Resident Physician Shortage Reduction Act of 2025
- Bill Number
- H.R. 4731
- Origin Chamber
- House
- Congress
- 119th Congress, Session 1
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2025-07-23: Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- Last Updated
- 2026-06-30T08:06:29Z
AI-Generated Summary
Purpose of the Legislation
The Resident Physician Shortage Reduction Act of 2025 aims to address shortages of resident physicians (doctors in training) by increasing the number of funded residency positions in hospitals. It does this by amending Medicare rules under title XVIII of the Social Security Act to distribute additional positions, focusing on underserved areas and promoting diversity in the healthcare workforce.
Key Provisions
- Additional Residency Positions (Section 2):
- Starting in fiscal year 2026 through 2032, the Secretary of Health and Human Services (HHS) will distribute up to 2,000 additional full-time equivalent (FTE) residency positions each year, totaling 14,000 over seven years. Undistributed positions carry over to the next year, and if fewer than 14,000 are distributed by 2032, distribution continues until the total is reached.
- Hospitals must apply in seven rounds (one per fiscal year), and approvals are effective for cost reporting periods starting July 1 of the relevant year.
- One-third of positions (about 667 per year) are reserved for hospitals already operating above their current resident limit (a cap on funded training slots), but only if they train at least 25% of residents in primary care or general surgery and maintain this for five years. These hospitals must exceed their limit by at least 10 positions to qualify.
- The remaining two-thirds are distributed based on factors like the hospital's ability to fill positions quickly (within five years) and priorities for:
- At least 10% to rural hospitals, sole community hospitals (key local providers), or those near them; hospitals in high-commuting rural areas; or those with rural training tracks after 2031.
- At least 10% to hospitals over their resident limit (beyond the reserved share).
- At least 10% to hospitals in states with new or expanding medical schools accredited after January 1, 2000.
- At least 10% to hospitals serving health professional shortage areas (HPSAs, regions with limited healthcare providers).
- Priority within HPSA hospitals goes to those affiliated with historically Black medical schools (e.g., Howard University, Meharry Medical College) or certain other designated schools.
- Hospitals must agree to actually increase their residency slots to receive funding; no hospital can get more than 75 additional positions total across this program and similar prior ones (unless demand is low, allowing more).
- These new positions qualify for Medicare's standard per-resident payments (for direct graduate medical education, or GME) and indirect medical education (IME) adjustments (extra payments for teaching hospitals' higher costs).
- After five years, hospitals can share these positions within affiliated groups under existing aggregation rules.
- Study on Workforce Diversity (Section 3):
- The U.S. Government Accountability Office (GAO) must study strategies to increase diversity among health professionals, focusing on recruiting from rural, low-income, and underrepresented minority communities.
- GAO will report to Congress within two years, including recommendations for new laws or HHS actions.
Significant Changes to Existing Law
- Amends Section 1886(h) of the Social Security Act (Medicare's GME rules) by adding a new paragraph (11) to create the distribution process, updating references in existing paragraphs (4)(F), (4)(H), and (7)(E) to include it.
- Modifies Section 1886(d)(5)(B) (IME payments) to count these new positions in teaching hospital adjustments starting July 1, 2027, treating them like prior slots.
- Introduces caps, priorities, and carryover rules not previously specified for such distributions, building on earlier temporary increases (e.g., under paragraphs 7-10 for specific needs like rural or children's hospitals).
- Adds definitions for terms like "reference resident level" (a hospital's recent training volume) and "qualifying hospital" to clarify eligibility.
Potential Impacts
- On Government Agencies: HHS (via the Centers for Medicare & Medicaid Services) will handle applications, distributions, and monitoring, potentially increasing administrative workload and Medicare spending on GME/IME (estimated at about $16 billion annually pre-bill; new slots could add costs proportional to 14,000 positions). GAO's study may lead to further policy changes.
- On Citizens: Could expand access to healthcare in rural, shortage, and underserved areas by training more physicians, especially in primary care. Benefits Medicare patients through better hospital staffing; promotes diversity to better serve minority and low-income communities.
- On International Relations: No direct impact, as the bill focuses on domestic U.S. healthcare training and funding.
Main Stakeholders Affected
- Hospitals: Teaching hospitals, rural facilities, those in HPSAs, and affiliates of new or minority-serving medical schools gain opportunities for funded slots; over-limit hospitals must meet training requirements to qualify.
