Virginia bill offers forgivable med school loans for service in state health care deserts
The bipartisan bill would forgive medical school loans of up to $50,000 a year.
In many parts of Virginia, patients have to travel long distances for basic health care due to a lack of doctors and hospitals likely to worsen with the implementation of President Donald Trump’s 2025 budget law, which slashed $1 trillion from Medicaid and other federal health programs over a decade.
A bipartisan bill currently being considered in the Virginia General Assembly, sponsored by Democratic Sen. Creigh Deeds and Democratic Del. Rodney Willett, is designed to increase the number of medical providers serving those health care deserts, areas that are without sufficient medical providers and facilities.
Senate Bill 625 and House Bill 663 would create a Medical Education Loan-for-Service Fund and Program, providing forgivable medical school loans of up to $50,000 per year for up to four years for those who agree to practice medicine at a rural Virginia emergency hospital or health clinic or provide needed services in other underserved Virginia locations following graduation. In order for the loans to be forgiven, the recipients would have to commit to two to five years of service, depending on how many years they received loans, or pay back the funds with interest.
“Looking at the experience of other states, we did a heck of a lot of research and talked to a heck of a lot of people, and ultimately came up with this medical education loan-for-service program,” Clark Barrineau, vice president of government affairs and public policy of the Medical Society of Virginia, told the Virginia Independent. “This would, as it says, drive people to go live and work in underserved parts of Virginia, increasing health care access and strengthening our workforce.” Similar laws have been adopted in Kansas, North Carolina, and New Mexico.
If approved, the legislation would cost Virginia $3 million annually and cover 60 loans per year.
Barrineau, whose organization strongly supports the bill, noted that Virginia has a statewide health care workforce crisis: “People have to drive for miles to see specialists in certain parts of southwest Virginia. So we need those people, primary care, pediatricians, OB-GYNs. We need them to go live where people are and where we know the needs are.” He noted that Trump’s budget law included a $200,000 cap on the amount a medical student can borrow in federal loans, below the total cost of all six Virginia medical schools. “This is an attempt to fix some of what the federal government decided to break, and this way we can address the problems that we have all across Virginia.”
“It would drive more and more of these individuals to these parts of the commonwealth, and the reason for that is because we lose more than we keep, in Virginia,” Barrineau said. “We train more people at our medical schools than we retain to live and work in Virginia once they graduate from medical school. If we are investing in them, we want them to stay and treat Virginia patients.”
Last year, Pulaski County community volunteer and stay-at-home mom Hazel Wines told the Virginia Independent that a lack of providers means her family often has to drive an hour to Roanoke for health care. “We often have to go outside, certainly outside of our county and sometimes outside of the New River Valley altogether, to get appropriate care, especially for our children,” she said.
Rural medical providers are cheering the legislation.
Dr. Stephen Combs is chief medical officer for Ballad Health Medical Associates, responsible for medical facilities operating in southwest Virginia and northeast Tennessee, and a practicing pediatrician in both states. He said in a phone interview that the mountainous terrain of southwest Virginia can present challenges both for patients to get to medical care and to have adequate Internet to use telehealth.
“This is really unique in that it addresses the workforce shortages early in the pipeline,” said Combs, who also . “So this is when students come out and go, Wow, I’d really like to do family medicine or pediatrics, but I already owe $200,000. I don’t know if I can afford it. We would be able to work with those students then and say, If you will commit to practicing in Virginia, commit to practicing one of these specialties — and it’s not just family medicine and pediatrics. Surprisingly, there’s a need for emergency medicine, OB-GYN, psychiatry, so there are multiple needs that would fill any medical student’s wish list — we would be able to help you.”
Wendy Welch, executive director of the nonprofit Southwest Virginia Graduate Medical Education Consortium, said her organization loves the bill: “I talked to a couple of the coordinators of residency programs here in southwest Virginia — there are four residency programs — and they said the same thing: This is going to be really helpful to rural kids who want to go to medical school. It’s going to be a quick infusion of cash available. In Scotland, where my husband’s from, they would call it ‘ ‘money for old rope,’” meaning a big return for little investment, though she noted that the time it takes to complete medical school, including residencies, means it will take a while for the bill’s impact to be fully felt.
“There is nothing about this that loses for rural people, especially rural medical students,” Welch said. “They’re going to get assistance to do something they want to do. The communities themselves are going to get good doctors from those rural students who are dedicated to rural education and rural health care provision. There’s nothing about that that’s wrong.”
