WASHINGTON — A 2,074-page health care bill unveiled in the Senate this week omits funding for proposed medical schools at the University of California at Merced and other institutions.
So now the Capitol Hill maneuvering on behalf of the proposed medical school gets more complicated.
Lawmakers must choose tactics. Lobbyists must track language, where a few words mean the difference between success and failure. Advocates on and off Capitol Hill must weigh one program against another.
"There's going to be a very strong push for this," Rep. Dennis Cardoza, D-Merced, said Thursday.
The massive Senate health care package made public Wednesday night is the counterpart to a 2,000-plus page bill narrowly approved by the House two weeks ago. In many respects, they are similar — sometimes, in ways that stretch the meaning of health care reform.
Both bills, for instance, require chain restaurants like McDonald's, Wendy's and Pizza Hut to post new nutrition information.
One difference, though, matters in particular to U.C. Merced and San Joaquin Valley lawmakers.
At the insistence of Cardoza and Rep. Jim Costa, D-Fresno, the House bill included a provision authorizing $500 million for developing medical schools in medically underserved areas. The money could be used for construction, equipment, faculty development and the like.
The Senate bill lacks this language.
The House provision did not specify U.C. Merced, and other schools already under construction including at the University of California at Riverside would be eligible. Nonetheless, U.C. Merced officials welcomed the potential funding, and officials in the White House and House leadership assured Cardoza and Costa of their support.
"The assurances that I've gotten are as good as they get in Washington," Cardoza said.
David Brown, director of health and clinical affairs for the University of California, said the House language authored by Costa and Cardoza "came on our radar screen prior to the House vote, but not much prior."
Brown added that though "we would like to see this provision in the Senate bill," it has not been the highest priority for the university system, whose hospitals could be greatly affected by the health care bill's broader cost implications.
"We have a lot of other issues in that bill that we're tracking," Brown noted.
California's two Democratic senators, Dianne Feinstein and Barbara Boxer, have suggested they are sympathetic but have not yet taken a public position on the medical school funding proposal. Staffers for both senators said this week they are still monitoring the issue, and Cardoza said he received a positive reaction when he talked to Boxer's chief of staff.
Patti Istas, spokeswoman for U.C. Merced, added Thursday that school officials have not been in touch with the Senate regarding the medical school language.
All of which means: Costa and Cardoza, who began focusing on including U.C. Merced assistance in the health care bill as early as last spring, still carry the burden of getting the measure passed.
"It's going to be a huge priority for us," Rumbeck said.
Potentially, senators could add the medical school provision to the Senate health care bill as an amendment. Public amendments can be tricky, though; particularly in the Senate, where the minority can employ myriad parliamentary tools.
Alternatively, final negotiations can await a House and Senate conference, when the medical school provision would be on the table along with other provisions. There, relatively discreetly, it might either be insisted upon or traded away.