Health and Human Services increases loan forgiveness for OBs, midwives who practice in rural areas

Indiana – On Thursday, the U.S. Department of Health and Human Services announced that primary care physicians in specific disadvantaged areas would now be eligible for a $25,000 boost in loan forgiveness. This implies that those who meet the requirements can receive forgiveness of up to $75,000 provided they commit to two years of full-time service.

Physician assistants who work in locations where primary care providers are in insufficient supply, as well as medical and osteopathic physicians, including OB-GYNs, pediatricians, nurse practitioners, and midwives, are eligible for the amount. The goal of the action is to improve primary care services in rural and historically neglected populations. Additionally, it might benefit places that were labeled “maternal care deserts” when clinics closed due to an inability to maintain acceptable staffing levels, which resulted in restricted or nonexistent care and required patients to travel great distances for routine consultations.

This has been a particular issue in places like South Dakota, Mississippi, and Idaho that have outlawed abortion since 2022. Since a nearly complete abortion ban went into force in late 2022, Idaho has lost half of its maternal-fetal medicine experts and 22% of its practicing OB-GYNs. Three facilities in the state also closed their labor and delivery units during that same period. Physicians have reported that it has proven challenging to find new hires for such positions; on Wednesday, one physician said that the number of out-of-state applications for available positions had drastically decreased.

As of 2022, around 7 million persons of reproductive age—or almost 35% of the population—live in counties that are classified as maternity care deserts, according to March of Dimes. It’s said that within the last two years, that number has increased. Of those, about 2.2 million reside in areas lacking obstetrics providers, birth centers, and hospitals that offer obstetric care. More than 97,000 Ohioans, the greatest number in any state, were impacted by decreased access to maternity care, according to the 2022 report.

According to the research, an additional 11.4% of people reside in an area with limited access to maternity care, which is defined as having fewer than two maternity hospitals or birth centers and fewer than 60 OB-GYN physicians. Research also shows that persons of color, especially Black patients, are disproportionately affected by difficulties accessing care in rural and medically disadvantaged places.

According to HHS, the expense of medical school has tripled, and the debt associated with it has quadrupled over the last 30 years; nonetheless, up until recently, the maximum loan forgiveness was $50,000. The program is run by HHS’s Health Resources and Services Administration division.

Those who pass an oral exam demonstrating their fluency in Spanish and practice in high-need areas with patients who have limited English proficiency will be eligible for an additional loan repayment of up to $5,000. According to American Medical Association research, those patients have worse encounters with providers and have lower health outcomes.

According to the statement, HHS is also planning to establish new primary care residency programs in rural areas, which, once operational, will offer 540 positions for doctors in specialty care. Additionally, it is offering over 25,000 training sessions to primary care practitioners in practice, including as OB-GYNs, nurse midwives, and other maternal care providers, to help them identify and treat mental health issues in patients who are pregnant, new mothers, kids, and teenagers.

Applications for the National Health Service Corps Loan Repayment Program are being accepted through May 9.