Key Takeaways
- •Members and witnesses emphasized lifting the 1997 Medicare cap on residency slots and modernizing Graduate Medical Education to address critical physician shortages in rural and underserved communities.
- •Andrew Racine (President, American Academy of Pediatrics) warned that stagnant funding for pediatric training is causing wait times of up to one year for children to see specialists.
- •Rep. Murphy (R-NC-3) and Jason Shenefield (President and CEO, Phelps Health) discussed how the high cost of travel nursing agencies is draining budgets of small rural hospitals.
- •Rep. Buchanan (R-FL-16) and Rep. Doggett (D-TX-37) reached a bipartisan consensus on the need to expand community-based training models and permanently extend telehealth reimbursement flexibilities for providers.
- •Lawmakers will likely consider legislation to increase National Health Service Corps funding and reform Graduate Medical Education to incentivize medical students to practice in high-need geographic areas.
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Hearing Analysis
Overview
The House Ways and Means Subcommittee on Health held a hearing on February 24, 2026, titled "Advancing the Next Generation of America’s Health Care Workforce" to address the escalating shortage of medical professionals across the United States. Chairman Vern Buchanan (R-FL-16) and Ranking Member Lloyd Doggett (D-TX-37) both emphasized that the crisis is particularly acute in rural and underserved urban areas, where patient wait times are increasing and access to essential services is declining. The hearing focused on modernizing Graduate Medical Education (GME), expanding loan repayment programs, diversifying the workforce, and integrating innovative care models like lifestyle medicine and telehealth.
Key Testimony
The witness panel provided diverse perspectives on the workforce pipeline. Dr. Andrew Racine, President of the American Academy of Pediatrics (AAP), testified that the pediatric workforce is at a crossroads due to high medical education costs and lower average earnings compared to adult medicine. He advocated for expanding the National Health Service Corps (NHSC) and the Pediatric Subspecialty Loan Repayment Program. Dr. Emily Hawes, Professor and Director of the Sheps Graduate Medical Education Technical Assistance Center at the University of North Carolina at Chapel Hill, focused on the geographic maldistribution of physicians. She argued that the current GME system, governed by a 1997 Medicare funding cap, fails to meet modern needs and suggested targeting new residency slots toward primary care and rural communities.
Mr. Jason Shenefield, President and CEO of Phelps Health, shared the challenges of a rural health system in Missouri, noting that high turnover and the lure of travel nursing have strained budgets. He emphasized the importance of the 340B Drug Pricing Program in funding recruitment and retention efforts. Dr. Jennifer Trilk, Director of Lifestyle Medicine Programs at the University of South Carolina School of Medicine Greenville, proposed a shift toward preventive care, arguing that training the workforce in lifestyle medicine could reduce the chronic disease burden on the healthcare system. Finally, Dr. Thomas Mohr, Dean of the Sam Houston State University College of Osteopathic Medicine, discussed the role of osteopathic physicians (DOs) in filling primary care gaps, noting that DOs are statistically more likely to practice in rural areas.
Policy Proposals
Several specific policy proposals and existing programs were debated. Witnesses and members discussed lifting or "re-capping" the Medicare GME funding limits to allow rural hospitals more flexibility. There was strong bipartisan support for the Children's Hospital Graduate Medical Education (CHGME) program and the Teaching Health Center Graduate Medical Education (THCGME) program, which supports training in community-based settings like Federally Qualified Health Centers (FQHCs). Rep. Gregory Murphy (R-NC-3) discussed the need to prioritize high-demand specialties like psychiatry and general surgery in GME expansion. Rep. Danny Davis (D-IL-7) highlighted the Health Profession Opportunity Grant (HPOG) program as a tool for providing low-income individuals with healthcare training and wraparound services like childcare.
Key Testimony
The industry impact of these discussions is significant for hospitals, medical schools, and community clinics. Rural hospitals, represented by the testimony regarding Phelps Health, are seeking permanent telehealth reimbursement and higher Medicare reimbursement rates to remain viable. Medical schools are looking for federal support for infrastructure and faculty development, particularly to address the shortage of nursing instructors. The pharmaceutical and hospital sectors are also monitoring the 340B program, which witnesses described as a "lifeline" for rural workforce funding.
Overview
The following organizations were identified and discussed during the hearing: - Health Resources and Services Administration (HRSA): Discussed as the agency managing critical workforce programs including the NHSC, the Health Careers Opportunity Program (HCOP), and Area Health Education Centers (AHEC). - Centers for Medicare & Medicaid Services (CMS): Referenced regarding its primary role in funding GME through Medicare and the need for permanent telehealth reimbursement flexibilities. - Sam Houston State University College of Osteopathic Medicine: Highlighted by Dr. Mohr as a model for recruiting students from rural areas to address local physician shortages. - Federally Qualified Health Centers (FQHC): Identified as essential community-based training sites that help retain physicians in underserved areas. - National Health Service Corps (NHSC): Praised by multiple witnesses as a vital tool for addressing student debt through loan repayment in exchange for service in high-need areas. - Phelps Health: Served as a case study for the recruitment, retention, and financial challenges faced by rural regional health systems. - American Academy of Pediatrics (AAP): Represented by Dr. Racine to advocate for pediatric-specific workforce needs and the CHGME program. - Cecil G. Sheps Center for Health Services Research (Sheps Center): Cited for its research on physician distribution and GME policy effectiveness. - University of South Carolina School of Medicine Greenville: Referenced regarding its innovative four-year lifestyle medicine curriculum. - University of North Carolina at Chapel Hill (UNC): Identified as the home institution for Dr. Hawes and the Sheps Center.
Partisan dynamics were largely collaborative, with both parties agreeing on the urgency of the workforce shortage. However, Democrats like Rep. Judy Chu (D-CA-28) and Rep. Steven Horsford (D-NV-4) placed greater emphasis on workforce diversity and the social determinants of education. Republicans, including Rep. Vern Buchanan (R-FL-16) and Rep. David Kustoff (R-TN-8), focused on reducing regulatory burdens, such as "administrative hoops" for mid-level providers (PAs and NPs) and the complexity of federal grant applications.
Notable exchanges included Rep. Gregory Murphy (R-NC-3) questioning the impact of travel nursing on community hospital stability and Rep. Dwight Evans (D-PA-3) discussing the "food desert" challenges associated with practicing lifestyle medicine in low-income urban areas. The hearing concluded with a consensus that GME reform and sustained funding for programs like CHGME and NHSC are essential next steps. Chairman Buchanan indicated the committee would continue to seek bipartisan solutions to bolster the healthcare pipeline.
Transcript
[Gavel sounds.] The subcommittee will come to order. Welcome to today's hearing on advancing the next generation of America's health care workforce. Without objection, the chair is authorized to declare a recess at any time. I now recognize myself for an opening statement. Today, we are here to discuss a critical issue facing our nation: the growing shortage of health care professionals and the need to bolster our health care workforce for the future. Across the country, patients are facing longer wait times for appointments, and many communities, particularly in rural and underserved areas, lack access to essential medical services. This shortage is not just a matter of convenience; it is a matter of public health and national security. We must take proactive steps to ensure that we have a robust and diverse pipeline of health care workers to meet the needs of our aging population. In today's hearing, we will hear from a panel of experts who will share their insights on the challenges and opportunities in health care workforce development. We will explore innovative models for training and education, the role of technology in expanding access to care, and the importance of supporting our current health care professionals. I look forward to a productive discussion on how we can work together to build a stronger, more resilient health care workforce for all Americans. I now recognize the ranking member, Mr. Doggett, for his opening statement.
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