AACOM Mitigates Higher Ed Provisions Enacted in Budget Reconciliation Bill

Following months of congressional action, the One Big Beautiful Bill Act, H.R. 1, was signed into law by President Trump on July 4, 2025, enacting sweeping changes to higher education policies impacting osteopathic medical students and schools. The bill narrowly passed the Senate on July 1 by a 51-50 vote, with Vice President Vance breaking the tie. It then returned to the House and passed 218-214 on July 3 after hours of intense negotiations.

Since January, AACOM led a targeted advocacy effort to:

• Maintain the Grad PLUS and Public Service Loan Forgiveness (PSLF) Programs
• Oppose loan caps and harmful risk-sharing proposals
• Secure interest deferment for medical residents

Our comprehensive strategy included:

• Meetings with House and Senate offices and committees, plus an OME advocacy fly-in
• Direct engagement by COM leaders with Congress
• National media outreach through The New York Times, Axios, Politico and The Guardian
• Mobilizing more than 10,000 messages to Congress through our Action Center
• Broad stakeholder coordination and advocacy

The enacted bill includes the following provisions relevant to osteopathic medicine:

• The Grad PLUS Loan Program will be eliminated for new borrowers starting July 1, 2026. Borrowers who received a Grad PLUS loan for their current program of study retain eligibility under the existing terms.
• New loan caps starting July 1, 2026
• Professional loan annual cap: $50,000
• Professional loan total cap: $200,000
• Lifetime federal loan cap: $257,500
• A new accountability formula starting July 1, 2026, which will evaluate graduate earnings four years after program completion, comparing median professional degree holders to undergraduate earners aged 25-34. Programs that fail this earnings benchmark in two out of three years will lose Title IV eligibility for at least two years.
• Time spent in medical residency or internships will continue to count towards PSLF eligibility. Prior legislation included a provision to eliminate this eligibility.

Although we were not successful in all areas, AACOM's joint advocacy yielded substantial improvements to the original House and Senate proposals including:

• Raising professional loan caps to $200,000 (up from $135-150k)
• Replacing institutional risk-sharing with a less harmful accountability model
• Preserving PSLF eligibility during medical residency and internship

Despite these improvements, AACOM maintains ongoing concerns with key provisions. We strongly oppose the elimination of the Grad PLUS Program and new loan caps that may limit access for disadvantaged students. AACOM is committed to working with Congress and the Department of Education (ED) to further alleviate harm and pursue legislative fixes where needed.

Read our analysis of key changes and advocacy impacts. Stay tuned for our upcoming FAQ and register for our webinar today.