Senate Committee Passes Pediatric Training Legislation

Today a Senate committee voted unanimously to reauthorize CHGME, a program that funds training for pediatricians in children's hospital. Read more about the program, and what the next steps are to ensure it continues.

While it’s certainly not going as smoothly as promised, the Affordable Care Act continues to be implemented and provide more people with access to insurance. That’s a great thing; the more people who can receive affordable health care the better. But an unintended consequence of the number of insured going up is that it exacerbates an already existing – and increasing - shortage of pediatric specialists. 

More insured kids and fewer physicians translate to longer wait times. While most hospitals set a benchmark of two weeks for clinic wait times, several specialties experience much longer waits for appointments. The average wait time to see a pediatric neurologist, for example, is nine weeks.

The simple answer to this problem is to train more physicians – but that costs money. Fortunately, in 1999, Congress enacted the Children's Hospitals Graduate Medical Education (CHGME) program, which supports children’s health care by providing certain children's hospitals with federal funding to train pediatricians and pediatric specialists. Since it was enacted, CHGME has supported the training of more than 6,000 resident physicians annually and eased critical shortages in many pediatric specialty areas.

Let’s take a break here to talk about the congressional budget process. (Don’t worry, it’ll be quick and painless.) Two things must be in place for a federal program like CHGME to receive funding. First, the program needs to be “authorized,” which is another way of simply saying “created.” That is, legislation must be passed that outlines what the program will do, and how much funding it is eligible to receive. Next, the program needs to be funded – this happens in a different piece of legislation called an appropriations bill; legislation which appropriates money to the federal program.

Here’s where it gets tricky. For most programs, the authorizations aren’t permanent. The authorizing bill outlines how long the program will last, and whether it can be “reauthorized.” Some programs aren’t meant to last more than a year or two, and simply go away. Others are given short authorizations so they can be amended and changed when Congress determines what parts of the program are or are not working.

Now back to CHGME. Since it was created in 1999, the program has been reauthorized with broad bipartisan support twice. Unfortunately, however, the most recent authorization expired last year. That doesn’t mean the program doesn’t get funded – in fact, many programs, such as the Federal Trade Commission and the Federal Aviation Administration have, at one time or another, continued to run as “unauthorized” programs. But it does mean that any legislator with an interest in reducing or eliminating funding for the program could point to its lack of authorization as a reason to defund it.

The House of Representatives passed legislation early last year that would reauthorize the program through 2017. Since then the House has been waiting on the Senate to pass identical or similar legislation that could then be reconciled with the House version (in something called a “conference committee”) and sent to the President for signature, thus reauthorizing the program.

Today, the Senate took one big step closer, when an important committee approved bipartisan legislation to reauthorize the program through 2018. This critical step allows the bill to come up for a vote before the full Senate. We’ll have a wealth of information on our site before the vote, including ways you can let your members of congress know you want them to pass this important legislation. Keep checking back to our Act Now page to learn more and take action.

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