[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 2954 Introduced in Senate (IS)]
<DOC>
119th CONGRESS
1st Session
S. 2954
To establish grant programs for health professional schools, and for
other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
September 30, 2025
Mr. Sanders (for himself and Mr. Merkley) introduced the following
bill; which was read twice and referred to the Committee on Health,
Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To establish grant programs for health professional schools, and for
other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Health Care Workforce Expansion Act
of 2025''.
SEC. 2. GRANT PROGRAMS FOR HEALTH PROFESSIONAL SCHOOLS.
(a) MED, DENTAL, and NURSE Grants.--Part A of title IV of the
Higher Education Act of 1965 (20 U.S.C. 1070) is amended by adding at
the end the following:
``Subpart 11--MED Grants
``SEC. 420S. DEFINITIONS.
``For the purposes of this subpart:
``(1) Eligible institution.--The term `eligible
institution' means an institution of higher education, as
defined in section 101, that is a school of medicine or school
of osteopathic medicine as defined in section 799B of the
Public Health Service Act (42 U.S.C. 295p).
``(2) Medical school candidate.--The term `medical school
candidate' means a student in attendance at an eligible
institution pursuing a professional doctor of medicine or
doctor of osteopathic medicine degree.
``SEC. 420T. PROGRAM ESTABLISHED.
``(a) Program Authority.--
``(1) Payments required.--The Secretary shall pay to each
eligible institution such sums as may be necessary to pay to
each medical school candidate who files an application and
agreement in accordance with section 420U, and who qualifies
under such section, a MED Grant in the amount of tuition and
required fees for each year during which that medical school
candidate is in attendance at the institution.
``(2) References.--Grants made under paragraph (1) shall be
known as `MED Grants'.
``(b) Payment Methodology.--
``(1) Prepayment.--Not less than 85 percent of any funds
provided to an eligible institution under subsection (a) shall
be advanced to the eligible institution prior to the start of
each payment period and shall be based upon an amount requested
by the institution as needed to pay medical school candidates
until such time as the Secretary determines and publishes in
the Federal Register with an opportunity for comment, an
alternative payment system that provides payments to
institutions in an accurate and timely manner, except that this
sentence shall not be construed to limit the authority of the
Secretary to place an institution on a reimbursement system of
payment.
``(2) Direct payment.--Nothing in this section shall be
interpreted to prohibit the Secretary from paying directly to
medical school candidates, in advance of the beginning of the
academic term, an amount for which medical school candidates
are eligible, in cases where the eligible institution elects
not to participate in the disbursement system required by
paragraph (1).
``(c) No Exceeding Cost.--The amount of a grant awarded under this
subpart, in combination with Federal assistance, shall not exceed the
cost of attendance (as defined in section 472) at the eligible
institution at which that medical school candidate is in attendance.
``(d) Period of Eligibility for Grants.--The period during which a
medical school candidate may receive a MED grant under this subpart
shall be the period required for the completion of the professional
medical degree being pursued by the medical school candidate at the
eligible institution at which the medical school candidate is in
attendance, except that the period during which a medical school
candidate may receive a MED Grant under this subpart shall not exceed 8
years.
``SEC. 420U. APPLICATION; AWARD.
``(a) Application; Award.--
``(1) Application.--The Secretary shall periodically set
dates by which medical school candidates shall file
applications for grants under this subpart. Each medical school
candidate desiring a grant under this subpart for any year
shall file an application containing such information as is
necessary to demonstrate that the medical school candidate--
``(A) is an eligible student for purposes of
section 484;
``(B) has completed a FAFSA;
``(C) would like to receive a MED grant; and
``(D) understands and agrees to the terms and
conditions of the agreement to serve described in
subparagraph (b).
``(2) Award.--The Secretary shall award a MED grant to each
eligible medical school candidate who meets the requirements
described in paragraph (1) for each year that the application
under such paragraph is submitted and such requirements are
met.
