White House faces bipartisan uproar over proposed pediatric training cuts

But children's hospitals say that wouldn't cover training for pediatric subspecialists, who are already in short supply. 
Rep. Frank Pallone (D-N.J.), the top Democrat on the Energy and Commerce health subcommittee, last week said he planned to soon
 introduce legislation reauthorizing the program.

During an appropriations hearing Friday, Reps. Kay Granger (R-Texas) and Rosa DeLauro (D-Conn.) made it clear to Health and Human Services Secretary Kathleen Sebelius that they also want the program to survive.
 "It's just been a wonderful source of training funds for pediatricians and pediatrics, especially ones that work in children hospitals," Granger said.


DeLauro, the top Democratic health appropriator, shared similar views.
"This is a critical modest investment we make as a nation to make sure we're training the next generation of physicians," she said.

Sebelius answered that the proposed cut was a painful budgetary decision that "in a better budget time, we would never have recommended."


"That is one of the toughest budget cuts that we made in this 2012 proposal," Sebelius said Friday. "The (graduate medical education) funding that goes to children's hospitals is somewhat different than the vast majority of GME funding in that it does not have to be used for training. ... There are some other avenues for training pediatricians, both incentives for primary care doctors and incentives that are in the GME funding for Medicaid."

Rep. Henry Waxman (D-Calif.), the top Democrat on the Energy and Commerce panel, told The Hill on Friday that he also has concerns. He fell short, however, of saying he'd support legislation to reauthorize the program past its Sept. 30 expiration date.

"I'm concerned about it," he said. "I think this is not the time to be making cuts in graduate medical education, and certainly not disadvantaging children's hospitals. So I'm going to look at it very carefully and see what we can do."
 

The program had broad bipartisan support last time it was reauthorized, in 2006. It was sponsored by the Republican chairman of
the health subcommittee at the time, Rep. Nathan Deal (Ga.), and sailed through the House, 421-4, and passed by unanimous consent in the Senate.

Sebelius can expect more tough questions on Monday when she addresses the American Academy of Pediatrics' legislative conference. Some 125 pediatricians will be in town starting Sunday for the closed-door conference, and they'll be descending on Capitol Hill on Tuesday.

The group hasn't made graduate medical education a focus of its lobbying efforts for next week - it's focusing instead on fighting against proposals to repeal healthcare reform and defund children's healthcare programs - but it has spoken out against the proposed cut.

In a statement last month, the association said it was "disappointed" in the president's decision to end the program.

"Without this investment in training the next generation of general pediatricians and expanding the ranks of pediatric subspecialists and pediatric surgical specialists in the United States, access to specialized children's health care services will only deteriorate further," said the statement from association president O. Marion Burton.

"There is already an unsustainable shortage of pediatric subspecialists in this country, and cutting funding for children’s
 hospitals graduate medical education programs will exacerbate the problem," the statement said.

Jason Millman contributed to this story.