Schakowsky, Durbin Announce Bill To Expand Health Workforce In Underserved Communities

April 24, 2020
Press Release
Health Heroes 2020 legislation will expand the National Health Service Corps and Nurse Corps scholarship & loan repayment programs to address health care shortages and bolster emergency surge capacity

EVANSTON – Amid the coronavirus (COVID-19) pandemic, U.S. Representative Jan Schakowsky (D-IL-09), a Senior Chief Deputy Whip, and U.S. Senate Democratic Whip Dick Durbin (D-IL) today announced bicameral legislation to provide a historic investment in the National Health Service Corps (NHSC) and Nurse Corps programs to cover the graduate education costs of approximately 300,000 clinicians in order to help address existing health workforce shortages throughout our health care system.

The COVID-19 pandemic has exposed existing health workforce shortages, while simultaneously imposing unprecedented strains on America’s heroic frontline health professionals.  A substantial barrier in meeting our nation’s health workforce needs is the student debt associated with graduate health education—which can average more than $200,000.  COVID-19 has also magnified alarming racial and ethnic disparities in health outcomes, which can be partially addressed by expanding the representation of minority populations working in health careers.

Schakowsky and Durbin’s legislation, Health Heroes 2020 Act, would address these challenges and entice promising students from diverse backgrounds—physicians, dentists, mental health professionals, nurses, and physician assistants—into primary health careers in underserved communities by providing historic new funding levels for scholarship and loan forgiveness options in exchange for a service commitment in an urban or rural area with a shortage of providers.  The legislation would also immediately surge $30 billion into the NHSC and Nurse Corps, further increase the annual funding level for NHSC by 300 percent, and create a new Reserve Corps to boost our health care surge capacity in response to public health emergencies. 

“The coronavirus pandemic has highlighted the need for more health care providers throughout many parts of our country.  We need to immediately reinforce those heroes who are working day and night to save lives.  Additionally, as we look beyond this crisis, we also have an opportunity to build the kind of world-class health infrastructure that meets the needs of all Americans in every community,” said Congresswoman Schakowsky.  “I am proud to introduce the Health Heroes 2020 Act with my friend and Senator, Dick Durbin.  Our plan will build a nationwide pipeline that will make it possible for students of every background to become the doctors and nurses we need without incurring huge debt.”

“Our health care professionals are doing heroic work on the front lines of our pandemic response.  But the current public health crisis has highlighted our need for a national policy that increases the number of health workers to address shortages, medical disparities, and respond to emergencies.  The Health Heroes 2020 Act is a tribute to the inspiring work of our health workforce and a commitment to our future by expanding the NHSC and Nurse Corps programs to provide a boost of more than 300,000 clinicians in underserved communities,” Senator Durbin said.  

The United States is projected to face a shortage of up to 120,000 doctors over the next decade, and the need for an estimated 200,000 new nurses for each of the next several years.  Within these fields, there are significant shortages in both urban and rural communities as well as among specialties, including in primary care and behavioral health.  COVID-19 has upended this equation, with providers being called back into service from retirement and health professionals traveling across state lines to deliver care.  Coronavirus has also magnified alarming racial and ethnic disparities in health outcomes, which can be partially addressed by expanding the representation of minority populations working in health careers.

Specifically, the Health Heroes 2020 Act would expand the NHSC and Nurse Corps programs by:

Emergency Surge Funding to Restore Workforce Pipeline

  • Providing a one-time, supplemental appropriation of $25 billion for scholarship and loan forgiveness awards through the NHSC, and $5 billion through the Nurse Corps program;
    • Includes a 40 percent set-aside for populations historically underrepresented in health care (racial/ethnic minorities and students from low-income urban/rural areas);

Sustainable Growth to Meet Nation’s Health Care Needs

  • Increasing the annual mandatory NHSC funding level from $310 million to $1 billion to increase scholarship and loan forgiveness awards to meet the nation’s health needs;

Creation of Reserve Corps for Surge Capacity

  • Establishing a NHSC Reserve Corps demonstration option to allow health professionals to serve for two years in “reserve status” for each qualifying year of scholarship.  Would permit such health professionals to work in the private practice setting of their choice, but:
    • In the event of a health emergency/disaster would be called up to serve at the direction of HHS Secretary (alongside the Public Health Commissioned Corps or health departments);
    • Require a monthly commitment, similar to the National Guard, to conduct preparedness training or deliver care to an underserved community; 
  • Allows currently practicing health care professionals—who did not participate in the NHSC program—to opt into this reserve status and obtain loan forgiveness;
  • Expands emergency surge capacity by allowing NHSC members to serve in high-need areas during a public health emergency.