``(b) Agreements To Serve.--Each application under subsection (a)
shall contain or be accompanied by an agreement by the applicant that--
``(1) the applicant will--
``(A) practice primary care, as defined in section
1886 of the Social Security Act (42 U.S.C. 1395ww), as
a physician for at least 10 years after their related
training is completed (including residency or
fellowship programs) within 15 years after completing
the degree for which the applicant received a MED Grant
under this subpart or such related training (referred
to in this section as the `service obligation window');
and
``(B) annually submit an employment certification,
for each year of service, showing that the requirement
under subparagraph (A) is being met;
``(2) in the event that the applicant is determined to have
failed or refused to carry out such service obligation, a
specified amount of any MED Grants received by such applicant
will be treated as a loan and collected from the applicant in
accordance with subsection (c) and the regulations thereunder;
and
``(3) contains, or is accompanied by, a plain-language
disclosure form developed by the Secretary that clearly
describes the nature of the MED Grant award, the service
obligation, and the loan repayment requirements that are the
consequence of the failure to complete the service obligation.
``(c) Repayment for Failure To Complete Service.--
``(1) In general.--In the event that any recipient of a
grant under this subpart fails or refuses to comply with the
service obligation in the agreement under subsection (b), a
specified amount as described in paragraph (3) of the MED
Grants received by such recipient shall, upon a determination
of such a failure or refusal in such service obligation, be
converted to a Federal Direct Unsubsidized Stafford Loan under
part D of title IV, and shall be subject to repayment, in
accordance with paragraph (2).
``(2) Interest and repayment.--Amounts that are converted
to a Direct Unsubsidized Stafford Loan under paragraph (1)
shall accrue interest at the rate applicable to such Direct
Unsubsidized Stafford Loans for borrowers as of the date of
conversion, and the recipient shall be eligible for the same
repayment plans and borrower protections with respect to such
converted loans as that recipient would otherwise be eligible
for with respect to a Federal Direct Unsubsidized Stafford Loan
under part D of title IV for a borrower that is disbursed on
the same date.
``(3) Specified amount to be repaid.--
``(A) 5 years or less.--If a MED Grant recipient
has completed 5 years or less of required service, the
lesser of--
``(i) the total amount of MED grants
received by the recipient; or
``(ii) $50,000.
``(B) Greater than 5 years and less than 10
years.--If a MED Grant recipient has completed more
than 5 years of required service but less than 10 years
of required service, the lesser of--
``(i) the total amount of MED grants
received by the recipient; or
``(ii) $25,000.
``(C) Cap.--The amount of MED Grants that is
converted to a loan and required to be repaid under
this subsection shall not exceed $50,000.
``(4) Reconsideration of conversion decisions.--
``(A) Request to reconsider.--In any case where the
Secretary has determined that a recipient of a grant
under this subpart has failed or refused to comply with
the service obligation in the agreement under
subsection (b) and has converted the grant into a
Federal Direct Unsubsidized Stafford Loan under part D
in accordance with paragraph (1), (including cases
where such loans have been fully or partially paid),
the recipient may request that the Secretary reconsider
such initial determination and may submit additional
information to demonstrate satisfaction of the service
obligation. Upon receipt of such a request, the
Secretary shall reconsider the determination in
accordance with this paragraph not later than 90 days
after the date that such request was received.
``(B) Reconsideration.--If, in reconsidering an
initial determination under subparagraph (A) (including
cases where such loans were fully or partially paid),
the Secretary determines that the reason for such
determination was the recipient's failure to timely
submit a certification required under subsection
(b)(1)(B), an error or processing delay by the
Secretary, a change to the fields considered eligible
for fulfillment of the service obligation (as described
in subsection (b)(1)(A)), a recipient having previously
requested to have the MED Grant converted to a loan, or
another valid reason determined by the Secretary, and
that the recipient has, as of the date of the
reconsideration, demonstrated that the recipient did
meet, or is meeting the service obligation in the
agreement under subsection (b), the Secretary shall--
``(i) discharge the Federal Direct
Unsubsidized Stafford Loan under part D, and
reinstate the recipient's grant under this
subpart;
``(ii) discharge any interest or fees that
may have accumulated during the period that the
grant was converted to a Federal Direct
Unsubsidized Stafford Loan under part D;
``(iii) if the recipient has other loans
under part D, apply any payments made for the
Federal Direct Unsubsidized Stafford Loan under
part D during such period to those other loans
under part D;
``(iv) if the recipient does not have other
loans under part D, reimburse the recipient for
any amounts paid on the Federal Direct
Unsubsidized Stafford Loan under part D during
such period;
``(v) request that consumer reporting
agencies remove any negative credit reporting
due to the conversion of the MED Grant to a
loan; and
``(vi) use the additional information
provided under subparagraph (A) to determine
the progress the recipient has made in meeting
the service obligation.
