H.R. 1216: To amend the Public Health Service Act to convert funding for graduate medical education in qualified teaching health centers from direct appropriations to an authorization of appropriations

H.R. 1216

To amend the Public Health Service Act to convert funding for graduate medical education in qualified teaching health centers from direct appropriations to an authorization of appropriations

Date
May 24, 2011 (112th Congress, 1st Session)

Staff Contact
Sarah Makin

Floor Situation

On Tuesday, May 24, 2011, the House is scheduled to consider H.R. 1216, a bill to amend the Public Health Service Act to convert funding for graduate medical education in qualified teaching health centers from direct appropriations to an authorization of appropriations, under a rule.  The rule provides for one hour of general debate equally divided and controlled by the chair and ranking member of the Committee on Energy and Commerce.  Additionally, the rule makes in order nine amendments, debatable for 5 minutes each, and provides for one motion to recommit with or without instructions.

 

H.R. 1216 was introduced by Rep. Brett Guthrie (R-KY) on March 29, 2011, and was referred to the House Committee on Energy and Commerce.  On April 27, 2011, the House Committee on Energy and Commerce ordered H.R. 1216 reported. 

Bill Summary

H.R. 1216 would amend the Public Health Service Act to convert mandatory funding for graduate medical education in qualified teaching health centers from direct appropriations to an authorization of appropriations.  This mandatory spending was required and established by Obamacare. 

 

The bill would also rescind any unobligated funds that were appropriated by Obamacare for health centers to expand or establish programs that provide training to medical residents.

Background

The President’s Patient Protection and Affordable Care Act (Obamacare) provided a $230 million direct appropriation for teaching health centers residence programs. 

Cost

According to Congressional Budget Office (CBO) cost estimates, enacting the legislation would decrease direct spending by about $195 million over the 2011-2016 period and by $220 million over the 2011-2021 period.  Pay-as-you-go procedures apply because enacting the legislation would affect direct spending.  Assuming appropriation of the specified amounts, CBO estimates that the discretionary spending to implement H.R. 1216 would total $184 million over the 2011-2016 period.

Amendments

Amendment No. 1—Rep. Castor (D-FL):  The amendment would prohibit the bill from taking effect until the Comptroller General of the U.S. determines that there is no primary care physician shortage in the U.S. 

 

Amendment No. 2—Rep. Tonko (D-NY):  The amendment would require a GAO study to determine the bill’s impact on the number of primary care physicians to be trained.  Specifically, the study would be required to determine:

 

  • The impacts that expanding existing and establishing new approved graduate medical residency training programs would have on the number of primary care physicians that would be trained if such funding were not repealed, rescinded, and made subject to the availability of subsequent appropriations; and
  • The amount by which such number of primary care physicians that would be trained would decrease as a result of the enactment of the bill.

 

Amendment No. 3—Rep. Castor (D-FL):  The amendment would require the Comptroller General of the U.S. to conduct a study to determine the impact that the bill would have on the health care costs of families and small businesses in the U.S. 

 

Amendment No. 4—Rep. Towns (D-NY):  The amendment would prioritize funding for school-based health centers. 

 

Amendment No. 5—Rep. Cardoza (D-CA):  The amendment would prohibit the bill from taking effect until there are no areas designated as health professional shortage areas under section 332 of the Public Health Service Act.

 

Amendment No. 6—Rep. Cardoza (D-CA):  The amendment would require the Comptroller General of the U.S. to conduct a study to determine:

 

  • The extent to which there is a shortage of physicians in the U.S., “including case studies of areas with significant shortages of physicians, such as the Central Valley of California;”
  • The impact that expanding existing and establishing new approved graduate medical residency training programs would have on the number of physicians that would be trained if such funding were not rescinded and made subject to the availability of subsequent appropriations; and
  • The impact that the enactment of the bill would have on the number of physicians who would be trained under approved graduate medical residency training programs.

 

Amendment No. 7—Rep. Foxx (R-NC):  The amendment would prohibit any funds made available under the Act to be used to provide any abortion or training in the provision of abortions, except in the cases of rape, incest, or in the case where a woman suffers from a physical disorder, physical injury, or physical illness, that would, as certified by a physician, place the woman in danger of death unless an abortion is performed including a life endangering physical condition caused by or arising from the pregnancy itself.

 

The amendment would prohibit any funds made available under the bill to be provided to a qualified teaching health center if such center subjects any institutional or individual health care entity to discrimination on the basis that the health care entity does not provide, pay for, provide coverage of, or refer for abortions.

 

The amendment would define the term “health care entity” to include an individual physician or other health care professional, a hospital, a provider-sponsored organization, a health maintenance organization, a health insurance plan, or any other kind of health care facility, organization, or plan.

 

Amendment No. 8—Rep. Foxx (R-NC):  The amendment would prohibit any funds made available under the Act to be used to provide any abortion or training in the provision of abortions, except in the cases of rape, incest, or in the case where a woman suffers from a physical disorder, physical injury, or physical illness, that would, as certified by a physician, place the woman in danger of death unless an abortion is performed including a life endangering physical condition caused by or arising from the pregnancy itself.

 

The amendment would prohibit any funds made available under the bill to be provided to a qualified teaching health center if such center subjects any institutional or individual health care entity to discrimination on the basis that the health care entity does not provide, pay for, provide coverage of, or refer for abortions.

 

The amendment would define the term “health care entity” to include an individual physician or other health care professional, a hospital, a provider-sponsored organization, a health maintenance organization, a health insurance plan, or any other kind of health care facility, organization, or plan.

 

Amendment No. 9—Rep. Cardoza (D-CA):  The amendment would require the Comptroller General of the U.S. to conduct a study to determine:

 

  • The impact that expanding existing and establishing new approved graduate medical residency training programs would have on the number of physicians that would be trained if such funding were not rescinded and made subject to the availability of subsequent appropriations; and
  • The impact that the bill would have on the number of physicians who would be trained under approved graduate medical residency training programs.