Related AMA-MSS Policies

The debt-related policies on this page include:

Tax Deductibility

H-305.955 Cost of Medical School and Educational Loan Interest
Our AMA encourages legislation to restore the tax deductibility of student loan interest. (Res. 305, I-92; Reaffirmation, A-00)

H-305.963 Tax Deductibility of Interest on Educational Loans
The AMA urges all members attending the 1990 Annual Meeting to immediately write to their Congressperson and Senator seeking support for HR 747 and SB 656 which would fully restore tax deductibility of interest on educational loans. (Res. 263, A-90; Reaffirmation, A-00)

H-305.965 Student Loans
Our AMA: (1) reaffirms its support of legislation that would defer the repayment of loans for education until the completion of residency training; and (2) lobby before the next federal budget for deferment of medical student loans for the full initial residency period. (Sub. Res. 203, A-90; Appended Res. 306, I-99)

H-305.970 Interest on Education Related Debt
Our AMA encourages Congress to return tax deductible status to interest on post-secondary education related to loans, as was the case prior to the passage of the 1986 Tax Reform Act. (Res. 157, A-89; Reaffirmed: Sunset Report and Reaffirmation, A-00)

H-305.978 Tax Deduction Status of Educational Loans
Our AMA supports the principle that interest on student educational loans should remain tax deductible. (Res. 121, I-86; Amended by Sunset Report, I-96; Reaffirmation, A-00, I-00))

H-305.997 Income Tax Exemption for Medical Student Loans and Scholarships
The AMA supports continued efforts to obtain exemption from income tax on amounts received under medical scholarship or loan programs. (Res. 65, I-76; Reaffirmed: Sunset Report, I-98)

Deferment

H-305.961 Student Loan Deferment
It is the policy of the AMA (1) to undertake an immediate major campaign to prevent further erosion of Higher Education Act provisions regarding student loan deferment and forbearance for physicians in training; (2) to seek the direct assistance of all appropriate organizations, including state and local medical societies and auxiliaries, national medical specialty societies, medical school deans and faculty, residency training program directors, and housestaff associations to galvanize support to maintain at least the current loan deferment and forbearance allowances for physicians in training; (3) to continue efforts to persuade Congress to extend deferment of repayment of educational program loans until the completion of residency training and to allow up to ten years of forbearance of such educational loans; and (4) to provide as soon as possible all factual information, such as medical student default rates, mean and median levels of student loans and average resident incomes to assist component societies in effective legislative efforts. (Sub. Res. 230, I-91, Reaffirmed: I-00)

H-305.972 Postgraduate Deferments for Guaranteed Student Loans
The AMA supports (1) working with organizations seeking to alter the provision of the Higher Education Act so that medical student borrowers will receive deferment for the duration of postgraduate training regardless of when or where the borrower received the loan and where the borrower is in training; and (2) working to simplify required documentation for deferment, such that proof of training from the residency director guarantees this deferment. (Res. 133, I-87; Reaffirmed: Sunset Report, I-97)

Tax Deductibility for NHSC and Related Programs

H-305.937 Taxation of Student Loan Repayment Programs
Our AMA supports utilization of S.288 and HR.324, and other legislative means to achieve federal income tax exemption for funds received through all state and federal loan repayment programs designed to improve physician supply in underserved areas and populations. (Res. 240, A-99)

H-305.940 Tax Exemption for Federal Medical Profession Scholarships
The AMA plans to work with the American Association of Medical Colleges in support of federal legislation that will assure that the direct medical school expense portion of the National Health Service Corps Scholarship program, the Armed Forces Health Professions Scholarship program and all other federally funded health profession scholarships is not taxable. (Res. 225, I-97)

NHSC and Physician Distribution

H-165.900 Support for the Health Care Infrastructure
The policy of the AMA is: (1) that any national legislation for health system reform include sufficient and continuing financial support for inner-city and rural hospitals, community health centers, clinics, special programs for special populations and other essential public health facilities that serve underserved populations that otherwise lack the financial means to pay for their health care; and (2) that any national legislation for health system reform include sufficient and continuing federal funding for special programs, including the National Health Service Corps, to enhance the recruitment and retention of physicians for practice in underserved areas. (Res. 124, A-94)

