Medicare would stop funding residency training for non-citizen doctors

What does this do?

HR 8943 would prohibit Medicare from including non-U.S. citizens or nationals when calculating graduate medical education payments to hospitals and training sites. Only trainees who are U.S. citizens or nationals would count toward the federal funding hospitals receive for running residency and internship programs. Facilities that violate the rule face a tiered penalty system starting with fines and escalating to full funding cutoffs.

Who does it affect?

Teaching hospitals, clinics, and other facilities that train doctors and receive Medicare graduate medical education funding are directly subject to the bill's requirements and penalties. International medical graduates currently in U.S. residency programs are also directly affected, as are patients in rural and underserved communities that rely heavily on those doctors.

Why does it matter?

If training programs shrink in response to reduced funding eligibility, access to physicians in rural and underserved areas could be affected, given that international medical graduates make up a significant share of doctors in those settings. Facilities that lose funding through penalties or repeated violations could face further strain on their ability to run training programs.

What does it cost, and who pays?

A first violation carries a fine equal to 25 percent of the payment that would have gone toward the non-citizen trainees. A second violation brings a $1 million fine, a third results in a five-year cutoff of all Medicare graduate medical education funding to that facility, and repeated violations after that trigger ten-year funding cutoffs.

Where does it stand?