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Learn about policy issues important to medical schools and teaching hospitals, with Executive Vice President Atul Grover, M.D., Ph.D.

Washington Highlights

House Committee Approves Bills on Prevention Fund, Teaching Health Centers

April 8, 2011—The House Energy and Commerce Committee April 5 voted on party lines to advance legislation that would eliminate the Prevention and Public Health Fund (PPHF) and restructure funding for the Teaching Health Center (THC) program, both established in the Affordable Care Act (ACA, P.L. 111-148 and P.L. 111-152). As expressed during the subcommittee’s March 31 markup of the bills [see Washington Highlights, April 1], committee Republicans oppose the mandatory appropriations provided in the ACA for the programs.

Citing a responsibility of “protecting the American taxpayer,” Committee Chair Fred Upton (R-Mich.) encouraged his colleagues to “prioritize our spending and ensure we are not funding duplicative programs” in an effort to “get our federal spending under control.” But Ranking Member Henry Waxman (D-Calif.) objected to Republicans’ characterizations of the PPHF as a “slush fund,” referencing a series of committee-prepared state- and district-specific fact sheets that outline the public health impacts of eliminating the prevention fund, as proposed in H.R. 1217. He criticized the committee’s majority for “sacrificing longstanding bipartisan policies” and voting “to end funding for the first and only federal program with dedicated, ongoing resources designed to make us a healthier nation.”

Rep. Waxman also highlighted the bipartisan concern over workforce shortages, stating “Republicans have scolded Democrats for not doing enough to expand the country’s health workforce,” but planned to vote against initiatives to bolster the health care workforce. Noting “no doubt that we’re facing a workforce shortage, especially in primary care and nursing,” Subcommittee Chair Joe Pitts (R-Pa.) explained that there was “no guarantee” that the Secretary of Health and Human Services would use her authority through the PPHF to invest in workforce development. Among other initiatives, the PPHF supported the Primary Care Residency Expansion program with a $168 million investment in FY 2010 [see Washington Highlights, June 18].

In addition to H.R. 1217, the panel debated a bill (H.R. 1216) that would convert the mandatory appropriation for payments to teaching health centers, or community-based, ambulatory patient care centers that operate primary care residencies, to a discretionary authorization. Subcommittee Ranking Member Frank Pallone (D-N.J.) joined fellow Democrats, Reps. Lois Capps (Calif.), Donna Christensen (V.I.), Gene Green (Texas), and Doris Matsui (Calif.) in voicing concern over the measure’s impact on the primary care workforce.

While the bill’s sponsor, Rep. Brett Guthrie (R-Ky.), acknowledged “the need for more primary care providers,” he expressed concern over providing mandatory funding for one workforce development program, while other similar programs are subject to discretionary appropriations. Similarly, Rep. Phil Gingrey (R-Ga.) listed the Title VII health professions programs and the Children’s Hospitals Graduate Medical Education program as examples of such discretionary programs; he also noted that though “some have advocated a need to move away from hospital-based medical education,” as facilitated by the THC program, those proposals should be debated further.

The committee approved H.R. 1217, 26-16, and H.R. 1216, 21-14, after rejecting a handful of Democratic amendments intended to preserve funding for the programs. The full House may consider the legislation as early as the week of April 11.

Contact:

Tannaz Rasouli
Sr. Director, Public Policy & Strategic Outreach
Telephone: 202-828-0525
Email: trasouli@aamc.org

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Washington Highlights, a weekly electronic newsletter, features brief updates on the latest legislative and regulatory activities affecting medical schools and teaching hospitals.


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Jason Kleinman
Sr. Legislative Analyst, Govt. Relations
Telephone: 202-903-0806
Email: jkleinman@aamc.org