H-200.959 Support for the Funding of the National Health Service Corps
The AMA supports the continuation of funding to the National Health Service Corps at least at the level originally appropriated in 1995. (Res. 241, A-95, Reaffirmed: I-00)

H-200.982 Significant Problem of Access to Health Care in Rural and Urban Underserved Areas
The AMA (1) declares that the primary care physician shortage represents a significant problem of access to medical care in rural and urban underserved areas; and (2) encourages state legislatures and the Congress of the United States to recognize this significant problem and to develop rapidly incentives to make practice in rural and urban underserved areas more attractive to primary care physicians in order to provide access to necessary medical services in these areas. (Sub. Res. 35, I-90; Reaffirmed: BOT Rep. GG, I-92)

H-200.983 Health Manpower
It is the policy of the AMA to (1) use its influence to convince the Administration and Congress of the continuing need for federal support for the education and training of primary care physicians, including reauthorization of federal programs under Title VII to help meet manpower requirements for primary care physicians; (2) use its influence to encourage federal funding to promote educational and training opportunities for primary care and increase the field strength of the NHSC in medically underserved urban and rural areas; and (3) oppose further erosion of Medicare funding for graduate medical education and training programs. (Res. 112, I-90; Reaffirmed: BOT Rep. GG, I-92)

H-200.984 National Health Service Corps Reauthorization
It is the policy of the AMA: (1) to support legislative efforts to revitalize and reauthorize the NHSC; and (2) to undertake efforts to assure that such legislation include increased funding for recruitment and retention efforts and adequate funding for both the loan repayment and scholarship programs. (Res. 120, A-90, Reaffirmed: I-00)

H-200.985 Increasing Support for Service in America's Inner Cities Through the National Health Service Corps
Our AMA (1) urges the U.S. Public Health Service to earmark a certain percentage of repayment opportunities for the National Health Service Corps (NHSC) loans and scholarships for underserved inner-city facilities; and (2) supports increased funding for NHSC. (Res. 78, I-89; Reaffirmed: Sunset Report, A-00)

H-200.989 National Health Service Corps
The AMA believes that since a sufficient need for physician manpower is expected to continue to exist in certain areas of the U.S., continuation of assistance from the NHSC is justified. As long as this need continues, the AMA does not think it would be appropriate to deprive residents of certain areas of the U.S. of necessary medical services by diverting NHSC physicians to other countries. (CMS Rep. F, A-86; Reaffirmed: Sunset Report, I-96, Reaffirmed I-00)

Graduate Medical Education Funding

H-305.945 Funding of Graduate Medical Education
The AMA: (1) supports the establishment of an authorization system yet to be specified (for example, a voucher system) to provide funding for the training program at the site where training occurs; (2) supports the development of a portable authorization system for use by US medical graduates, recognizing that the MD/DO degree is only a mid-point of formal medical education; (3) supports establishment of an authorization system which guarantees funding for US Medical Graduates and additional funding for International Medical Graduates on a competitive basis, based on limits set by the new public/private sector workforce planning group; (4) supports the development of alternative options for support of teaching hospitals to achieve fiscal stability with reductions in Medicare Indirect Medical Education Adjustment payments and to develop alternative approaches to provide patient services previously provided by resident physicians; (5) encourages the use of international assistance funds to provide for appropriate US training for physicians from other countries to increase the level of medical care in their home countries; and (6) supports efforts to allow completion of training of IMG graduates already in training who might be adversely affected by an authorization system. (CME Rep. 1, I-96; Reaffirmed by CME Rep. 13, A-97)

