House hearing targets rural physician shortages and GME reform

On February 24, the House Ways and Means Health Subcommittee held a hearing on “Advancing the Next Generation of America’s Health Care Workforce,” with a sharp focus on physician shortages in rural and underserved areas.

The impact: Members from both parties signaled interest in expanding and better targeting GME to address workforce gaps that affect access to care for your patients.

• Rural areas have far fewer physicians per capita, yet only about 2% of residency programs are based in rural communities.
• Witnesses stressed that physicians are much more likely to practice in rural areas if they complete residency there.
• Persistent barriers include 1990s-era Medicare GME caps, limited rural training infrastructure, high startup costs for new programs, and the cost of medical education.

Key provisions: Ideas and proposals discussed during the hearing included:

• Rural residency growth: Members in both parties voiced support for adding rural residency slots, extending federal startup support for rural programs, and ensuring Medicare payment policies don’t disadvantage rural hospitals.
• Resident Physician Shortage Reduction Act: Several promoted this bipartisan bill to add 14,000 new Medicare-supported residency positions over seven years.

Take action: You can use our Action Center to send a message about physician workforce issues to your representatives. 

Between the lines: The hearing also surfaced partisan fault lines that could shape future workforce and GME legislation.

• International medical graduates (IMGs): Members discussed the $100,000 H-1B visa supplemental fee, which took effect for new applications filed after September 21 of last year, and questioned witnesses regarding the parameters of a potential physician visa exemption as well as broader physician visa policy.
• Some noted IMGs are disproportionately likely to serve in rural and high-poverty communities.

The big picture: Lawmakers broadly agreed that the current GME system, built on outdated caps and urban-centered funding formulas, is not delivering enough primary care, pediatric, and rural physicians.

Go deeper: Re-watch the hearing.