OME Advocate Newsletter

AACOM applauds U.S. Representatives Diana Harshbarger (R-TN), Chellie Pingree (D-ME), Sam Graves (R-MO), Carol Miller (R-WV) and Don Davis (D-NC) for reintroducing the Fair Access In Residency (FAIR) Act, H.R. 2314, to promote transparency and fairness in the residency selection process. H.R. 2314 is supported by more than 70 national and state healthcare organizations.

As our nation grapples with a worsening physician shortage, we must eliminate unnecessary barriers that prevent highly qualified osteopathic medical students from accessing residency opportunities. The FAIR Act provides a commonsense solution to longstanding inequities in the residency selection process—without federalizing medical education, imposing quotas or regulating the makeup of residency programs. We are deeply grateful to Representatives Harshbarger, Pingree, Graves, Miller and Davis for their leadership in advancing a fairer, more transparent system.

-AACOM President and CEO Robert A. Cain, DO

I represent a very rural part of Tennessee that’s already facing physician shortages. There’s no reason to continue practices that keep qualified doctors from serving the communities that need them most. That’s why I’m proud to lead the reintroduction of this legislation. Congress must ensure our taxpayer-funded residency programs are tapping into the full pipeline of talent — both DOs and MDs — without discrimination. The FAIR Act promotes transparency and fairness in GME, with the ultimate goal of increasing the number of trained physicians ready to care for our communities.

-Rep. Diana Harshbarger (R-TN)

Discrimination against DO applicants remains a persistent problem in residency placement. The National Resident Matching Program reports that 29 percent of residency program directors never or seldom interview DO candidates, and 73 percent of those who do interview DOs require them to take the MD licensing exam, despite the COMLEX-USA being the required exam for osteopathic students. These practices create unnecessary challenges for DO students, adding emotional and financial strain that complicates their path to residency.

The FAIR Act enhances transparency in Medicare-funded graduate medical education programs by requiring that programs submit annual reports on the number of DO and MD applicants they receive and accept and affirm that DO applications and COMLEX-USA exam scores are accepted for consideration.

Learn more and urge Congress to cosponsor and pass the FAIR Act, H.R. 2314!

• On April 2, 2025, Senate Budget Chairman Lindsey Graham unveiled the text of a compromise budget reconciliation blueprint that would make President Trump’s 2017 tax cuts permanent and increase the debt limit by $5 trillion.
• The blueprint melds elements of the Senate’s earlier framework with the House's resolution, H Con Res 14, which would provide $4.5 trillion in tax cuts, at least $2 trillion in spending cuts and increase the debt limit by $4 trillion. Both chambers adopted their initial versions in late February.
• Budget reconciliation is a fast-track budgetary tool that can be used to advance the party’s priorities with a simple majority vote in each chamber.
• Both chambers must adopt identical resolutions to start the reconciliation process. Then, the designated House and Senate committees prepare the budgetary policies to meet the prescribed amounts of savings/reductions outlined in the budget framework.
• The Senate adopted the resolution in a 51-48 vote over the weekend, teeing it up for a vote in the House this week.
• Internal GOP divisions threaten progress as hardline House conservatives are already threatening to withhold support for the Senate-passed resolution due to a lack of sufficient spending cuts.

• On March 27, 2025, the U.S. Department of Health and Human Services (HHS) announced a major restructure that would reduce HHS’ total workforce by 20,000 employees, including 10,000 layoffs, and consolidate its 28 divisions into 15. Layoffs at many HHS agencies have already begun.
• Under the restructure, a new Administration for a Healthy America would be created, combining multiple agencies, including the Health Resources and Services Administration (HRSA) and the Substance Abuse and Mental Health Services Administration. Other changes include eliminating divisions within the Centers for Disease Control and Prevention (CDC), creating a new Assistant Secretary for Enforcement and reorganizing services for older adults and people with disabilities.
• For more information, view the HHS fact sheet.

• On March 26, 2025, the U.S. Department of Education (ED) reopened the online application process for income-driven repayment (IDR) plans and loan consolidation after removing them from their website in February.
• In response to the initial removal, the American Federation of Teachers filed a lawsuit, claiming it unlawfully restricted access to IDR plans—critical for Public Service Loan Forgiveness eligibility.
• Meanwhile, following the Executive Order signed on March 20, 2025, that would dismantle ED, President Trump indicated his plans to transfer functions of ED, including student loans and programs that benefit students with disabilities or special needs, to the Small Business Administration (SBA) and HHS respectively.
• At this time, no timeline has been provided, and it is unclear how the Administration plans to operationalize this directive, particularly as the Federal Student Aid office is statutorily mandated to be housed at ED.
• The proposal has drawn criticism, with many lawmakers questioning the SBA’s capacity to manage the complexities of student loans. Legal challenges are likely.

• On Thursday, April 3, 2025, ED announced a rulemaking process to overhaul multiple federal student aid and loan repayment programs, including the Public Service Loan Forgiveness Program, the Pay As You Earn (PAYE) Repayment plan, and the Income-Contingent Repayment (ICR) plan.
• ED shared it was inviting public feedback as it evaluated ways to “streamline” student-loan assistance programs, including for public-service workers and low-income borrowers, with the aim of creating “efficiencies for students, institutions, and key stakeholders.” The deadline for public comment is Monday, May 5, 2025.
• The Department will also host two public hearings: an in-person meeting on Tuesday, April 29, 2025, and a virtual hearing on Thursday, May 1, 2025. For more information on the rulemaking and public hearings, visit ED’s negotiated rulemaking page.

• On Tuesday, March 25, 2025, the Senate voted 53-47 along party lines to confirm Jay Bhattacharya, MD, PhD, as the next director of the National Institutes of Health (NIH).
• Later that day, the Senate voted 56-44 to confirm Martin Makary, MD, MPH, to lead the Food and Drug Administration (FDA), which has also been targeted for cuts in HHS’ restructure. On Thursday, April 3, 2025,
• On Thursday, April 3, 2025, the Senate voted 53-45 along party lines to confirm Mehmet Oz, MD, as the next administrator of the Centers for Medicare and Medicaid Services (CMS).
• Dr. Bhattacharya's, Dr. Makary’s and Dr. Oz’s confirmations come during a period of great change at all three agencies. Widespread reductions in force saw the NIH, FDA and CMS begin the elimination of 1,200, 3,500 and 300 positions respectively.

• On March 26, 2025, Senators Tammy Baldwin (D-WI) and Peter Welch (D-VT) convened a Senate forum with 15 of their Democratic colleagues to highlight the impacts of cuts at the NIH.
• The “Cures in Crisis: What Gutting NIH Research Means for Americans with Cancer, Alzheimer’s and Other Diseases” featured former NIH Director Monica Bertagnolli, MD, two Alzheimer’s disease researchers from the University of Wisconsin-Madison and Emory University and two patients who have benefitted from NIH clinical trials.
• AACOM continues to monitor the Executive Orders and other activities related to the NIH and will provide updates as needed. View our analysis. If you have questions or comments, please contact aacomgr@aacom.org.

• On Monday, March 24, 2025, President Donald Trump nominated Susan Monarez, PhD, as the new director of the CDC.
• Monarez’s nomination comes after the president withdrew his first nominee to lead the CDC, Florida Rep. David Weldon, MD.
• Dr. Monarez, who has served as the CDC’s acting director since January, previously worked for the Advanced Research Projects Agency for Health.