H-305.988 Cost and Financing of Medical Education and Availability of First-Year Residency Positions
The AMA: (1) believes that medical schools should further develop an information system based on common definitions to display the costs associated with undergraduate medical education; (2) in studying the financing of medical schools, supports identification of those elements that have implications for the supply of physicians in the future; (3) believes that the primary goal of medical school is to educate students to become physicians and that despite the economies necessary to survive in an era of decreased funding, teaching functions must be maintained even if other commitments need to be reduced; (4) believes that a decrease in student enrollment in medical schools may not result in proportionate reduction of expenditures by the school if quality of education is to be maintained; (5) supports continued improvement of the AMA information system on expenditures of medical students to determine which items are included, and what the ranges of costs are; (6) supports continued study of the relationship between medical student indebtedness and career choice; (7) encourages students to seek out creative methods of financing; (8) believes medical schools should consider allowing more flexible scheduling to permit students leaves of absence to obtain gainful employment; (9) believes medical schools should avoid counterbalancing reductions in revenues from other sources through tuition and student fee increases that compromise their ability to attract students from diverse backgrounds; (10) urges all states to adopt AMA model legislation for loan programs to students; (11) supports continued analysis of current and proposed student loan programs to determine their characteristics and to identify alternatives; (12) supports continued federal government support of medical education; (13) supports continued state government support for medical education; (14) supports expansion of the number of affiliations with appropriate hospitals by institutions with accredited residency programs; (15) encourages for profit-hospitals to participate in medical education and training; (16) supports AMA monitoring of trends that may lead to a reduction in stipends paid to resident physicians; (17) believes that the cost of graduate medical education should be funded as an integral part of the financing of medical care; (18) encourages all sponsoring institutions to make financial information available to help residents manage their educational indebtedness. (CME Rep. A, I-83; Reaffirmed: CLRPD Rep. I-93-1; Res. 313, I-95; Reaffirmed by CME Rep. 13, A-97)

H-305.995 Funding for Medical Students
The AMA: (1) reminds legislators and the public of the public interest in the quality of medical education and the training of students who will be the physicians of the future; (2) encourages state medical societies to urge state legislators to adequately fund and support the medical education systems in their states; (3) urges each medical school to publicize the cost of attending that medical school to prospective students and to the student advisors at the colleges and universities that are educating significant numbers of their pre-med students, where these can be identified; (4) continues to urge that medical schools make every effort to generate financial support from multiple and diverse sources in order to preserve reasonable self-determination; (5) urges medical schools to review the operations of their financial aid offices and make any changes that may seem appropriate and feasible that would assist medical students to find available funds, manage debt responsibly, and minimize abuse of programs that could discourage aid sources; and (6) urges medical schools, even as their budgets tighten, to consider the educational advantages of selecting able and motivated students who reflect an appropriate mix of the range of socioeconomic strata in America. (BOT Rep. JJ, I-81; Reaffirmed: Sunset Report, I-98)

H-305.959 Reduction in the Cost of Medical School Education
The AMA will work with all appropriate bodies to study how the cost to students of medical education can be reduced significantly in coming years. (Res. 308, A-92)

H-305.966 Medical School Disclosure of Available Financial Aid Resources
Our AMA encourages all medical schools to make available to prospective students information and statistics on their schools' available financial aid resources. (Res. 262, A-90; Reaffirmed: Sunset Report, I-00) The following language from CME Report 2 I-00 was adopted at the Interim Meeting in Orlando:

