This blog is an unabashed effort to get you to do something very easy, very cheap and very important. You have the power to improve access to the right doctor at the right time for thousands of sick children by ensuring the training of pediatric specialists continues to be supported by federal dollars. This blog is all about you – and the Children’s Hospital Graduate Medical Education program (CHGME).
It’s impossible to overstate the importance of the CHGME to children’s health, and more specifically, to a robust pediatric workforce. CHGME is the only federal program that reliably supports the training of pediatricians and pediatric specialists in children’s teaching hospitals. Before the program was enacted in 1999, the pediatric physician workforce was decreasing and the number of residents in freestanding children’s teaching hospitals had been in decline. Since the enactment, however, children’s teaching hospitals have reversed this trend, increasing their training by 35 percent and training more than 5,000 pediatricians and pediatric specialists each year.
Now this important program has hit two roadblocks that threaten its vitality, and N.A.C.H. has been working throughout the year to overcome these obstacles and ensure that this vital program continues.
Roadblock #1: Reauthorization
Most federal programs like CHGME are created when Congress passes authorizing legislation; that is, legislation to bring the program into existence and cap how much money can be allocated to the program annually. (The exact amount that a program gets in a given year is determined by appropriations legislation; more on that in a minute.) CHGME was created with authorizing legislation in 1999, and the program was reauthorized in 2006. The current authorization has actually expired, but the program is being kept alive on a short-term basis by Congress. But this won’t last much longer.
That’s the bad news. The good news is legislation to reauthorize the program has enjoyed broad bipartisan support in Congress. The House of Representatives unanimously passed a bill to reauthorize the program for another five years on September 20. The Senate has also introduced legislation which is ready for consideration, but unfortunately the bill has yet to be brought up for debate – and this is the roadblock.
Generally, the leaders on both sides of the aisle in the Senate like a sure thing. They don’t want to bring up a bill unless they know what the outcome is going to be. Most of the actual bargaining and debate is done behind the scenes. Bills will often get stuck in limbo as Senators weigh in and request changes. Unfortunately, that’s where we are with the CHGME reauthorization bill.
N.A.C.H. is currently undertaking a broad grassroots campaign to urge Senate Majority Leader Harry Reid (D-NV) and Senate Minority Leader Mitch McConnell (R-KY) to bring up the bill for a vote. Both Senators have acknowledged the importance of the bill, and, as noted above, the bill enjoys broad bipartisan support. Now it’s just a matter of beating the drum loud enough. You can help by utilizing our Legislative Action Center to write to your Senators regarding the importance of CHGME. It takes just a couple of minutes, but could make a big difference.
Roadblock #2: Appropriations
Assuming the bill is eventually reauthorized, Congress must determine how much funding the program should receive. This normally routine process had a rather sizable monkey-wrench thrown into it in February, when the Obama administration recommended that Congress provide no funding for CHGME.
However, the President is only able to recommend spending levels; it is up to Congress to create and pass their own budget. Fortunately, the Senate did not heed the suggestion, and has passed a bill that would fund CHGME at about $268.4 million in the next fiscal year (again, assuming the bill is reauthorized). The House has yet to act on CHGME appropriations.
Here’s where it gets even MORE complicated – both the House and Senate must pass appropriations bills to fund every federal program. As you can imagine, with debate about spending and deficits dominating the headlines, Congress is stalled out on passage of any of these bills. In fact, fiscal year 2011 ended on September 1, last year’s bills have expired, and Congress has yet to pass a single spending bill for the current fiscal year. Congress continues to fund government programs through a “continuing resolution;” essentially a bill that keeps programs (including CHGME) going at the previous year’s funding level.
It’s likely that at some point, Congress will pass an “omnibus” appropriations bill, bundling many if not all of the spending bills into one large package. Should that happen, CHGME may face additional, though minor cuts.
The best thing we can do now is pressure the Senate to bring up the reauthorization bill. Please help by taking just a few minutes to visit our Legislative Action Center and write to your Senators. If you have any questions, please contact Justin Beland, Director of Advocacy Outreach.