[Congressional Record Volume 157, Number 73 (Wednesday, May 25, 2011)]
[House]
[Pages H3432-H3434]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                              {time}  1400
       REPEALING MANDATORY FUNDING FOR GRADUATE MEDICAL EDUCATION

  The SPEAKER pro tempore (Mrs. Miller of Michigan). Pursuant to clause 
1(c) of rule XIX, further proceedings will resume with the third 
reading of the bill (H.R. 1216) to amend the Public Health Service Act 
to convert funding for graduate medical education in qualified teaching 
health centers from direct appropriations to an authorization of 
appropriations.
  The bill was read the third time.


                           Motion to Recommit

  Mr. CLYBURN. Madam Speaker, I have a motion to recommit at the desk.
  The SPEAKER pro tempore. Is the gentleman opposed to the bill?
  Mr. CLYBURN. In its current form, I am, Madam Speaker.
  The SPEAKER pro tempore. The Clerk will report the motion to 
recommit.
  The Clerk read as follows:

       Mr. Clyburn moves to recommit the bill H.R. 1216 to the 
     Committee on Energy and Commerce with instructions to report 
     the same to the House forthwith with the following amendment:
       Page 3, after line 14, insert the following new paragraph 
     (and redesignate subsequent paragraphs accordingly):
       (2) in subsection (b)(2), by adding at the end the 
     following new subparagraph:
       ``(C) Ensuring authorized amounts first provided to 
     underserved areas.--
       ``(i) In general.--Subject to subparagraphs (A) and (B), in 
     determining the amounts payable under this section to 
     qualified teaching health centers for a fiscal year, the 
     Secretary shall--

       ``(I) first make payments under this section to qualified 
     teaching health centers in underserved areas, based on the 
     full amount determined for such centers pursuant to clause 
     (ii); and
       ``(II) after application of subclause (I), from any 
     remaining amounts appropriated for such fiscal year pursuant 
     to subsection (g), make payments under this section to 
     qualified teaching health centers not described in subclause 
     (I).

       ``(ii) Determination.--For purposes of making payments 
     under clause (i)(I), the Secretary shall determine such 
     amounts that would be payable under this section to qualified 
     teaching health centers described in such clause as if the 
     full amount authorized to be appropriated under subsection 
     (g) for such fiscal year is the amount appropriated to carry 
     out this section for such fiscal year.'';

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
South Carolina is recognized for 5 minutes in support of his motion.
  Mr. CLYBURN. Madam Speaker, last month, Republicans voted to end 
Medicare. According to the nonpartisan Congressional Budget Office, 
their plan would raise seniors' health care costs by more than $6,000 
per year, doubling their out-of-pocket costs.
  Now, this week, Republicans want to cut training for new primary care 
doctors. This is another part of their attempt to repeal health care 
reform piece by piece. Madam Speaker, there is bipartisan agreement 
that we need more primary care physicians. Yet Republicans are bringing 
up a bill that will make sure that even fewer primary care doctors are 
trained to meet the growing demand. This is a terrible idea but not 
surprising.
  I oppose this bill because we need to be training more primary care 
doctors, not fewer; but at a minimum, we must ensure that the Nation's 
neediest areas have access to the doctors they need.
  This final amendment will ensure that training programs in the areas 
most in need of primary care doctors are to be prioritized for funding. 
This is common sense.
  My district, like so many others represented in this body, has some 
very rural communities. In many areas, families have to drive for 
dozens of miles to reach the nearest doctor. People who live in remote 
communities, like Brittons Neck and Salters, travel great distances in 
search of primary care, and many don't have public or private 
transportation. This is not just an abstract debate about compassion. 
For many people, it is literally a matter of life and death.
  Madam Speaker, we all know that, for decades, many communities across

