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Why the Physician Assistant Higher Education Modernization Act of 2021 should pass

The Physician Assistant Higher Education Modernization Act of 2021 (HR 2274) was introduced to the House of Representatives on March 29, 2021, by California’s 37th district representative, Karen Bass. The bill aims to amend the Higher Education Act of 1965 to expand education opportunities for physician assistant students and physician assistants. Some advantages of HR 2274 include (1.) increasing Subsidized Stafford Loan (SSL) limits and loan forgiveness programs (2.) increasing grants awarded to historically black colleges and universities (HBCUs) and Hispanic programs (3.) increasing enrollment of minorities and students from rural areas in PA programs and postbaccalaureate PA programs.

Over the years the cost of higher education has increased while salaries have remained stagnant. Millions of Americans have student debt and the number continues to rise with minorities and women being disproportionally affected1. Tuition for PA programs continue to increase with tuitions ranging between $30,000 to over 120,000. Many PA students fund their education with student loans, specifically federal aid. Currently graduate students can apply for the Unsubsidized Stafford Loan (USL) which caps at $65,0002 which is less than what most PA programs cost. If a student needs additional aid, they can apply for the GradPlus Loan which is a federal loan that requires a passed credit check. To my knowledge this is a common route students take, but for students who do not qualify private loans are the next option. Thus, increasing the SSL limits would allow students to receive loans with no or lower interest rates and forgo high interest rates that come with private loans. Furthermore, expansion of loan forgiveness programs will grant more students the ability to take advantage of these programs and minimize their education debt.

According to the PAEA Program Report 35 of the 10, 846 first-year PA students, 3.9% were African American, 0.5% were American Indian or Alaskan Native, and 7.6% were Hispanic. HBCUs have been pioneer’s in producing black graduates in health professional careers3. Currently only three HBCUs (Morehouse, Xavier, University of Maryland Eastern Shore) of the 79 have PA programs 4, 5 . Note, US News and World Report4 did not have Charles Drew listed, which is an HBCU that has a PA program. Additionally, Meharry Medical College and Howard University two HBCUs working towards receiving provision accreditation. Thus, increased funding can help more HBCUs establish PA programs, aiding in developing a more diverse workforce within the PA profession and allowing for minorities to have an equitable chance at building generational wealth.

Studies show racial and ethnic minorities are less trusting of their healthcare providers and the healthcare system. Mistrust is influenced by various factors, such as a history of unethical treatment, negative encounters with providers, and sustained racial disparities6, all which are built on the foundation of systemic racism. Due to this marginalized communities might be more receptive to providers that share similar backgrounds. Further, one might argue students from marginalized communities are more enthusiastic about serving these communities compared to their counterparts given they can relate to these communities. Therefore, increasing enrollment of such students could help improve health professional shortage areas (HPSA) which are usually in communities less desirable to health professionals as well has aid in bridging health disparities that plague such communities.

Disadvantages

Note there are some disadvantages to HR 2274. For starters, it does not provide non-repayable options to PA students, such as increasing grants directly provided to students. Increasing the SSL limit will certainly help reduce the amount of interest students owe, but to significantly reduce student debt the government needs to focus on non-repayable options to PA students. In addition, increasing post-baccalaureate PA program enrollment is necessary, but the focus needs to center around less expensive programs. For instance, many PA students who do a postbac complete a non-traditional postbac at a community college which is significantly less expensive compared to master-level programs. HR 2274 funding should focus on similar alternatives, such as postbac bridge programs with community colleges.

Overall, if passed HR 2274 will allow minorities to have an equitable chance at building generational wealth, diversifying the PA profession, and allow all students to begin achieving life milestones, such as starting a family, that might be postponed due to prioritizing student loan payments. As a PA student and future PA-C I hope the bill gets passed🙏🏽.

Stay blessed. Remember, you are loved ❤️

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