Congress Races to Finalize Reconciliation Package Ahead of July 4 Deadline

The Senate began a vote-a-rama Monday morning following a 51-49 procedural vote over the weekend to move forward with debate and consideration of the One Big Beautiful Bill Act, H.R. 1. The Senate Budget Committee released an updated version of the bill over the weekend, reflecting compliance with the Byrd Rule after the Parliamentarian’s review.

The Budget Committee text adopts the Senate's institutional accountability framework in place of the House risk-sharing plan. However, the new draft changes the earnings formula from 10 years after enrollment to 4 years after program completion. AACOM is very concerned that this new formula will penalize medical schools by counting earnings during residency, and we are working hard to modify this provision to only count earnings post-residency.

AACOM also maintains strong concerns with the effect that proposed changes to education and student loan programs, including eliminating the Grad PLUS Loan Program and capping federal borrowing, will have on medical student affordability and access. AACOM has continued sharing these concerns with lawmakers, including through a comment letter submitted to the Health Education, Labor and Pensions (HELP) Committee Ranking Member Sanders (I-VT).

Last week, the Senate Parliamentarian ruled that several provisions in the HELP bill— including the exclusion of loan payments made by medical residents from counting toward Public Service Loan Forgiveness—were not compliant with the Byrd Rule. To preserve the bill's eligibility for passage by a simple majority, the Senate removed this provision.

President Trump has indicated that he wants the final bill passed and on his desk by the 4th of July. Once the Senate passes its version, the bill will return to the House, where it may be amended further or passed as is. AACOM continues to monitor these developments closely and remains actively engaged with congressional offices.

For more information on the HELP Committee proposal and a comparison with the House bill, see AACOM’s summary. We encourage you to contact your congressional offices to share how these changes will impact you and make it harder to train the next generation of doctors.

Tell Congress to Preserve Grad PLUS!