[[Page H3433]]

the country have been left out of the American Dream year after year 
after year. We call these places persistent poverty counties--counties 
where more than 20 percent of their populations have existed below the 
poverty level for at least 30 years. Approximately 15 percent of all 
counties in America qualify as persistent poverty counties under this 
definition. Because a majority of these counties is rural, it only 
comprises about 7 percent of the Nation's population. These are the 
places that this amendment targets for funding.
  These communities are diverse and are spread across the country, 
including Appalachian communities in Kentucky and West Virginia, Native 
American communities in South Dakota and Alaska, Latino communities in 
Arizona and New Mexico, African American communities in Mississippi and 
South Carolina, and urban communities in Philadelphia, New York, 
Baltimore, and St. Louis.
  So I say to my colleagues on the other side: If you're going to cut 
funding for training new doctors, let us at least ensure that the 
communities with the greatest needs are placed at the front of the 
line. I urge my colleagues to vote ``yes'' on this final amendment.
  Madam Speaker, I yield back the balance of my time.
  Mr. GUTHRIE. Madam Speaker, I rise in opposition to the motion to 
recommit.
  The SPEAKER pro tempore. The gentleman from Kentucky is recognized 
for 5 minutes.
  Mr. GUTHRIE. Madam Speaker, as we began the debate about Medicare 
just a minute ago, we knew last week when we left to go home to work in 
our districts that Medicare's actuary said it is going to go bankrupt 
in 2024.
  This side of the aisle has offered a plan to make it stable, secure 
and sustainable. There is no member--no member as we heard all day 
yesterday--of the Greatest Generation on whom this will have any 
effect. As a matter of fact, over half the baby boomer generation will 
have no changes. We are changing Medicare to make it work so it is 
sustainable.
  If we follow the plan introduced by the President, which does raise 
taxes on the rich but still does not address the sustainability of 
Medicare in the future, my daughter, when she is my age 30 years from 
now, will wake up and go to work, and 100 percent of the Federal income 
tax she pays will pay for my generation to be retired. The Greatest 
Generation provided my generation opportunities, and we're working to 
make sure our children have opportunities as well.
  On the underlying bill, what's interesting is that this bill only 
takes this program back to the way it was passed out of the House in 
the health care bill. We are doing exactly what the majority passed out 
of the House. It changed to a mandatory program in the Senate, and was 
adopted when it came back from the Senate.
  So, if this program is so important that it has to be mandatory 
funding as they say it has to be, why didn't they do it when they 
debated the health care bill before and include the provision that is 
in this motion to recommit?

                              {time}  1410

  As a matter of fact, this bill authorizes changes in medical 
education in hospitals, teaching hospitals, children's hospitals, 
nurses' programs, geriatric programs, pediatric programs. There are all 
sorts of them, and none of them have the provision that this motion to 
recommit wants to put on this program.
  So I say we need to get a handle on the budget so we can have a 
future for this country. We need to quit putting programs on autopilot, 
and put them in the process, that they go through the appropriations 
process so they can be reviewed and they can be determined which 
programs are successful and moving forward.
  It is important that we have primary care physicians trained at 
teaching health centers, but it's also important we have them at 
children's hospitals that were zeroed out in the President's budget. So 
as we put these programs on mandatory spending, we are losing 
opportunities to fund other programs. Community health centers, they 
compete for discretionary funding. This is money that would be taken 
from that area and on to mandatory funding.
  So, Madam Speaker, this side of the House is ready to say to the 
Greatest Generation, we're preserving what you have. We also want to 
tell our children they have a future as great as the Greatest 
Generation gave us.
  Madam Speaker, I ask my colleagues to vote against this motion to 
recommit.
  Mr. GUTHRIE. I yield back the balance of my time.
  The SPEAKER pro tempore. Without objection, the previous question is 
ordered on the motion to recommit.
  There was no objection.
  The SPEAKER pro tempore. The question is on the motion to recommit.
  The question was taken; and the Speaker pro tempore announced that 
the noes appeared to have it.


