Beginning next week, the House and Senate will begin work on funding for programs pertaining to the Department of Health & Human Services (HHS), including the Children’s Hospitals Graduate Medical Education (CHGME) program. (No more acronyms in this post, I promise). The Senate is scheduled to kick off the process Tuesday, with the House following suit not long after.
How Does That Work?
A quick high school civics class refresher: each February, the president releases his budget request, essentially telling Congress how the Administration thinks certain programs should be funded. For 2013, the president has requested just $88 million for CHGME, well below the $317.5 million which we believe is needed to sustain workforce needs and a growing population of children in the U.S.
Having received the president’s suggestions, the House and Senate appropriations subcommittees (so named because they "appropriate" federal funds to government programs) will write a first draft of the appropriations bill. They’ll divvy up the money they’ve been allotted among all programs under HHS. This first step is called a "markup," so named because the legislators will take a draft version of the bill and literally mark it up with agreed changes.
Will the House and Senate Bills Be the Same?
Since the House and Senate are both under different leadership – the House is controlled by the Republicans, and the Senate by the Democrats – each chamber’s bill will look very different. The Senate will frame their bill around the President’s proposed budget, while the House will follow a blueprint provided by House Budget Committee chairman, Paul Ryan (R-WI).
How Will That Effect CHGME?
Even though the President has requested just $88 million for the program, we’re hearing that CHGME will likely receive more in the House and Senate bills because of broad bipartisan support for the program. However, we won’t know how exactly how much until the first markup occurs.
Now is the time to let your legislators know that they should support this important program. Using our Legislative Action Center you can send a letter to your members of Congress urging them to fund CHGME at a level that will sustain the program as the bill moves through Congress. Even if your legislator isn't on the appropriations subcommittee, they can influence the process by making suggestions to their colleagues who are. Using our Legislative Action Center is quick and easy, and can make a big difference.
What Happens After the Subcommittee Markups?
After the House and Senate subcommittees sign off on their versions of the bill, it then moves to each chamber’s full appropriations committee where a larger group of legislators will debate the bill and make additional changes. If the subcommittee recommends funding levels that we feel are too low, we will once again organize a grassroots campaign to urge the full committees in the House and Senate to increase funding for CHGME.
And After That?
After the full appropriations committees have finished their versions of the bill, it’s ready for action by the full House and Senate. In theory the House and Senate vote on their versions of the bill, then a conference between the two bodies is convened to iron out the differences.
Again, that’s in theory. The House and Senate haven’t come to agreement on appropriations bills for several years. The process usually stalls out, and to keep the government running, Congress has had to pass "continuing resolutions" which fund government programs at the previous year’s levels. For example, in 2011 no agreements could be reached, and the vast majority of government programs were level-funded by a continuing resolution that passed in mid-December. Given that this is an election year, this scenario is even more likely.
What Would That Mean For CHGME?
We're getting a little ahead of ourselves, but the most likely scenario is that many appropriations bills are left unfinished as Congress adjourns in the fall so that legislators can campaign in their home states. They’ll return after the election for a "lame duck" session in which a large continuing resolution is likely to be passed, combining suggestions of the House and Senate on funding levels. We’ll cross that bridge when we get there.
For now, we ask that you write your legislators today to tell them to support CHGME funding for 2013. We’ll keep you posted as these markups take place.
Comments