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) argued that funding graduate medical education through discretionary spending was the more fiscally responsible approach: “Discretionary spending allows Members of Congress the opportunity to be wise stewards of the taxpayers' money by not funding ineffective or duplicative programs. On the contrary, mandatory spending operates irrespective of congressional appropriations and must be spent whether we have the money or not. The most recognized mandatory spending programs are Medicare, Medicaid and Social Security which operate on autopilot and have not been subject to congressional oversight from year to year as funds automatically stream from the treasury to anyone who qualifies for a particular benefit.

Rep. Doris Matsui (D-CA) criticized the underlying graduate medical education bill: “Unfortunately, the bill before us would call all of this into question. If this bill were enacted, we would no longer have the pipeline of primary care providers to meet demand and we would continue the status quo, which for too many is either foregoing care or seeking care in the emergency room. This perpetuates the onset of chronic conditions such as heart disease, diabetes, and cancer. This is increasing costs and costing lives.”

Foxx also praised the underlying Defense bill: “Not only does this bill ensure that our troops are properly equipped, but it also provides the men and women of the military and their families with the resources and support they need, deserve, and have earned. The fiscal year 2012 National Defense Authorization Act takes a detailed approach to ensuring that the investments in our national security are in line with our fiscal priorities and realities.”
 
Rep. Jared Polis (D-CO) opposed the underlying Defense bill because it sought to continue the military’s Don’t Ask Don’t Tell policy, which banned gays from serving openly in the armed forces. President Obama had signed legislation repealing that law in 2010. Polis argued: “Don’t Ask, Don't Tell requires brave men and women in our military to live in constant fear of being dismissed for an aspect of their personal lives that has no bearing on their job performance. It's a law that serves no purpose. It's a law that hinders our military's effectiveness. It's a law that Congress has already voted to appeal[repeal]. And it's a law, frankly, that's un-American. Yet here we are, again, considering a bill that would continue to codify discrimination. We should not go back to those dark days, and we will not go back.”

[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. Democratic leaders used this “same-day rule” procedure for legislation extending the Patriot Act.]

The House agreed to this resolution by a vote of 238-181. Voting “yea” were 232 Republicans and 6 Democrats. 180 Democrats and 1 Republican voted “yea.” As a result, the House proceeded to formal floor debate on 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. As an additional result, the House approved a “same-day rule” allowing for expedited consideration of the government surveillance law known as the Patriot Act.