                             Recorded Vote

  Mr. CLYBURN. Madam Speaker, I demand a recorded vote.
  A recorded vote was ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 and clause 9 of rule 
XX, this 15-minute vote on the motion to recommit will be followed by 
5-minute votes on passage of H.R. 1216, if ordered; ordering the 
previous question on House Resolution 276 and the amendment thereto; 
adoption of the amendment to House Resolution 276, if ordered; and 
adoption of House Resolution 276, if ordered.
  The vote was taken by electronic device, and there were--ayes 184, 
noes 236, not voting 11, as follows:

                             [Roll No. 339]

                               AYES--184

     Ackerman
     Andrews
     Baca
     Baldwin
     Barrow
     Bass (CA)
     Becerra
     Berkley
     Berman
     Bishop (GA)
     Bishop (NY)
     Blumenauer
     Boren
     Boswell
     Brady (PA)
     Brown (FL)
     Butterfield
     Capps
     Capuano
     Cardoza
     Carnahan
     Carney
     Carson (IN)
     Castor (FL)
     Chandler
     Chu
     Cicilline
     Clarke (MI)
     Clarke (NY)
     Clay
     Cleaver
     Clyburn
     Cohen
     Connolly (VA)
     Cooper
     Costa
     Costello
     Courtney
     Critz
     Crowley
     Cuellar
     Cummings
     Davis (CA)
     Davis (IL)
     DeFazio
     DeGette
     DeLauro
     Deutch
     Dicks
     Dingell
     Doggett
     Donnelly (IN)
     Doyle
     Edwards
     Ellison
     Engel
     Eshoo
     Farr
     Fattah
     Frank (MA)
     Fudge
     Garamendi
     Gonzalez
     Green, Al
     Green, Gene
     Grijalva
     Gutierrez
     Hanabusa
     Heinrich
     Higgins
     Himes
     Hinchey
     Hinojosa
     Hirono
     Holden
     Holt
     Honda
     Hoyer
     Inslee
     Israel
     Jackson Lee (TX)
     Johnson (GA)
     Johnson, E. B.
     Jones
     Kaptur
     Keating
     Kildee
     Kind
     Kissell
     Kucinich
     Langevin
     Larsen (WA)
     Larson (CT)
     Lee (CA)
     Levin
     Lewis (GA)
     Lipinski
     Loebsack
     Lofgren, Zoe
     Lowey
     Lujan
     Lynch
     Maloney
     Markey
     Matheson
     Matsui
     McCollum
     McDermott
     McGovern
     McIntyre
     McNerney
     Meeks
     Michaud
     Miller (NC)
     Miller, George
     Moore
     Moran
     Murphy (CT)
     Nadler
     Napolitano
     Neal
     Olver
     Owens
     Pallone
     Pascrell
     Pastor (AZ)
     Payne
     Pelosi
     Perlmutter
     Peters
     Peterson
     Pingree (ME)
     Polis
     Price (NC)
     Quigley
     Rahall
     Rangel
     Reyes
     Richardson
     Richmond
     Ross (AR)
     Rothman (NJ)
     Roybal-Allard
     Rush
     Ryan (OH)
     Sanchez, Linda T.
     Sanchez, Loretta
     Sarbanes
     Schakowsky
     Schiff
     Schrader
     Schwartz
     Scott (VA)
     Scott, David
     Serrano
     Sewell
     Sherman
     Shuler
     Sires
     Slaughter
     Smith (WA)
     Speier
     Stark
     Sutton
     Thompson (CA)
     Thompson (MS)
     Tierney
     Tonko
     Towns
     Tsongas
     Van Hollen
     Velazquez
     Visclosky
     Walz (MN)
     Wasserman Schultz
     Waters
     Watt
     Waxman
     Weiner
     Welch
     Wilson (FL)
     Woolsey
     Wu
     Yarmuth

                               NOES--236

     Adams
     Aderholt
     Akin
     Alexander
     Altmire
     Amash
     Austria
     Bachmann
     Bachus
     Barletta
     Bartlett
     Barton (TX)
     Bass (NH)
     Benishek
     Berg
     Biggert
     Bilbray
     Bilirakis
     Bishop (UT)
     Black
     Blackburn
     Bonner
     Bono Mack
     Boustany
     Brady (TX)
     Brooks
     Broun (GA)
     Buchanan
     Bucshon
     Buerkle
     Burgess
     Burton (IN)
     Calvert
     Camp
     Campbell
     Canseco
     Capito
     Carter
     Cassidy
     Chabot
     Chaffetz
     Coble
     Coffman (CO)
     Cole
     Conaway
     Conyers
     Cravaack
     Crawford
     Crenshaw
     Culberson
     Davis (KY)
     Denham
     Dent
     DesJarlais
     Diaz-Balart
     Dold
     Dreier
     Duffy
     Duncan (SC)
     Duncan (TN)
     Ellmers
     Emerson
     Farenthold
     Fincher
     Fitzpatrick
     Flake
     Fleischmann
     Fleming
     Flores
     Forbes
     Fortenberry
     Foxx
     Franks (AZ)
     Gallegly
     Gardner
     Garrett
     Gerlach
     Gibbs
     Gibson
     Gingrey (GA)
     Gohmert
     Goodlatte
     Gosar
     Gowdy
     Granger
     Graves (GA)
     Graves (MO)
     Griffin (AR)
     Griffith (VA)
     Grimm
     Guinta
     Guthrie
     Hall