Full text of the legislation is available HERE.

This bill follows the enactment of provisions from Congresswoman Schakowsky’s bipartisan Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act of 2019 (H.R. 2781), which were signed into law on March 27, 2020 as part of the Coronavirus Aid, Relief and Economic Security (CARES) Act. The EMPOWER for Health Act increases access to health care in underserved areas and diversifies the health care workforce to meet the needs of different populations by updating and assuring funding for the programs within Title VII of the Public Health Service Act (PHSA), which support clinician training and faculty development, including the training of practitioners in family medicine, general internal medicine, geriatrics, pediatrics, and other medical specialties. These programs strengthen the health care workforce to better meet the health care needs of certain populations, such as older individuals and those with chronic diseases, who are at increased risk of contracting COVID-19.

The Health Heroes 2020 Act is supported by the following organizations: Association of Clinicians for the Underserved, Association of American Medical Colleges, National Association of Community Health Centers, American Association of Colleges of Nursing, Physician Assistant Education Association, American Association of Nurse Practitioners, and Illinois Primary Health Care Association.

“ACU wholeheartedly supports Senator Durbin’s and Congresswoman Schakowsky’s bold proposal in support of the National Health Service Corps to address the overwhelming need of millions of people living in communities with severe health care workforce shortages. More than 80 million people live in communities with primary care provider shortages. Sadly, the COVID-19 pandemic has only exacerbated these provider shortages leaving millions at risk of further reduced access to care. Now more than ever, the need for immediate placement of health care providers as well as provider pipeline strategies to care for the nations underserved is critical. ACU applauds Senator Durbin’s and Congresswoman Schakowsky’s visionary approach to address the nation’s health care workforce shortages in the face of the COVID-19 pandemic and beyond. We look forward to working with the sponsors and their Senate and House colleagues to ensure health care providers can be placed in communities of highest need at this vital time,” said the Association of Clinicians for the Underserved.

“Unfortunately, the Coronavirus pandemic highlights a nationwide shortage of physicians — projected to grow to between 46,000 and 122,000 by 2032.  The AAMC applauds the Health Heroes Act of 2020 for recognizing the need to increase the federal investment in our nation’s health workforce to address new and emerging public health challenges in underserved communities across the country,” said the Association of American Medical Colleges.

“As a nurse and nurse educator, I know how essential these programs are to ensuring that our communities, especially those underserved, have access to health care services,” said Dr. Susan Bakewell-Sachs, Chair of the American Association of Colleges of Nursing (AACN) Board of Directors.  “AACN is especially grateful to see this $5 billion investment in the Nurse Corps Loan Repayment and Scholarship programs as our nursing schools, faculty, and students continue to address this public health challenge. These additional resources will make it possible for our nursing students and nurses to practice where they are needed the most, today and in the future.”

“On behalf of Community Health Centers we deeply appreciate the leadership of Senator Durbin and Representative Jan Schakowsky in advancing legislation that strengthens our nation’s primary care workforce,” said Tom Van Coverden, President and CEO of the National Association of Community Health Centers (NACHC).  “We need a strong public health infrastructure to fight this pandemic and the ones that come after – we cannot do that without investing in the frontline ranks of health care providers.”

“I want to thank Senator Durbin and Representative Schakowsky for introducing the Health Heroes 2020 Act and for their continued support of nurse practitioners. As of 2019, there were over 3,000 nurse practitioners in the National Health Service Corp (NHSC), making NPs one of the largest provider groups in the program. This legislation will provide additional funding to the NHSC to increase the number of providers in the scholarship and loan repayment program and create a new reserve service program to bolster care for patients in underserved areas and our public health response to national emergencies. As NPs continue to provide care on the front lines of the COVID-19 pandemic, we are thankful for this critical support,” said American Association of Nurse Practitioners President Sophia L. Thomas, DNP, FNP, PNP, FAANP.

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