  1. That Policy H-305.989, which states that "students should not be denied an opportunity to undertake medical education because of a lack of funds," be reaffirmed. (Reaffirm HOD Policy)
  2. That Policies H-305.978, H-305.980, H-305.961, dealing with creating more favorable conditions for loan repayment, and Policies H-200.959, H-200.984, and H-200.989, dealing with adequate funding for the National Health Service Corps, be reaffirmed. (Reaffirm HOD Policy)
  3. That the Board of Trustees of our American Medical Association (AMA) pursue the introduction of member benefits to help medical students, resident physicians, and young physicians manage and reduce their debt burden. This should include consideration of the feasibility of developing web-based information on financial planning/debt management; introducing a loan consolidation program, automatic bill collection and loan repayment programs, and a rotating loan program; and creating an AMA scholarship program funded through philanthropy. The AMA also should collect and disseminate information on available opportunities for medical students and resident physicians to obtain financial aid for emergency and other purposes. (Directive to Take Action)
  4. That our AMA vigorously advocate for ongoing, adequate funding for federal and state programs that provide scholarship or loan repayment funds in return for service, including funding in return for practice in underserved areas, participation in the military, and participation in academic medicine or clinical research. Obtaining adequate support for the National Health Service Corps and similar programs, tied to the demand for participation in the programs, should be a focus for AMA advocacy efforts. (Directive to Take Action)
  5. That our AMA collect and disseminate information on successful strategies used by medical schools to cap or reduce tuition. (Directive to Take Action)
  6. That our AMA encourage medical schools to provide yearly financial planning/debt management counseling to medical students. (Directive to Take Action)
  7. That our AMA urge the Accreditation Council for Graduate Medical Education (ACGME) to revise its Institutional Requirements to include a requirement that financial planning/debt management counseling be provided for resident physicians. (Directive to Take Action)
  8. That our AMA work with other organizations, including the Association of American Medical Colleges, residency program directors groups, and members of the Federation, to develop and disseminate standardized information, for example, computer-based modules, on financial planning/debt management for use by medical students, resident physicians, and young physicians. (Directive to Take Action)
  9. That our AMA work with other concerned organizations to promote legislation and regulations with the aims of increasing loan deferment through the period of residency, promoting the expansion of subsidized loan programs, eliminating taxes on aid from service-based programs, and restoring tax deductibility of interest on educational loans. (Directive to Take Action)
  10. That Policy H-310.934, which states that the AMA elevate the issue of medical student debt to on of the top several legislative priorities on its agenda, and that policy H-305.946, which states that the AMA encourage society and payers of health care to recognize the cost of medical education and develop a stable funding source specifically dedicated to support the education of medical students, be reaffirmed and that the BOT report at I-01 on proactive measures the AMA has taken to implement these policies.

Loan Repayment

H-305.950 Fairness in Publication of Names of Loan Defaulters
The AMA opposes the selective publication of names of defaulters on federally funded student loans. (Res. 309, A-94)

H-305.982 Student Loan Repayment Defaults
The AMA encourages the HHS Inspector General to pursue all legal avenues within his jurisdiction to withhold Medicare and Medicaid reimbursements, research grant awards, and salaries or stipends from physicians who have defaulted on repayments of student loans, unless a physician can prove hardship. (Sub. Res. 69, A-85; Reaffirmed by CLRPD Rep. 2, I-95)

H-305.989 Financial Assistance for Medical Students
(1) Our AMA continues to urge the public, legislators, constituent medical societies and medical schools to consider the importance of attracting the best students to pursue medicine as a career. (2) Physicians who have outstanding educational loans and medical student borrowers are urged to meticulously meet the repayment responsibilities assumed with each student loan. (3) Our AMA believes that the best students should not be denied an opportunity to undertake medical education because of a lack of funds. (BOT Rep. O, A-83; Reaffirmed: CLRPD Rep. I-93-1; Reaffirmed: CME Rep. 2, I-00)

H-305.991 Repayment of Educational Loans
The AMA (1) believes that it is improper for any physician not to repay his or her educational loans; (2) urges increased efforts to collect overdue debts from the present medical student loan programs in a manner that would not interfere with the provision of future loan funds to medical students; and (3) encourages medical school financial aid officers to counsel individual medical student borrowers on the status of their indebtedness and payment schedules prior to their graduation. (Sub. Res. 47, A-83; Reaffirmed: CLRPD Rep. I-93-1)

H-305.992 Student Loans
The AMA supports efforts to secure public and private funds at reasonable interest rates for student loans. (Sub. Res. 83, I-82; Reaffirmed: CLRPD Rep. A, I-92)

