We, the undersigned medical students at Rocky Vista University College of Medicine (RVUCOM) and Medical Professionals of Colorado, write to express our deep concern and strong opposition to the provisions in the proposed House reconciliation bill “One Big Beautiful Bill Act” (formerly known as), "Student Success and Taxpayer Savings Plan", which seeks to eliminate the Grad PLUS loan program, ends IDR (income-driven repayment) plans like SAVE (Saving on a Valuable Education), ICR (Income-Contingent Repayment), and PAYE (Pay As You Earn), and nearly eliminates the PSFL (Public Service Loan Forgiveness) program beginning July 1, 2026.

As future physicians, we are pursuing an education that is both demanding and essential to the health of our nation. However, the cost of medical school is extraordinarily high, with average annual tuition alone exceeding $50,000 and total attendance often surpassing $390,000 over four years. For many students, Grad PLUS loans are the only available financing option that covers the full cost of attendance after we exhaust our unsubsidized federal loans.

Rural America faces a critical physician shortage, with approximately 65% of rural areas experiencing a lack of primary care providers. Only about 9% of U.S. physicians practice in these regions, despite 20% of the population residing there. The proposed elimination of Grad PLUS loans in the House reconciliation bill threatens to exacerbate this issue by limiting access to medical education for students from rural and underserved backgrounds. These loans are often essential for covering the full cost of medical school. Without them, aspiring physicians may be deterred from entering the field or forced to seek private loans with less favorable terms, further reducing the pipeline of doctors willing to serve in high-need rural communities. This policy change risks deepening existing healthcare disparities and undermining efforts to address the rural physician shortage.

Eliminating Grad PLUS loans would:

• Limit access to medical education, particularly for students from low-income, minority, or nontraditional backgrounds.
• Push students toward private loans, which offer fewer borrower protections, less flexibility, and higher interest rates.
• Worsen the physician shortage, especially in rural and underserved areas, by discouraging students from pursuing or completing medical training.
• Eliminating IDR, PAYE, and SAVE Disproportionately Hurts Medical and Professional Students

Affects on Students:

• Medical and Professional students often graduate with $200,000+ in debt, and flexible IDR plans are critical to making repayment manageable during low-income residency years.
• Eliminating PAYE and SAVE removes affordable options that cap monthly payments based on income, forcing new doctors into unaffordable repayment plans.
• Without income-based options, medical trainees may face financial hardship or delayed entry into practice, especially in primary care or underserved specialties.
• The changes may discourage applicants from entering medicine at all, especially those from disadvantaged backgrounds. This is critical as CO Congressional districts 3, 4, 5, and 8 all severely suffer from primary care physician shortages.
• Nearly half of all medical students currently rely on Grad PLUS loans to finance their education once federal unsubsidized loan limits are met.
• 70% of U.S. medical schools are private, and the average annual tuition at private medical schools is $67,950, placing a significant financial burden on students.
• The proposed bill eliminates Grad PLUS, cutting off the only federal loan option that ensures full coverage of medical school costs for many.

PSLF Changes in the Bill Harm current and future Medical Residents:

• Under the new bill, payments made during medical or dental residency under RAP will not count toward PSLF, erasing up to 7 years of service-based repayment progress.
• This change penalizes trainees who are already working full-time in nonprofit hospitals serving vulnerable populations.
• Medical students planning careers in public service may now lose PSLF eligibility or be forced to repay their loans in full, despite serving in qualifying roles.

We urge members of Congress, especially those representing Colorado’s most underserved districts, to oppose the elimination of the Grad PLUS Loan program, income-driven repayment plans like SAVE and PAYE, and critical protections under the Public Service Loan Forgiveness (PSLF) program as outlined in the proposed reconciliation bill.

As future physicians and current physicians committed to serving our communities, we ask that you:

• Vote against provisions that restrict access to affordable medical education.
• Publicly advocate for equitable student loan reforms that recognize the unique financial trajectory of medical and professional students.
• Engage directly with medical students and healthcare education leaders to craft policies that strengthen, not jeopardize, the physician pipeline, particularly in rural and underserved regions.