Pediatric Policy Council Update

The APS and SPR are members of the Pediatric Policy Council (PPC) which actively advocates for children and academic pediatrics at the federal level. APS representatives to the PPC are Drs. DeWayne Pursley and Jonathan M. Davis; Drs. Joyce Javier and Shetal Shah represent the SPR.

The PPC also includes representatives from the Academic Pediatric Association (APA) and the Association of Medical School Pediatric Department Chairs (AMSPDC). The PPC is based in the Washington DC office of the American Academy of Pediatrics (AAP), who supplies staff and other support.

The latest advocacy developments are summarized by the PPC below


February 16, 2024

What Matters Now in Washington:

  1. House and Senate appropriations leaders secured an agreement on spending totals, paving the way for subcommittees to begin crafting annual spending bills.
  2. Lawmakers are moving towards reauthorizing the Emergency Medical Services for Children (EMSC) program for another five years.
  3. The House passed a $79 billion tax package that partially expands the Child Tax Credit on an overwhelmingly bipartisan vote, but its prospects remain uncertain in the Senate.
  4. The Senate has passed a bipartisan foreign aid package, but it remains to be seen if the House will take it up.
  5. Major social media executives gathered on Capitol Hill for a hearing on child safety online.
  6. The Health Resources and Services Administration released metrics on the first round of awardees for the Pediatric Subspecialty Loan Repayment Program.
  7. Registration for the AAP’s Advocacy Conference is open.
  8. Find new funding opportunities, research findings, and more below.
  9. See what other developments we’re tracking with implications for child health advocacy.

Appropriators agree on Fy 2024 allocations. Last week, Appropriations Committee Chairs Representative Kay Granger (R-Texas) and Senator Patty Murray (D-Wash.) reached a deal on the totals for each of the 12 appropriations bills for Fiscal Year (FY) 2024, which will provide federal agencies with updated budgets for the current fiscal year. This latest agreement will allow for subcommittee chairs and lawmakers to negotiate and draft spending bills consistent with FY 2024 targets. The deal comes after Speaker Mike Johnson (R-La.) and Senate Majority Leader Chuck Schumer (D-N.Y.) set the topline spending level at $1.7 trillion. The government is currently operating on a two-tiered continuing resolution (CR), which keeps some federal agencies open until March 1 and others, including the Department of Health and Human Services, open through March 8.

—Congressional Action Still Needed to Increase WIC Funding. As lawmakers negotiate and craft the finer details of each spending bill, it is imperative that Congress take action to provide additional funding for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), which is still facing a funding shortfall. The White House requested an extra $1 billion for the program, funding Congress has yet to provide. Without additional funding, the program would have to resort to cutting benefits or implementing waitlists.

EMSC PROGRAM DUE TO BE REAUTHORIZED. Lawmakers are gearing up to reauthorize the Emergency Medical Services for Children (EMSC) Program. On Thursday, Sens. Bob Casey (Pa.) and Ted Budd (R-N.C.) introduced the bipartisan Emergency Medical Services for Children Program Reauthorization Act of 2024 (S. 3765) to reauthorize EMSC, while Reps. Kathy Castor (D-Fla.), Buddy Carter (R-Ga.), Kim Schrier (D-Wash.), and John Joyce (R-Pa.) previously introduced identical legislation on the other side of the Capitol. The House Energy and Commerce Health Subcommittee will consider the House legislation at a legislative hearing on Wednesday, February 14. EMSC funding is used to equip hospitals and ambulances with the tools they need to treat pediatric emergencies, to provide pediatric training to paramedics and first responders, and to improve the systems that allow for efficient and effective pediatric emergency medical care. As the only federal program dedicated to improving emergency care for children, EMSC has brought vital attention and resources to an otherwise neglected population. The PPC organizations have endorsed these bills, which would reauthorize the program for five years, to ensure children can receive timely emergency medical services designed for their needs.