H-305.954 Repayment of Medical School Loans
Our AMA: (1) will work with the Health Resources and Services Administration and other interested parties to develop mechanisms for increasing financial aid opportunities for medical students, including the loan repayment option if feasible; and (2) further develop and more aggressively publicize a low interest and extended payment loan program for young physician members of the AMA to assist them in retiring their educational debts. (CME Rep. O, A-93; Appended: Res. 610, I-98)

D-305.981 Financing Federal Consolidation Loans
Our AMA will: (1) support the refinancing of Federal Consolidation Loans; and (2) actively advocate for modification of pending and future legislation which that provides the opportunity to refinance Federal Consolidation Loans. (Res. 849, I-03)

Medical Education: Financing and Support
Policies in AMA Policyfinder

CME Reports

Other/General

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H-310.934 Medical Student Debt
Our AMA: (1) continues to recognize the seriousness of the problem of the expanding burden of Medical Education related debt; (2) shall elevate this issue to one of the top several legislative priorities on its agenda; and (3) continues to recognize the serious problem of the expanding burden of medical education related debt. (Res. 304, A-98; Appended: Res. 306, I-99; Reaffirmation, A-00; Reaffirmed: CME Rep. 2, I-00)

H-305.946 The Ecology of Medical Education: Financing Undergraduate Medical Education
The AMA: (1) encourages society and payers of health care to recognize the cost of medical education and develop a stable funding source specifically dedicated to support the education of medical students; (2) encourages medical schools to develop systems to more closely link revenues and teaching expenditures so faculty can receive explicit reimbursement for assisting the medical school in fulfilling its educational mission; and (3) along with medical schools and other interested groups, will work toward development of a system similar to CPT codes for education with funding from a stable source. (CME Rep. 6, I-96; Reaffirmed: CME Rep. 13, A-97; Reaffirmed: BOT Rep. 7, A-99)

H-305.973 Financing Undergraduate Education
(1) The pluralistic system of financial support for undergraduate education for the health professions should be maintained. (2) The federal government should continue its support of undergraduate education for the health professions, especially to enhance access to the professions for minority and disadvantaged students and to supply professionals to underserved areas. The role of the Armed Forces, the Public Health Service and the Veterans Administration in health professions education is important and should be continued. State and local governments should continue to support undergraduate programs of education for the health professions. (3) Public and private programs of undergraduate education for the health professions should actively solicit contributions from alumni and from private foundations. (4) While income from patient care should be used to support undergraduate educational programs for the health professions, disproportionate reliance on this source of funding should be avoided. (5) Undue reliance on tuition and fees to support undergraduate education for the health professions should be avoided. (6) Undergraduate programs for health professions education should consider financial aid trust funds as a means of increasing funding for student financial aid, including scholarships. (BOT Rep. NN, A-87; Modified: Sunset Report, I-97)

H-305.938 Use of Social Security Numbers in Student Loan Accounts
Our AMA will work with student loan servicers and other associated agencies to end the use of Social Security Numbers as account numbers. (Res. 302, I-98)

H-305.941 Recognizing Dependent Care Expenses in Determining Medical Education Financial Aid
AMA policy is to pursue changes to federal legislation or regulation, and specifically to the Higher Education Act, to change the cost of attendance definition for medical education to include costs for food, shelter, clothing and health care for all dependents, and for dependent care. (Res. 205, I-97)

D-305.986 Recognizing Spouse and Dependent Care Expenses in Determining Medical Education Financial Aid
Our AMA will: (1) work with the Liaison Committee on Medical Education to require, as part of the accreditation standards for medical schools, that dependent health insurance, dependent care, and dependent living expenses be included both as part of the "cost of attendance" and as an educational expense for the purposes of student budgets and financial aid in medical schools; (2) encourage medical schools to include spouse and dependent health insurance, dependent care, and dependent living expenses as part of the "cost of attendance" and as an educational expense for the purposes of student budgets and financial aid;

