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Dynamic Chiropractic – May 6, 2008, Vol. 26, Issue 10

Are Chiropractors Finally Eligible for Loan Repayment?

Yes, says report submitted to Congress as part of the Health Care Safety Net Act.

By Editorial Staff

According to a report accompanying legislation (S.901) to reauthorize the National Health Service Corps (NHSC) Loan Repayment Program, doctors of chiropractic are eligible to qualify for inclusion in the program.

The NHSC program allows for select primary health care providers to be reimbursed for their student loans provided they establish and maintain their practices in areas designated "medically underserved" by the federal government.

The report accompanies S.901, the Health Care Safety Net Act of 2007, under review by the Senate Committee on Health, Education, Labor and Pensions as of April 10. In the report, the committee states:

"Currently various types of primary care providers are funded through the NHSC scholarship and loan repayment programs. The committee recognizes that the intent of the NHSC program, as stated in statute, is to assure an adequate supply of primary care providers such as physicians, dentists, behavioral and mental health professionals, certified nurse midwives, certified nurse practitioners, and physician assistants, and if needed by the Corps, other health professionals. The committee understands that these other practitioners provide first contact care for basic health services that are needed by most or all of the population. For the purposes of the Act, Section 338B National Health Service Corps Loan Repayment Program, the term 'other health professionals' is intended to include optometrists, pharmacists, chiropractors and physical therapists."

S.901 is sponsored by Sen. Edward Kennedy (D-Mass.), chair of the Committee on Health, Education, Labor and Pensions. According to the report, the legislation "reauthorizes and strengthens three programs [the NHSC, the Health Centers Program and Rural Health Programs] which together provide a safety net that helps millions of Americans each year access needed health care services. In doing so, the committee is acting to maintain, improve and increase its support for these programs, which enable safety net providers located in rural and urban areas throughout this country to offer health care services to millions of underserved people."

Glenn Manceaux, DC, president of the American Chiropractic Association, commented: "For more than 35 years, doctors of chiropractic were excluded from the National Health Service Corps because we were not mentioned explicitly as eligible providers. Many areas of the country are experiencing shortages of qualified health professionals, and doctors of chiropractic are uniquely positioned to provide high-quality, cost-effective care to the nation's underserved communities. I applaud the Senate committee for taking this action and I look forward to chiropractic inclusion in the program."

The Association of Chiropractic Colleges (ACC) added its congratulations. "This is a great victory, particularly for chiropractic students who are ready, willing and able to serve in the NHSC," said ACC President Carl Cleveland III, DC. "Chiropractic graduates enter the profession well-qualified, prepared and most eager to serve, but many are positioned to enter practice with considerable student loan indebtedness. Thanks to the committee's action, doctors of chiropractic, especially the next generation of doctors graduating from our colleges, will soon have an opportunity to participate in this important loan forgiveness program."

The chiropractic student loan program began as a demonstration project stipulated by the Health Care Safety Net Improvement Act (H.R. 3450), passed on Oct. 17, 2002. Section 338L of the bill established "a demonstration project to provide for the participation of individuals who are chiropractic doctors or pharmacists in the Loan Repayment Program." The inclusion of chiropractic in the program was a policy change that stemmed from nearly two years of lobbying efforts by the ACA and ACC.

In 2004, the project was extended via House Resolution 4818, an omnibus appropriations bill. The provision, sponsored by Sens. Tom Harkin (D-Iowa) and Arlen Specter (R-Pa.), again received the full support of the ACA and ACC. As of press time, the Health Resources and Services Administration is evaluating results from the demonstration project.

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