[[Page H3434]]


     Hanna
     Harper
     Harris
     Hartzler
     Hayworth
     Heck
     Hensarling
     Herger
     Herrera Beutler
     Huelskamp
     Huizenga (MI)
     Hultgren
     Hunter
     Hurt
     Issa
     Jenkins
     Johnson (IL)
     Johnson (OH)
     Johnson, Sam
     Jordan
     Kelly
     King (IA)
     King (NY)
     Kingston
     Kinzinger (IL)
     Kline
     Labrador
     Lamborn
     Lance
     Landry
     Lankford
     Latham
     LaTourette
     Latta
     Lewis (CA)
     LoBiondo
     Lucas
     Luetkemeyer
     Lummis
     Lungren, Daniel E.
     Mack
     Manzullo
     Marchant
     Marino
     McCarthy (CA)
     McCaul
     McClintock
     McCotter
     McHenry
     McKeon
     McKinley
     McMorris Rodgers
     Meehan
     Mica
     Miller (FL)
     Miller (MI)
     Miller, Gary
     Mulvaney
     Murphy (PA)
     Myrick
     Neugebauer
     Noem
     Nugent
     Nunes
     Nunnelee
     Olson
     Palazzo
     Paul
     Paulsen
     Pearce
     Pence
     Petri
     Pitts
     Platts
     Poe (TX)
     Pompeo
     Posey
     Price (GA)
     Quayle
     Reed
     Rehberg
     Reichert
     Renacci
     Ribble
     Rigell
     Rivera
     Roby
     Roe (TN)
     Rogers (AL)
     Rogers (KY)
     Rogers (MI)
     Rohrabacher
     Rokita
     Rooney
     Ros-Lehtinen
     Roskam
     Ross (FL)
     Royce
     Runyan
     Ryan (WI)
     Scalise
     Schilling
     Schmidt
     Schock
     Schweikert
     Scott (SC)
     Scott, Austin
     Sensenbrenner
     Sessions
     Shimkus
     Shuster
     Simpson
     Smith (NE)
     Smith (NJ)
     Smith (TX)
     Southerland
     Stearns
     Stivers
     Stutzman
     Sullivan
     Terry
     Thompson (PA)
     Thornberry
     Tiberi
     Tipton
     Turner
     Upton
     Walberg
     Walden
     Walsh (IL)
     Webster
     West
     Westmoreland
     Whitfield
     Wilson (SC)
     Wittman
     Wolf
     Womack
     Woodall
     Yoder
     Young (AK)
     Young (FL)
     Young (IN)

                             NOT VOTING--11

     Braley (IA)
     Cantor
     Filner
     Frelinghuysen
     Giffords
     Hastings (FL)
     Hastings (WA)
     Jackson (IL)
     Long
     McCarthy (NY)
     Ruppersberger

                              {time}  1432

  Messrs. GUTIERREZ and PAYNE changed their vote from ``no'' to 
``aye.''
  So the motion to recommit was rejected.
  The result of the vote was announced as above recorded.
  Stated for:
  Mr. FILNER. Madam Speaker, on rollcall 339, I was away from the 
Capitol region attending the Civil Rights Freedom Riders' 50th 
Anniversary Celebration. Had I been present, I would have voted 
``aye.''
  The SPEAKER pro tempore. The question is on the passage of the bill.
  The question was taken; and the Speaker pro tempore announced that 
the ayes appeared to have it.