(3) ask its Council on Medical Education, Section on Medical Schools, and Women Physicians Congress to consider options to carry out the intentions of current House of Delegates' policy on the issue of spouse and dependent health insurance, dependent care, and dependent living expenses; and

(4) report back on actions taken on this resolution, and their results, to the House of Delegates at the 2004 Annual Meeting. (Res. 301, A-03)

D-305.980 Immediate Legislative Solutions to Medical Student Debt
Our AMA will: (1) endorse and actively lobby for the Reauthorization of the Higher Education Act, including: (a) Elimination of the "single-holder" rule; (b) Continuation of the consolidation loan program and a consolidator’s ability to lock in a fixed interest rate; (c) Expansion of the deferment period for loan repayment to cover the entire duration of residency and fellowship; (d) Broadening of the definition of economic hardship as used to determine eligibility for student loan deferment; (e) Retention of the option of loan forbearance for residents who are ineligible for student loan deferment; and (f) Inclusion of dependent care expenses in the definition of "cost of attendance"; and (2) lobby for passage of legislation that would: (a) Eliminate the cap on the student loan interest deduction; (b) Increase the income limits for taking the interest deduction; (c) Include room and board expenses in the definition of tax-exempt scholarship income; and (d) Make permanent the education tax incentives that our AMA successfully lobbied for as part of Economic Growth and Tax Relief Reconciliation Act of 2001. (Res. 850, I-03)

D-305.982 Long-Term Solutions to Medical Student Debt
Our AMA will: (1) explore membership in the American Council on Education and/or the Committee for Education Financing, in order to build our ties to the higher education community and report back by the 2004 Annual Meeting;

(2) more aggressively publicize existing work done through the Coalition for Student Loan Fairness;

(3) study and report back at the 2004 Interim Meeting on potential new sources of Graduate Medical Education funding and ways to increase resident salaries;

(4) study and report back at the 2004 Interim Meeting on feasible strategies for creating new and/or expanded loan programs specifically for the health professions;

(5) study and report back at the 2005 Annual Meeting on the feasibility of earmarking federal funds to undergraduate medical education for the purpose of reducing medical school tuition at public and private universities;

(6) study and report back at the 2004 Interim Meeting on the need for non-primary-care physicians in underserved areas, with a focus on showing how the National Health Service Corps and similar loan repayment programs could feasibly be expanded to cover specialties beyond primary care; and

(7) study and report back at the 2005 Annual Meeting on appropriate methods for calculating the value of the clinical work performed by medical students and taking such calculations into account when determining the cost of educating a medical student. (Res. 848, I-03)

H-305.932 State and Local Advocacy on Medical Student Debt
Our AMA: (1) opposes the charging of broad and ill-defined student fees by medical schools, such as but not limited to professional fees, encouraging in their place fees that are earmarked for specific and well-defined purposes; (2) encourages medical schools to use their collective purchasing power to obtain discounts for their students on necessary medical equipment, textbooks, and other educational supplies; and (3) encourages medical schools to cooperate with undergraduate institutions to establish collaborative debt counseling for entering first-year medical students. (Res. 847, I-03)

D-305.983 Strategies to Combat Mid-year and Retroactive Tuition Increases
Our AMA will: (1) assist state medical societies in advocacy efforts in opposition to mid-year and retroactive tuition increases;

(2) make available, upon request, the judicial precedent that would support a successful legal challenge to mid-year tuition increases;

(3) identify and disseminate information about model financial aid programs for medical students that have the potential to reduce student debt;

(4) continue to encourage individual medical schools and universities, federal and state agencies, and others to expand options and opportunities for financial aid to medical students; and

(5) study the funding of medical education programs, to identify:

(a) The status of revenue sources used to support undergraduate and graduate medical education programs, including current constraints on these revenue sources;

(b) Strategies to reduce these financial constraints; and

(c) Mechanisms to ensure that funding for undergraduate and graduate medical education programs is maintained, so as to reduce the financial burden on medical students and resident physicians. (CME Rep. 3, I-03)