- Medical Residents and Physicians: More training positions could ease shortages (U.S. faces ~100,000 physician shortfall by 2030 per some estimates), particularly for primary care and surgery in underserved areas.
- Medicare Beneficiaries and Patients: Improved physician supply may enhance care quality and availability, especially for older adults and rural residents.
- Medical Schools and Communities: New and historically Black schools benefit from priorities; rural and low-income areas see targeted recruitment.
- Government: HHS for implementation; Congress for oversight and potential follow-up on diversity recommendations.
Notable Legal, Constitutional, or Political Implications
- Legal: Ensures new positions integrate seamlessly into Medicare's GME/IME framework (a 1997 cap limited slots to ~100,000 FTEs), with enforcement via payment reductions for non-compliance (e.g., failing primary care training). Relies on existing accreditation standards from bodies like the Liaison Committee on Medical Education.
- Constitutional: No apparent issues; aligns with Congress's spending power under Article I for healthcare programs like Medicare.
- Political: Addresses bipartisan concerns over physician shortages (introduced by Reps. Sewell and Fitzpatrick), emphasizing equity (e.g., HPSA and minority school priorities) without mandating unfunded expansions. Could influence future budgets amid debates on Medicare sustainability; the diversity study signals focus on social justice in workforce development.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Rep. Sewell, Terri A. [D-AL-7]
Cosponsors (128)
Rep. Fitzpatrick, Brian K. [R-PA-1], Rep. Lawler, Michael [R-NY-17], Rep. Davis, Donald G. [D-NC-1], Rep. Ryan, Patrick [D-NY-18], Rep. Case, Ed [D-HI-1], Rep. Mrvan, Frank J. [D-IN-1], Rep. Kennedy, Timothy M. [D-NY-26], Rep. Carbajal, Salud O. [D-CA-24], Rep. Dexter, Maxine [D-OR-3], Rep. Malliotakis, Nicole [R-NY-11], Rep. Thompson, Bennie G. [D-MS-2], Rep. Castor, Kathy [D-FL-14], Rep. Scholten, Hillary J. [D-MI-3], Rep. Velázquez, Nydia M. [D-NY-7], Rep. Nadler, Jerrold [D-NY-12], Rep. Bresnahan, Robert P. [R-PA-8], Rescom. Hernández, Pablo Jose [D-PR-At Large], Rep. Levin, Mike [D-CA-49], Rep. Riley, Josh [D-NY-19], Rep. Clarke, Yvette D. [D-NY-9], Rep. Garbarino, Andrew R. [R-NY-2], Rep. Suozzi, Thomas R. [D-NY-3], Rep. Swalwell, Eric [D-CA-14], Rep. Mullin, Kevin [D-CA-15], Rep. Torres, Ritchie [D-NY-15], Rep. Quigley, Mike [D-IL-5], Rep. Zinke, Ryan K. [R-MT-1], Rep. Hayes, Jahana [D-CT-5], Rep. Tlaib, Rashida [D-MI-12], Rep. DelBene, Suzan K. [D-WA-1], Rep. Goldman, Daniel S. [D-NY-10], Rep. Scanlon, Mary Gay [D-PA-5], Rep. Doggett, Lloyd [D-TX-37], Rep. Bacon, Don [R-NE-2], Rep. Lieu, Ted [D-CA-36], Del. Norton, Eleanor Holmes [D-DC-At Large], Rep. McCollum, Betty [D-MN-4], Rep. DeSaulnier, Mark [D-CA-10], Rep. Castro, Joaquin [D-TX-20], Rep. Dingell, Debbie [D-MI-6], Rep. Smith, Adam [D-WA-9], Rep. Bishop, Sanford D. [D-GA-2], Rep. Davids, Sharice [D-KS-3], Rep. McGarvey, Morgan [D-KY-3], Rep. Meuser, Daniel [R-PA-9], Rep. Moulton, Seth [D-MA-6], Rep. Harder, Josh [D-CA-9], Rep. Trahan, Lori [D-MA-3], Rep. Lynch, Stephen F. [D-MA-8], Rep. Krishnamoorthi, Raja [D-IL-8] and 78 more
Recent Actions
- 2025-07-23: Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2025-07-23: Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2025-07-23: Introduced in House
- 2025-07-23: Introduced in House
Bill Versions
- Resident Physician Shortage Reduction Act of 2025 — issued 2025-07-23 — PDF (17 pages)