This was a vote on final passage of legislation limiting federal funding for graduate medical education to $46 million per year.

Specifically, this graduate medical education bill repealed a provision of a major health care reform law (that established near-universal health care coverage in the U.S., and was signed into law by President Obama in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. Brett Guthrie (R-KY) urged support for the bill: “This bill is not about the merits of graduate medical education or teaching health centers. Everyone agrees that there is a strong need for more primary care physicians in our health care system, but picking and choosing one program over another to receive automatic funding is irresponsible. Making these programs mandatory spending is unfair to all of the other health care programs that have to compete every year to continue to receive funds….We are $14.3 trillion in debt, and our deficit for this year will approach $1.5 trillion. Congress is making difficult decisions about which programs to fund and which to reduce. We must prioritize, and I find it unfair that some programs are completely shielded and do not have to prove their merit to earn continued funding.”

Rep. Gene Green (D-TX) opposed the bill: “ It's hypocritical for my Republican colleagues to take away this funding. They continue to argue that there are not enough physicians to provide care to people who need them in primary care services. This program is designed to help address this very problem. But they keep trying to have it both ways in health reform debate, and this is just another example….Turning the health center program into a discretionary one will make it challenging for these 11 programs that have already made the decision to participate in consultation with key stakeholders, like teaching hospitals and their boards, and based on the expectation that continued funding will be available. Converting this program to discretionary funding will also deter other entities from making the business decision necessary to expand residency training, since funding over the next few years could be subject to the annual appropriations fight. This is yet another political stunt by the majority to attempt to defund health reform--this, through their playing games with funds dedicated to ensure that we have physicians in our country.

The House passed this bill by a vote of 234-185. Voting “yea” were 231 Republicans and 3 Democrats. 181 Democrats and 4 Republicans voted “nay.” As a result, the House passed legislation limiting federal funding for graduate medical education to $46 million per year. The Senate, however, was unlikely to bring up this bill. Thus, the graduate medical education program remained intact.