Urban lawmakers concerned with hospital payment proposal

"Our hope is that we get new standards that are satisfactory to the secretary [of Health and Human Services] and then people meet them and we pay out all the money," Hackbarth told The Hill. "This really isn't trying to pry dollars out of them, it's trying to influence the shape of Graduate Medical Education."

A number of program directors in internal medicine and other educators, he added, think using Medicare payments to hold teaching hospitals accountable for their students' educational performance is the most sure way to get those results.

"There's always resistance to change," he said, "and [these educators] see Medicare as the catalyst for moving in the direction they know GME needs to go."

He added that the funding proposal would only kick in three years from now, at which point teaching hospitals would already be benefitting from provisions in the healthcare reform law.

"We're saying three years from now," he said. "The other thing that happens three years from now is moving toward universal coverage, so teaching hospitals [that say they currently lose money on treating the uninsured] will be getting a big influx of dollars through health reform at that three-year window."