``(C) Extension of time to complete service
obligation.--In the case of a recipient whose MED Grant
was reinstated in accordance with subparagraph (B), the
Secretary shall, upon such reinstatement--
``(i) extend the time remaining for the
recipient to fulfill the service obligation
described in subsection (b)(1) to a period of
time equal to--
``(I) 10 years; minus
``(II) the number of years that the
recipient completed service as a
physician in primary care prior to the
reconversion of the loan to a MED Grant
under subparagraph (B), including any
years of qualifying service completed
during the period when the MED Grant
was in loan status; and
``(ii) treat any years of service described
in subclause (II) of clause (i) as years that
count toward the individual's service
obligation (regardless of whether the MED Grant
funds were in grant or loan status) if that
time otherwise meets the requirements of this
section.
``(d) Additional Administrative Provisions.--
``(1) Extenuating circumstances.--The Secretary shall
establish, by regulation, categories of extenuating
circumstances under which a recipient of a grant under this
subpart who is unable to fulfill all or part of the recipient's
service obligation may be excused from fulfilling that portion
of the service obligation.
``(2) Communication with recipients.--The Secretary shall
notify MED grant recipients not less than twice per calendar
year regarding how to submit the employment certification under
subsection (b)(1)(B) and the recommendations and requirements
for submitting that certification under paragraph (3).
``(3) Submission of employment certification.--
``(A) Recommended submissions.--
``(i) In general.--The Secretary shall
notify MED Grant recipients that the Department
recommends that MED Grant recipients submit the
employment certification described in
subsection (b)(1)(B) as soon as practicable
after the completion of each year of service.
``(ii) Form.--The Secretary shall provide a
standardized annual certification form for use
under this section and allow electronic
submission by the recipient or employer.
``(B) Required submission.--A MED Grant recipient
shall be required to submit to the Department
employment certification within the timeframe that
would allow that individual to complete their service
obligation before the end of the service obligation
window.
``(C) Notification.--The Secretary shall notify MED
Grant recipients of the required submission deadlines
described in this paragraph.
``(D) Adjustment of deadline.--The Secretary shall
adjust the submission deadline described in
subparagraph (B) to account for a service obligation
window extension.
``(E) Alternative to certification.--The Secretary
shall provide an alternative to the certification of
employment described in subsection (b)(1)(B) for
recipients who cannot obtain such required
certification of employment because the recipient can
demonstrate the employer is no longer in existence or
the employer refuses to cooperate.
``SEC. 420V. PROGRAM PERIOD AND FUNDING.
``Beginning on July 1, 2026, there shall be available to the
Secretary to carry out this subpart, from funds not otherwise
appropriated, such sums as may be necessary to provide MED Grants in
accordance with this subpart to each eligible applicant.
``Subpart 12--DENTAL Grants
``SEC. 420W. DEFINITIONS.
``For the purposes of this subpart:
``(1) Eligible institution.--The term `eligible
institution' means an institution of higher education, as
defined in section 101, that is a school of dentistry as
defined in section 799B of the Public Health Service Act (42
U.S.C. 295p).
``(2) Dental school candidate.--The term `dental school
candidate' means a student in attendance at an eligible
institution pursuing a professional dental degree.
``(3) Rural area.--The term rural area has the meaning
given that term in section 861(b)(2).
``SEC. 420X. PROGRAM ESTABLISHED.
``(a) Program Authority.--
``(1) Payments required.--The Secretary shall pay to each
eligible institution such sums as may be necessary to pay to
each dental school candidate who files an application and
agreement in accordance with section 420Y, and who qualifies
under such section, a DENTAL Grant in the amount of tuition and
required fees for each year during which that dental school
candidate is in attendance at the institution.
``(2) References.--Grants made under paragraph (1) shall be
known as `DENTAL Grants'.
``(b) Payment Methodology.--
``(1) Prepayment.--Not less than 85 percent of any funds
provided to an eligible institution under subsection (a) shall
be advanced to