This analysis was prepared by Venable, LLP, on behalf of AACOM.

The House of Representatives is currently working on a Budget Reconciliation bill which includes significant spending on families, healthcare, climate, infrastructure, and jobs. AACOM has identified sections of the bill with important provisions for the osteopathic medical education community and provided a summary below. We will continue to update this blog post as the bill moves through the reconciliation process.

House Education and Labor Committee

Section 22008 Industry or Sector Partnership Grants

• Provides $10,000,000,000 in grants to remain available through September 30, 2026.
• The Secretary shall award grants on a competitive basis to eligible partnerships for the purposes of expanding workforce development and employment opportunities for high-skill, high-wage, or in-demand industry sectors. Public health is listed among the eligible sectors.

Section 22302 Grants to Support the Direct Care Workforce

• Provides $1,480,000,000 in grants to remain available through September 30, 2031.
• Eligible entities receiving a grant shall use the funds to provide competitive wages, benefits and other supportive services and accommodations to direct care workers.
• Grant funds can also be used for:
  • Developing and implementing a strategy for recruitment of direct care workers
  • Developing and implementing an education and training program for direct care workers

Section 20033 Active Duty Deferment Periods Counted Toward Public Service Loan Forgiveness

• Allows the Secretary to deem each month a loan payment was in deferment or in forbearance while on active duty to count as if the borrower had made a payment for the purpose of public service loan forgiveness.
• This provision only applies to Federal Direct Loans made before the first day of fiscal year 2031.

Section 20031 Increasing the Maximum Federal Pell Grant

• Appropriates such funds as may be necessary to increase Pell Grants by $500 for the 2022-2023 award year.
• Increases by another $500 for award years 2023-2024 through 2029-2030

Section 20032 Federal Student Aid Eligibility

• Extends federal student aid eligibility to DREAMers and to those on temporary protected status as defined under section 244 of the Immigration and Nationality Act.

House Energy and Commerce Committee

Subtitle J: Budget Reconciliation Legislative Recommendations Related to Public Health

Section 31004 Funding for Community-Based Care Infrastructure

• Provides $500,000,000 to remain available until expended for purposes of making awards to qualified teaching health centers and behavioral health centers.
• Funds are to be used to support the improvement, renovation, or modernization of infrastructure at such centers.

Section 31005 Funding for Schools of Medicine in Underserved Areas

• Provides $1,000,000,000 to remain available until expended for the purposes of making awards to eligible entities for the establishment, improvement, or expansion of an allopathic or osteopathic school of medicine, or a branch campus of an allopathic or osteopathic school of medicine.
• Use of funds:
  • The Secretary shall take in consideration equitable distribution of awards among the geographic regions of the United States. Shall include rural regions and locations of existing schools of medicine and osteopathic medicine.
  • To recruit, enroll, and retain students, including individuals from disadvantaged backgrounds, rural and underserved areas, low-income individuals, and first-generation college students at a school of medicine or osteopathic medicine or branch campus of a school of medicine or osteopathic medicine.
  • To develop, implement, and expand curriculum that emphasizes care for rural and underserved populations, including accessible and culturally appropriate and linguistically appropriate care and services at such school or branch campus.
  • To plan and construct a school of medicine or osteopathic medicine in an area in which no other school or branch campus of such a school is based.
  • To plan, develop, and meet criteria for accreditation for a school of medicine or osteopathic medicine or branch campus of such a school.
  • To hire faculty, including faculty from racial and ethnic groups who are underrepresented among the medical and other health professions, and other staff to serve at such a school or branch campus.
  • To support educational programs at such a school or branch campus, including modernizing curriculum.
  • To modernize and expand infrastructure at such a school or branch campus.
  • To support other activities that the Secretary determines will further the establishment, improvement, or expansion of a school of medicine or osteopathic medicine or branch campus of a school of medicine or osteopathic medicine.
• In awarding the grants, the Secretary shall give priority to minority-serving institutions.

Section 31006 Funding for Nursing Education Enhancement and Modernization Grants in Underserved Areas

• Provides $1,000,000,000 to remain available until expended for making awards to schools of nursing and to enhance and modernize nursing education programs and increase the number of faulty and students at such schools.
• Use of funds:
  • The Secretary shall take into consideration equitable distribution of awards among the geographical regions of the United States and the capacity of a school of nursing to provide care in underserved areas.
  • To enhance enrollment and retention of students at such schools, with a priority for students from disadvantaged backgrounds, individuals from rural and underserved areas, low-income individuals, and first-generation college students.
  • To create, support, or modernize educational programs and curricula at such schools.
  • To retain current faculty, and hire new faculty, with an emphasis on faculty from racial or ethnic groups that are underrepresented in the nursing workforce.
  • To modernize infrastructure at such school, including audiovisual or other equipment, personal protective equipment, simulation and augmented reality resources, telehealth technologies, and virtual and physical laboratories.
  • To partner with a health care facility, nurse-managed health clinic, community health center, or other facility that provides healthcare, to provide educational opportunities for the purpose of establishing or expanding clinical education.
  • To enhance and expand nursing programs that prepare nurse researchers and scientists.
  • To establish nurse-led intradisciplinary and interprofessional educational partnerships.
  • Other activities that the Secretary determines will further the development, improvement, and expansion of schools of nursing.