                             Recorded Vote

  Ms. CASTOR of Florida. Madam Speaker, I demand a recorded vote.
  A recorded vote was ordered.
  The SPEAKER pro tempore. This will be a 5-minute vote.
  The vote was taken by electronic device, and there were--ayes 234, 
noes 185, not voting 12, as follows:

                             [Roll No. 340]

                               AYES--234

     Adams
     Aderholt
     Akin
     Alexander
     Amash
     Austria
     Bachmann
     Bachus
     Bartlett
     Barton (TX)
     Bass (NH)
     Benishek
     Berg
     Biggert
     Bilbray
     Bilirakis
     Bishop (UT)
     Black
     Blackburn
     Bonner
     Bono Mack
     Boren
     Boustany
     Brady (TX)
     Brooks
     Broun (GA)
     Buchanan
     Bucshon
     Buerkle
     Burgess
     Burton (IN)
     Calvert
     Camp
     Campbell
     Canseco
     Cantor
     Capito
     Carter
     Cassidy
     Chabot
     Chaffetz
     Coble
     Coffman (CO)
     Cole
     Conaway
     Cravaack
     Crawford
     Crenshaw
     Culberson
     Davis (KY)
     Denham
     Dent
     DesJarlais
     Diaz-Balart
     Dold
     Dreier
     Duffy
     Duncan (SC)
     Duncan (TN)
     Ellmers
     Emerson
     Farenthold
     Fincher
     Fitzpatrick
     Flake
     Fleischmann
     Fleming
     Flores
     Forbes
     Fortenberry
     Foxx
     Gallegly
     Gardner
     Garrett
     Gerlach
     Gibbs
     Gibson
     Gingrey (GA)
     Gohmert
     Goodlatte
     Gosar
     Gowdy
     Granger
     Graves (GA)
     Graves (MO)
     Griffin (AR)
     Griffith (VA)
     Grimm
     Guinta
     Guthrie
     Hall
     Harper
     Harris
     Hartzler
     Hayworth
     Heck
     Hensarling
     Herger
     Herrera Beutler
     Huelskamp
     Huizenga (MI)
     Hultgren
     Hunter
     Hurt
     Issa
     Jenkins
     Johnson (IL)
     Johnson (OH)
     Johnson, Sam
     Jones
     Jordan
     Kelly
     King (NY)
     Kingston
     Kinzinger (IL)
     Kline
     Labrador
     Lamborn
     Lance
     Landry
     Lankford
     Latham
     LaTourette
     Latta
     Lewis (CA)
     LoBiondo
     Lucas
     Luetkemeyer
     Lummis
     Lungren, Daniel E.
     Mack
     Manzullo
     Marchant
     Marino
     McCarthy (CA)
     McCaul
     McClintock
     McCotter
     McHenry
     McIntyre
     McKeon
     McKinley
     McMorris Rodgers
     Mica
     Miller (FL)
     Miller (MI)
     Miller, Gary
     Mulvaney
     Murphy (PA)
     Myrick
     Neugebauer
     Noem
     Nugent
     Nunes
     Nunnelee
     Olson
     Palazzo
     Paul
     Paulsen
     Pearce
     Pence
     Petri
     Pitts
     Platts
     Poe (TX)
     Pompeo
     Posey
     Price (GA)
     Quayle
     Rangel
     Reed
     Rehberg
     Reichert
     Renacci
     Ribble
     Rigell
     Rivera
     Roby
     Roe (TN)
     Rogers (AL)
     Rogers (KY)
     Rogers (MI)
     Rohrabacher
     Rokita
     Rooney
     Ros-Lehtinen
     Roskam
     Ross (FL)
     Royce
     Runyan
     Ryan (WI)
     Scalise
     Schilling
     Schmidt
     Schock
     Schweikert
     Scott (SC)
     Scott, Austin
     Sensenbrenner
     Sessions
     Shimkus
     Shuster
     Simpson
     Smith (NE)
     Smith (NJ)
     Smith (TX)
     Southerland
     Stearns
     Stivers
     Stutzman
     Sullivan
     Terry
     Thompson (PA)
     Thornberry
     Tiberi
     Tipton
     Turner
     Upton
     Walberg
     Walden
     Walsh (IL)
     Webster
     West
     Westmoreland
     Whitfield
     Wilson (SC)
     Wittman
     Wolf
     Womack
     Woodall
     Yoder
     Young (AK)
     Young (FL)
     Young (IN)

