Date: 2011-05-24
Speaker: GENE GREEN (democrat)
Chamber: H
State: Texas

I yield myself such time as I may consume. Mr. Chairman. I rise today in strong opposition to H.R. 1216. legislation to convert mandatory funding authorized under the Affordable Care Act for Teaching Health Centers to authorized funding. The Affordable Care Act authorized and appropriated $230 million for a 5year payment program to support accredited primary care residency training operated by communitybased entities. including communitybased health centers. This training takes place in communitybased settings such as community health centers. Research shows that CHCtrained physicians. for example. are more than twice as likely as their nonCHCtrained counterparts to work in underserved areas. ensuring that that kind of training takes place. which is what mandatory spending support for programs does. It will help strengthen the primary care workforce in underserved areas. particularly in areas that struggle to recruit and retain a sufficient workforce. The Teaching Health Center program supports the training of individuals who will practice family medicine. internal medicine. pediatrics. internal medicine pediatrics. obstetrics and gynecology. psychiatry. general dentistry. pediatric dentistry. and geriatricsthose disciplines where were experiencing significant physician shortages. Its hypocritical for my Republican colleagues to take away this funding. They continue to argue that there are not enough physicians to provide care to people who need them in primary care services. This program is designed to help address this very problem. But they keep trying to have it both ways in health reform debate. and this is just another example. Today. the majority is going to say they have an obligation to ensure this program is subject to the appropriations process due to the need for transparency in our spending process and current budget process. Let me remind the majority that were not the only party whos directed mandatory funding for programs. The majority must have certainly supported autopilot spending. as Representative Foxx described the Teaching Health Center program earlier this afternoon. when they passed the Medicare Modernization Act of 2003. which required mandatory funding for transitional programs. I suppose at that time. the majority certainly felt they knew better than the appropriators that the MMA was a worthy program and deserved mandatory funding. even though they passed it under the cover of night with a lot of armtwisting. I cant understand the opposition. particularly from my Republican colleagues. They repeatedly and inaccurately complain that we dont do enough to promote health workforce expansions. and now theyre going to cut funding for the health workforce expansion. Turning the Health Center program into a discretionary one will make it challenging for these 11 programs that have already made the decision to participate in consultation with key stakeholders. like teaching hospitals and their boards. and based on the expectation that continued funding will be available. Converting this program to discretionary funding will also deter other entities from making the business decision necessary to expand residency training. since funding over the next few years could be subject to the annual appropriations fight. This is yet another political stunt by the majority to attempt to defund health reformthis. through their playing games with funds dedicated to ensure that we have physicians in our country. Several weeks ago. they couldnt stop talking about how Medicaid will be greatly improved with the Ryan budget because it provides States with block grants to run their Medicaid programs. How great would it be to eliminate Medicare by giving seniors vouchers to purchase health insurance? And this week. were busy taking away funds to ensure that we train enough physicians to ensure all Americans have access to affordable care. Once again. the majority has their own priorities. Mr. Chairman. I reserve the balance of my time.