Keeping Both Eyes on Congress

Each year, Congress considers thousands of bills and pieces of legislation that affect all of us.  It is central to our mission to keep a watchful eye on the actions of Congress and to ensure that bills – small and large bills alike – don’t fly under the radar.

One such bill was the Children’s Hospital Graduate Medical Education Support Reauthorization Act of 2013.  The name of the bill sounds nice, and at first glance, it may seem a no-brainer to support the bill; in fact, it was put on the House “suspension calendar” which is reserved for “non-controversial” bills.  Since the bill sounds nice and is an easy way for politicians to gain political support back home, it does not surprise us that some lawmakers would react with skepticism when we said they should oppose the bill.

However, a closer look at the bill reveals that it was not as palatable as its name suggests.

The revised CBO score revealed the bill would authorize $1.4 billion in spending from 2013 to 2018.  In light of our staggering $16 trillion debt and annual trillion-dollar deficits, we explained that such an authorization would be inconsistent with getting the nation on a path to fiscal balance.  In fact, CBO explained the authorization would cost taxpayers an additional $60 million this year, compared to previously appropriated levels.

We also explained:

Setting the authorization level of an expired program above current appropriation levels isn’t fiscally responsible because it gives appropriators the authority to increase funding above current levels.  For it to not be a spending increase, either this year or in the future, appropriators will have to stay at the $270 million level.

For those that said this bill does not amount to a spending increase, we plan to remain vigilant, ensuring annual appropriations NEVER exceed $270 million.  But what is even more interesting, is that even President Obama called for a significant cut in this program in his FY 2013 budget proposal.

In advocating a two-thirds reduction in the program’s cost, the administration explained:

Within the constrained budget environment, this proposal supports only the direct costs of training pediatricians. As such, CHGME grants will no longer fund the indirect costs associated with graduate medical education. … Indirect graduate medical education (IME) costs are not well-documented and studies indicate that they may be overstated.  The funding reduction for IME in 2013 may not have a substantial impact on the number of residents trained…

Indeed, the Department of Health and Human Services was able to identify areas of the program in which spending could be cut in a manner that would better align Graduate education payments with patient care costs.

Conservatives are not “against children, sick children” as some unnamed (SHOCKING!) Republican claimed.  The point is that political expediency and a nice sounding name don’t make a fiscally irresponsible bill good.

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