Lawmakers in a massive year-end spending and COVID-19 relief bill added new Medicare GME slots for the first time in two decades.
To curtail Medicare spending, the Balanced Budget Act of 1997 kept the number of medical residents for existing teaching hospitals at 1996 levels. An exception was made in 1999 to fund more slots at rural teaching hospitals. But for the majority of the more than 1,100 teaching hospitals in the U.S., residency positions have been relatively unchanged for more than two decades.
Congress on Monday authorized Medicare to support 1,000 new GME slots. Priority will be given to training programs in rural areas, hospitals that are training residents over their caps, states with new medical schools, and facilities that provide care for underserved communities.
As Medicare-supported residency slots have stayed stagnant, teaching hospitals have borne a greater share of the cost for their GME programs.
"I'm pleased that we could open up the medical training pipeline and help alleviate some of the pressure on our nation's teaching hospitals," said House Ways & Means Chair Richard Neal (D-Mass.) in a written statement.
The Association of American Medical Colleges supported a bill that would have added 15,000 slots, but still viewed the increase as a win.
"1,000 is a good start, continue to build upon that," AAMC Senior Director of Government Relations and Legislative Advocacy Leonard Marquez said. "We're very excited, it's a great step."
Marquez said he expects nationwide demand for the slots. Teaching hospitals will have to apply to CMS for the additional support.
The Greater New York Hospital Association also lobbied for the increase, and Senate Minority Leader Chuck Schumer (D-N.Y.) pushed the measure. New York produces the most medical school graduates of any state, according to 2018 data analyzed by the Kaiser Family Foundation.
"The bill I championed tackles the doctor shortage head-on by creating new residency training slots nationwide and prioritizing those slots for communities that need them most," Schumer said in a written statement.
The AAMC estimates that the United States will face a physician shortage of up to 139,000 doctors by 2033.
"If we're going to meet the future needs of our residents and ensure access to quality health care, we must close the gap by lifting the arbitrary cap–quickly," Sen. Bob Menendez (D-N.J.) said in a written statement.
President Donald Trump has not yet signed Congress' end-of-year deal into law.