HR-6672-119
Referred to the House Committee on Energy and Commerce.
Sponsored by Andrea Salinas (D-OR)
What it does
The bill would create a new Health Resources and Services Administration program that pays off up to $250,000 of eligible education loans for mental health professionals who work full-time in designated mental health shortage areas for up to six years. Payments would come in sixths each year, with the remainder paid at year six. It would authorize $25 million per year for fiscal years 2026 through 2035, bar double benefits from other federal loan programs, and require biennial reports to Congress starting five years after enactment.
Who benefits
Mental health professionals (psychiatrists, psychologists, social workers, counselors, psychiatric nurses, therapists, and others) with graduate-level education debt who take jobs in shortage areas. Patients in rural and underserved areas who may gain easier access to treatment. Clinics, community health centers, and private practices in shortage areas that struggle to recruit staff. Workers who leave before six years may keep payments already earned, if they served in good faith.
Who is hurt
Taxpayers would bear the cost of up to $250 million over ten years in authorized funding, subject to appropriation. Professionals in non-shortage areas or in jobs not primarily involving direct treatment would not qualify. Because funding is modest relative to the loan balances allowed, only a limited number of applicants could be served, leaving many eligible workers without awards. Existing loan forgiveness programs, such as the National Health Service Corps, may face competition for the same workforce. The Health Resources and Services Administration would bear new administrative work.
Supporters argue
Supporters argue that large parts of the country lack enough mental health providers and that graduate education debt discourages clinicians from practicing in low-paying, underserved settings. They contend that targeting repayment to shortage areas with a multi-year service commitment directs federal dollars to places of greatest need, and that biennial reporting requirements add accountability. They point to the bipartisan group of sponsors and to existing programs like the National Health Service Corps as evidence that service-for-repayment models can work.
Opponents argue
Opponents argue that $25 million per year is small against the scale of the shortage and the $250,000 per-person cap, so the program may fund only a small number of clinicians and have limited effect. They contend that existing programs already offer loan repayment to similar workers, so a new program adds overlap and administrative cost. They also point out that the bill allows a first report only after five years, and that the breach provisions let participants leave early without penalty, which may weaken the service commitment.
Constitutional context
Congress creates this program under its Taxing and Spending Clause power (Art. I, Sec. 8, cl. 1), which permits spending for the general welfare, and South Dakota v. Dole (1987) upholds conditions on federal funds when they are related to the program's purpose. The program makes voluntary agreements with individuals rather than imposing conditions on states, so the coercion concerns in NFIB v. Sebelius (2012) are not implicated.
Checks and balances
The executive branch (HHS and HRSA) gains authority to run the program and set additional criteria, while Congress retains control through annual appropriations, notice requirements for new rules, and biennial reports.
Historical precedent
The National Health Service Corps Loan Repayment Program (Section 338B of the Public Health Service Act) already provides loan repayment to health professionals who serve in designated shortage areas, and this bill is modeled on a similar service-for-repayment structure.