S-2287-119
Committee on Health, Education, Labor, and Pensions. Hearings held.
Sponsored by Tammy Baldwin (D-WI)
What it does
This bill would authorize the Department of Health and Human Services to award grants and contracts to medical, nursing, social work, and chaplaincy education programs to train faculty and practitioners in palliative and hospice care. It would create academic career awards, workforce development fellowships, and career incentive awards for individuals entering the field, direct HHS to disseminate public information on palliative care, and direct NIH to expand palliative care research. It authorizes $15 million per year (2026-2030) for the main education programs and $5 million per year for nursing-specific programs, and it explicitly bars use of funds for physician-assisted suicide or euthanasia.
Who benefits
Medical, nursing, social work, physician assistant, chaplaincy, and pharmacy schools and their faculty who would receive grants; junior faculty in palliative/hospice fields seeking career awards; patients with serious or life-threatening illnesses and their families who may gain better access to trained palliative and hospice specialists; rural, underserved, tribal, and pediatric populations prioritized for outreach; NIH researchers studying palliative care.
Who is hurt
No group is directly harmed by the funding itself, though taxpayers bear the roughly $100 million cost over five years, and institutions or disciplines not prioritized (e.g., those outside the listed professions) may compete for a limited pool of grants; existing similar education programs could see resources diluted if overlapping priorities are not well coordinated.
Supporters argue
Supporters argue the United States faces a well-documented shortage of clinicians trained in palliative and hospice care even as the population of Americans with serious chronic and terminal illnesses grows, and that dedicated federal funding for faculty training and career development addresses a specific workforce gap that private markets have not filled. They contend the bill's targeted priorities for rural, underserved, tribal, and pediatric populations would help close documented access disparities in end-of-life and serious-illness care.
Opponents argue
Opponents argue that creating multiple new overlapping federal grant programs, career award tracks, and reporting requirements adds administrative complexity and cost without a clear enforcement mechanism to ensure the funding measurably increases the palliative care workforce rather than subsidizing institutions already offering similar training. They contend that at $20 million annually, the program's modest scale limits its ability to meaningfully close workforce shortages that some studies estimate would require thousands of additional trained specialists nationwide.
Constitutional context
Congress's authority to fund these grant programs rests on the Spending Clause (Art. I, §8, cl. 1), which permits Congress to attach conditions to federal funds as long as they are not unduly coercive; this bill involves voluntary grants to institutions rather than mandates, so it does not raise the coercion concerns addressed in NFIB v. Sebelius (2012) regarding Medicaid expansion.
Checks and balances
Congress authorizes and appropriates funding while HHS's Secretary retains substantial discretion to set grant criteria, priorities, and definitions, with oversight limited to congressional appropriations review and standard administrative procedure.
Historical precedent
Similar workforce training grant structures exist under other Title VII and Title VIII Public Health Service Act programs, such as geriatric education centers, which this bill explicitly references and builds upon.