IHS Workforce Parity Act of 2025

The bill would amend the Indian Health Care Improvement Act to permit two groups — recipients of Indian Health Professions Scholarships and participants in the IHS Loan Repayment Program — to meet their service obligations through half-time rather than full-time clinical practice. Scholarship recipients who choose half-time practice would have to serve twice as long as the standard full-time obligation and would sign a written agreement confirming that arrangement. Loan repayment participants would have three options: full-time service for at least two years, half-time service for at least four years (or its equivalent when a longer full-time period was agreed to), or two years of half-time service at 50 percent of the standard loan payment amount. The bill would also update breach-of-contract rules to require that any unfinished half-time service be converted to its full-time equivalent before calculating damages.

The bill does not change the underlying scholarship or loan repayment benefit amounts for full-time participants, nor does it alter which types of Indian health programs qualify as service sites. It relies on existing Public Health Service Act definitions of "full-time" and "half-time" to govern how the new options are administered.

Health professionals who receive Indian Health Professions Scholarships or participate in the IHS Loan Repayment Program, including physicians, nurses, and other clinicians serving in IHS facilities, tribally operated health programs under the Indian Self-Determination and Education Assistance Act, or qualifying private practices that serve a substantial number of American Indians and Alaska Natives in health professional shortage areas.

Clinicians who cannot commit to full-time IHS service — due to family responsibilities, part-time residency requirements, or other practice obligations — could now participate in IHS scholarship or loan repayment programs by working half-time. This flexibility could expand the pool of health professionals willing to serve Indian health programs, where workforce shortages are persistent and severe, without reducing the total service hours those programs receive.

The bill is largely self-executing through its statutory text. Participants who elect half-time service would sign a written agreement specifying the doubled obligation period and the breach-of-contract terms before beginning service. IHS would apply existing Public Health Service Act definitions of "full-time" and "half-time" to administer the options. The Secretary retains existing authority to assign participants to Indian health programs and to apply damages formulas — now updated to convert half-time service to full-time equivalents — if participants fail to begin or complete their obligations. No new rulemaking is explicitly required.