BIPARTISAN TAX PACKAGE PASSES IN THE HOUSE. In late January, the House of Representatives passed the Tax Relief for American Families and Workers Act in a bipartisan 357-70 vote. The $79 billion tax package offers much-needed assistance to low-income families by partially expanding the Child Tax Credit (CTC). The $33 billion cost of the expanded CTC would be equal to that of three business provisions that lower corporate tax liabilities. The package to expand the CTC includes an increase of the refundability cap to $1,800 in 2023; $1,900 in 2024; and $2,000 in 2025 to index for inflation, as well as allow families to use a prior year’s income to calculate their benefits in 2024 and 2025.

While this bill enjoyed broad bipartisan support, 23 Democrats voted against the package. Though the CTC expansion is expected to help 16 million children in low-income families and pull as many as 400,000 children out of poverty, the legislation doesn’t go far enough for key advocates like House Appropriations Committee Ranking Member Rosa DeLauro (D-Conn.), who stated that the deal “lopsidedly benefits big corporations while failing to ensure a substantial tax cut to middle- and working-class families.” However, many Democrats still supported this bill with hopes that this expansion would set the stage for further beneficial reform to the CTC in 2025. Republicans, particularly members of the House Freedom Caucus, voiced additional concerns about the ability of undocumented immigrants to receive CTC benefits, but House Ways and Means Chairman Jason Smith (R-Mo.) dismissed these concerns.

The tax package now heads to the Senate, where Republican opposition is frustrating Democrats who worked in earnest to negotiate a bipartisan agreement palatable to leaders on both sides of the aisle. Senate Republicans are principally concerned that the proposal’s “lookback” provision, which allows beneficiaries to choose between their past two years’ income to calculate the value of their credit, will disincentivize workforce participation. The package must also compete with a long list of priorities for the Senate as they prepare to take up a national security package and continue finalizing appropriations legislation.

SENATORS PASS NATIONAL SECURITY SUPPLEMENTAL FOREIGN AID PACKAGE. The Senate has recently passed on a bipartisan vote of 70-29 a $95 billion package that includes new military aid for Ukraine, Israel, and Taiwan, as well as humanitarian assistance for Gaza and the West Bank. Despite the bipartisan support in the Senate, this package faces steep odds in the House, where Speaker Johnson has already signaled that he has no plans for taking up the Senate package due to its lack of border security provisions.

However, it is worth noting that this began as a national security supplement that paired additional foreign aid with increased border security policy. The original $118 billion package included the foreign aid component, along with significant changes in US border policy. The border policy piece, negotiated by Senators James Lankford (R-Okla.), Chris Murphy (D-Conn.), and Kyrsten Sinema (I-Ariz.), included provisions that would tighten the standards for asylum screening, end the policy of community release as an alternative to detention following apprehension at the border, and create a new executive branch authority to shut down the southern border whenever crossings reach a certain threshold. Not included in this package was a pathway to citizenship for Dreamers—undocumented immigrants brought to the U.S. as children. The legislation did, however, aim to provide a pathway to citizenship for “Documented Dreamers,” or children of H-1B visa holders, by ensuring that those children are not deemed ineligible for Green Cards once they become adults. Additionally, the bill would increase the cap on immigrant visas by adding 250,000 Green Cards over five years, prioritizing family reunification. The bill would also grant all unaccompanied migrant children under the age of 13 government-funded legal representation. Despite enjoying support from both Majority Leader Schumer and Minority Leader Mitch McConnell (R-Ky.), much of the Senate Republican conference voted against advancing the original package. Some Democrats from the progressive wing of the party also declined to support the border piece, expressing concerns over its stricter asylum measures. Months of bipartisan negotiation and GOP pressure to pair any foreign aid with immigration provisions quickly fell apart after former President Trump voiced strong opposition to any border policy compromises, hoping to maintain immigration as a central issue in his 2024 presidential campaign.

Amid widespread Republican opposition, Leader Schumer moved the package forward absent the border provisions. Despite former President Trump’s opposition to more Ukraine aid, 22 Republicans still joined almost all Democrats in supporting the bill. A few Democrats voted against the bill mainly due to their concerns with Israel’s military operations in Gaza. As the bill heads to the House, it faces several obstacles, including a House Republican conference that has overwhelmingly become more hostile to Ukraine funding. While the bill’s prospects in the House remain uncertain, House Minority Leader Jeffries (D-N.Y.) has made clear his inclination to “use every available legislative tool” to get the bill on the floor if Speaker Johnson refuses, a hint towards the possible use of a discharge petition which would require the support of a majority of House members.

