AAPPR Endorses the Resident Physician Shortage Reduction Act

Last week, Rep. Terri Sewell (D-AL) and Rep. Brian Fitzpatrick (R-PA) reintroduced the Resident Physician Shortage Reduction Act of 2025. The legislation addresses the growing physician shortage by expanding the number of Medicare-supported graduate medical education (GME) slots by 14,000 over the next seven years.

The legislation also directs the new residency positions to be distributed strategically, with specific allocations for hospitals in rural areas, those training residents above their current GME cap, hospitals in states with new medical schools or branch campuses, and facilities serving health professional shortage areas—including a priority for those affiliated with historically Black medical schools.

AAPPR is proud to endorse this important legislation, as it directly supports our mission to strengthen the physician workforce and improve healthcare access, particularly in underserved and high-need communities. We will be transmitting an endorsement letter to the sponsors and key stakeholders and will follow up with AAPPR members on how to help raise awareness for this important legislation to increase the number of GME slots across the country.

J-1 Visa Appointments Temporarily Suspended

We are working with stakeholders regarding the temporary pause in scheduling new visa appointments for J-1 visa holders (and other student visa categories). We understand the pause has impacted a limited number of incoming J-1 physicians and will provide additional updates next month at the start of the academic year for many residency programs. If you have any questions or are impacted by this pause, please reach out for more information.

Other Legislative Updates

The Department of Health and Human Services recently released its FY 2026 Administration for a Healthy America (AHA) Congressional Justification, which outlines significant proposed cuts to health workforce programs, including the elimination of 15 key initiatives previously under Health Resources and Services Administration (HRSA), such as diversity training, primary care, and nursing workforce development.
While some programs like the Pediatric Specialty Loan Repayment Program would maintain current funding levels, the budget also proposes eliminating the Children’s Hospitals Graduate Medical Education program and reallocating funds to other workforce initiatives. We are closely monitoring these proposed cuts given Congress must ultimately enact such changes.

Reconciliation (“The Big, Beautiful Bill”) Update

The Senate is making progress on the House-passed reconciliation package, but key hurdles remain and the timing of passage is unclear. House leadership hope to see the measure pass the Senate by the July 4th recess, but several senators think prior to the August recess is more realistic if they can overcome numerous challenges by then.

The reconciliation bill proposes significant cuts to Medicaid, roughly $800B over the next decade, and places restrictions on ACA Marketplace funding and state oversight. These changes could increase the number of uninsured by up to 11 million people, leading to more uncompensated care and financial strain on hospitals, especially those serving large numbers of Medicaid and low-income patients. The bill also greatly limits states’ ability to use provider taxes and state-directed payments to support hospital funding, which could harm rural and safety-net hospitals.

We continue to follow the status of the reconciliation package and its approach to Medicaid and insurance markets. A growing number of stakeholders are concerned that such changes will lead to reduced services, personnel shortages, and potential hospital closures.

Closing Word

Republicans have been able to navigate this new Congress thus far without really having to work with Democrats. However, if the reconciliation package is not passed soon, it may coincide with the anticipated debt limit default date at the end of July. Addressing the debt limit is a real and urgent issue that may require bipartisan cooperation absent swift passage of the reconciliation bill. This timing, along with the upcoming fiscal year 2026 budget deadlines, presents both challenges and opportunities for Democrats in the minority. It is a dynamic that will be watched closely over the next month.