California medical schools will benefit from health care bill — if provision survives

WASHINGTON — A health care reform bill could mean millions of dollars for the University of California at Merced's proposed medical school, but the university isn't promised a dime.

Serious hurdles remain before U.C. Merced, or any medical school, can get a check cut from the massive health care bill approved Saturday by the House. For university officials and San Joaquin Valley lawmakers alike, this will be more a marathon than a sprint.

"This has still got to be done," Rep. Dennis Cardoza, D-Merced, said Tuesday, adding that "there are no guarantees in life."

Cardoza and Rep. Jim Costa, D-Fresno, have been longtime proponents of a U.C. Merced medical school. Both fought to get medical school funding included in the health care bill, and both cited the medical school provision as an important reason why they supported the controversial health care legislation.

"The Valley is one of the fastest-growing regions in the state and deserves the same access to high-quality health care, and a supporting medical school, as found elsewhere in California," U.C. Merced Chancellor Steve Kang said in a statement Tuesday.

The last-minute medical school provision, Section 2539 of the sprawling bill, thus illustrates the deal-making common on Capitol Hill. It also shows how devilish legislative details can be.

To take one example: The bill offers funding to developing medical schools in federally designated "health professional shortage areas." Numerous portions of Merced County have received this designation, but so have more than 6,000 other regions nationwide.

This means potential competition. Educators at U.C. Riverside, for instance, are already building a new medical school slated to accept its first students in the fall of 2012.

Nationwide, nine developing medical schools are currently in the process of obtaining accreditation, according to the Liaison Committee on Medical Education. Virginia Tech, for instance, is developing a medical school in the medically underserved city of Roanoke.

The nine developing schools seeking accreditation does not include those, like U.C. Riverside's, that have yet to begin classroom operations.

The House medical school language, in any event, must next survive all the way to the finish line.

The Senate will next take up its version of health care reform. If the Senate passes a bill, House and Senate negotiators will start haggling. The medical school language will only matter if it is included in a final bill signed by President Barack Obama.

"We've received assurances from the (House) speaker and the White House, that they understand this is an imperative," Cardoza said.

Because it potentially offers assistance to many regions, the medical school funding might attract general congressional support. On the other hand, fiscal hawks could theoretically oppose it as too costly for a bill whose price tag already circles the vicinity of $1 trillion.

The medical school provision does not identify any school by name. It is not an earmark, as that term is commonly understood.

Neither does the provision assure the delivery of money. It is an authorization only, of $100 million a year for the next five years. The money won't arrive, though, unless Congress in each year appropriates the funds, and that's an arena with many contestants.

Patti Istas, spokeswoman for U.C. Merced, said Tuesday that "we are working to pinpoint an exact timeline for the opening of an independently accredited medical school." As early as 2012, the university hopes to establish a medical education curriculum that can be affiliated with an existing medical school.

Cardoza cited potential total costs of roughly $126 million for development of an independent medical school.