Section 31007 Funding for Teaching Health Center Graduate Medical Education

• Provides $6,000,000,000 to remain available until expended.
• For the program of payments to teaching health centers that operate graduate medical education programs.
• For the awarding of teaching health center development grants pursuant to section 749A of the Public Health Service Act
• Use of funds:
  • For making payments to establish new approved graduate medical residency training programs pursuant to section 340H(a)(1)(C) of the Public Health Service Act.
  • For making payments under section 340H(a)(1)(A) of the Public Health Act to qualified teaching health centers for maintenance of filled positions at existing approved graduate medical residency training programs.
  • For making payments under section 340H(a)(1)(B) of the Public Health Act for the expansion of existing approved graduate medical residency training programs.
  • For making awards under section 749A of the Public Health Service Act to teaching health centers for the purpose of establishing new accredited or expanded primary care residency programs.
  • To provide an increase to the per resident amount described in section 340H(a)(2) of the Public Health Service Act.

Section 31046 Funding for Education and Training at Health Professions Schools to Identify and Address Health Risks Associated with Climate Change

• Provides $85,000,000 to remain available until expended for grants to accredited medical schools, accredited schools of nursing, teaching hospitals, midwifery programs, physician assistant education programs, residency or fellowship programs, or other programs determined appropriate by the Secretary to support the development and integration of education and training programs for identifying health risks associated with climate change for pregnant, lactating, and postpartum individuals.

House Ways and Means Committee

Part 6 – Pathway to Practice Training Programs

Section 137601

• Establishing Rural and Underserved Pathway to Practice Training Programs for Post-Baccalaureate Students and Medical Students. This section establishes Section 1899C of the Social Security Act for the Rural and Underserved Pathway to Practice Training Program for Post-Baccalaureate and Medical Students. This section incentivizes those from rural and underserved communities to become physicians and to practice in those communities through a scholarship and stipend for qualifying medical students to attend medical school or post-baccalaureate and medical school. Students eligible for this program include first generation college or professional students; Pell Grant recipients; those who lived in a medically underserved, rural, or health professional shortage areas.
• Beginning in 2023, the Secretary shall award 1,000 scholarships per year, which includes tuition, academic fees, textbooks, equipment, and a monthly stipend tied to the amount in for the Armed Forces Health Professions Scholarship Program, which for 2021 is $2,540. The Secretary shall prioritize those students who participated in the Health Careers Opportunity Program, were Area Health Education Scholars, are disadvantaged students as defined by the National Health Service Corps, or attended a Historically Black College or University or minority serving institution. Upon scholarship acceptance, the student agrees to complete medical school (and post-baccalaureate program as applicable), residency, and practice for at least one year per scholarship year in a health professional shortage area, a medically underserved area, or a rural area. If the student is not compliant with the terms of the scholarship, the student must repay the amounts and the Secretary will collect these repayments with interest, except for the case of hardship.

Section 137602

• Funding for the Rural and Underserved Pathway to Practice Training Programs for Post-Baccalaureate Students and Medical Students. The provision creates a new refundable Pathway to Practice medical scholarship voucher credit under section 36G of the Internal Revenue Code for qualified educational institutions. The credit amount for a taxable year is equal to the aggregate amount paid or incurred by a qualified educational institution during the taxable year pursuant to an annual award of a Pathway to Practice medical scholarship voucher to a qualifying student.

Section 137603

• Establishing Rural and Underserved Pathway to Practice Training Programs for Medical Residents. This section amends Section 1886 of the Social Security Act to incentivize additional residency training by increasing physician residency training positions to certain applicable hospitals that are recognized by the Accreditation Council for Graduate Medical Education (ACGME) for committing to train physicians with additional requirements, such as increased mentorship, structural and cultural competency training, and training in the community. There are 1,000 slots per year for these residency positions, beginning on October 1, 2026.

Section 137604

• Administrative Funding of the Rural and Undeserved Pathway to Practice Training Programs for Post-Baccalaureate Students, Medical Students, and Medical Residents. This section invests $6 million into implementation of the Pathway to Practice program.

Please contact AACOM Government Relations at aacomgr@aacom.org with questions or for further information.

Click here to return to the AACOM Action Center.