TECH CEOS TESTIFY BEFORE CONGRESS ON CHILD SAFETY. In late January, the Senate Judiciary Committee held a hearing focusing on the dangers that social media can pose to young people, bringing together the chief executives of major tech companies to testify before Congress. Both Democrats and Republicans used the hearing to sharply criticize the group and individual tech executives for their failure to keep young people safe on their platforms. The hearing was attended by dozens of parents, who held pictures of their children who have been harmed due to social media.

The hearing also served as a platform for senators to highlight bills to create new safeguards for young people online, including the Kids Online Safety Act (KOSA), landmark bipartisan legislation that would create new safeguards for young people online while requiring platforms to guard against certain harms to young people. X’s Linda Yaccarino and Snap CEO Evan Spiegel announced their support for KOSA, though the other CEOs present declined to endorse the bill. Child advocates are continuing to push for the Senate to take up KOSA, and action may come as soon as next month.

Pediatric Subspecialty Loan Repayment Program Implementation update. The Pediatric Policy Council (PPC) has long advocated for increased support to strengthen the pediatric health care workforce. Last year, as the result of tireless advocacy of pediatric subspecialists and academicians, the Health Resources and Services Administration (HRSA) announced the launch of the Pediatric Subspecialty Loan Repayment Program (PSLRP), a $15 million investment to recruit and retain clinicians who provide health care to children and adolescents.

122 applicants were awarded last year in the program’s inaugural year, though implementation decisions have made it difficult for many pediatric subspecialists to qualify; data from HRSA indicate that the acceptance rate for physicians was just 4.1% to that of 14.7% for non-physicians. The PPC is working closely with the AAP and the Children’s Hospital Association to advocate for changes to ensure that program requirements are consistent with the nature of pediatric subspecialty training and practice and will continue working with HRSA ahead of the launch of the program’s second award cycle to address these issues. Read more about the PPC’s recommendations for improving PSLRP implementation in this letter sent to HRSA last summer. The PPC will also be advocating to Congress for funding of $30 million for PSLRP in FY 2025, which would allow HRSA to roughly double the number of awards it can make.

JOIN US FOR THE 2024 AAP ADVOCACY CONFERENCE. Registration is open for the 2024 AAP Advocacy Conference! The conference will take place in Washington, DC, April 14 – 16, 2024. The conference brings together pediatricians, pediatric subspecialists and pediatric trainees who share a passion for child health advocacy. During the conference, participants will hear from distinguished guest speakers, attend advocacy skills-building workshops and learn about timely policy issues impacting children, families, and pediatricians. On the final day, participants from each state will attend meetings with their congressional offices to discuss a timely child health issue.

To learn more and register for the conference, visit


  1. Science Update: Preterm infants fed donor milk had fewer intestinal complications than formula-fed infant, February 7, 2024
  2. Science Update: Preterm infants protected by maternal COVID-19 vaccination, NIH-funded study suggests January 31, 2024
  3. Cognitive behavioral therapy alters brain activity in children with anxiety , January 24, 2024


  1. Cathy McMorris Rodgers won’t seek reelection, the latest establishment Republican planning to leave Congress, February 8, 2024 (CNN)
  2. ‘People of Florida aren’t stupid’: State high court grapples with abortion measure, February 7, 2024 (Politico)
  3. A Look at Substance Use and Mental Health Treatment Facilities Across the U.S. February 2, 2024 (KFF)
  4. HHS hires White House official, NIH alum as director of long Covid office, January 26, 2024 (Politico)
  5. ‘The politics have changed’: South warms to expanded health benefits, January 31, 2024 (Politico)
  6. Historic 21.3 Million People Choose ACA Marketplace Coverage, January 24, 2024 (Centers for Medicare & Medicaid Services)
  7. Senators push for more investment in long COVID research, January 19, 2024 (The Hill)