                               NOES--185

     Ackerman
     Altmire
     Andrews
     Baca
     Baldwin
     Barletta
     Barrow
     Bass (CA)
     Becerra
     Berkley
     Berman
     Bishop (GA)
     Bishop (NY)
     Blumenauer
     Boswell
     Brady (PA)
     Brown (FL)
     Butterfield
     Capps
     Capuano
     Cardoza
     Carnahan
     Carney
     Carson (IN)
     Castor (FL)
     Chandler
     Chu
     Cicilline
     Clarke (MI)
     Clarke (NY)
     Clay
     Cleaver
     Cohen
     Connolly (VA)
     Cooper
     Costa
     Costello
     Courtney
     Critz
     Crowley
     Cuellar
     Cummings
     Davis (CA)
     Davis (IL)
     DeFazio
     DeGette
     DeLauro
     Deutch
     Dicks
     Dingell
     Doggett
     Donnelly (IN)
     Doyle
     Edwards
     Ellison
     Engel
     Eshoo
     Farr
     Fattah
     Frank (MA)
     Fudge
     Garamendi
     Gonzalez
     Green, Al
     Green, Gene
     Grijalva
     Gutierrez
     Hanabusa
     Hanna
     Heinrich
     Higgins
     Himes
     Hinchey
     Hinojosa
     Hirono
     Holden
     Holt
     Honda
     Hoyer
     Inslee
     Israel
     Jackson Lee (TX)
     Johnson (GA)
     Johnson, E. B.
     Kaptur
     Keating
     Kildee
     Kind
     King (IA)
     Kissell
     Kucinich
     Langevin
     Larsen (WA)
     Larson (CT)
     Lee (CA)
     Levin
     Lewis (GA)
     Lipinski
     Loebsack
     Lofgren, Zoe
     Lowey
     Lujan
     Lynch
     Maloney
     Markey
     Matheson
     Matsui
     McCollum
     McDermott
     McGovern
     McNerney
     Meehan
     Meeks
     Michaud
     Miller (NC)
     Miller, George
     Moore
     Moran
     Murphy (CT)
     Nadler
     Napolitano
     Neal
     Olver
     Owens
     Pallone
     Pascrell
     Pastor (AZ)
     Payne
     Pelosi
     Perlmutter
     Peters
     Peterson
     Pingree (ME)
     Polis
     Price (NC)
     Quigley
     Rahall
     Reyes
     Richardson
     Richmond
     Ross (AR)
     Rothman (NJ)
     Roybal-Allard
     Ruppersberger
     Rush
     Ryan (OH)
     Sanchez, Linda T.
     Sanchez, Loretta
     Sarbanes
     Schakowsky
     Schiff
     Schrader
     Schwartz
     Scott (VA)
     Scott, David
     Serrano
     Sewell
     Sherman
     Shuler
     Sires
     Slaughter
     Smith (WA)
     Speier
     Stark
     Sutton
     Thompson (CA)
     Thompson (MS)
     Tierney
     Tonko
     Towns
     Tsongas
     Van Hollen
     Velazquez
     Visclosky
     Walz (MN)
     Wasserman Schultz
     Waters
     Watt
     Waxman
     Weiner
     Welch
     Wilson (FL)
     Woolsey
     Wu
     Yarmuth

                             NOT VOTING--12

     Braley (IA)
     Clyburn
     Conyers
     Filner
     Franks (AZ)
     Frelinghuysen
     Giffords
     Hastings (FL)
     Hastings (WA)
     Jackson (IL)
     Long
     McCarthy (NY)


                Announcement by the Speaker Pro Tempore

  The SPEAKER pro tempore (during the vote). There are 2 minutes 
remaining on this vote.

                              {time}  1439

  So the bill was passed.
  The result of the vote was announced as above recorded.
  A motion to reconsider was laid on the table.
  Stated against:
  Mr. FILNER. Madam Speaker, on rollcall 340, I was away from the 
Capitol region attending the Civil Rights Freedom Riders' 50th 
Anniversary Celebration. Had I been present, I would have voted, 
``no.''

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