The National Health Service Corps (NHSC) continues to stand as a cornerstone in the fight to address pervasive healthcare provider shortages and ensure access to care, particularly in medically underserved areas. Paragon Health Institute (Paragon), a D.C.-based think tank, recently made a recommendation to prevent a NHSC funding increase that is not just disappointing—it is dangerous. This proposal threatens a program that has consistently proven invaluable in addressing systemic healthcare disparities, fostering a sustainable workforce, and supporting underserved communities.
The Association of Clinicians for the Underserved (ACU) rejects this misguided proposal, and we reaffirm that it is critical to highlight the evidence-based benefits, bipartisan support, and the urgent moral imperative to protect and expand NHSC funding.
NHSC: A Proven Solution with Bipartisan Support
Since its inception in 1972, the NHSC has been pivotal in addressing healthcare gaps across the country. By providing scholarships and loan repayment to clinicians who serve in Health Professional Shortage Areas (HPSAs), the NHSC ensures that millions of Americans gain access to critical primary care, behavioral health, and dental services.
The NHSC’s value has garnered strong bipartisan support for decades. Lawmakers from both parties understand that investments in the NHSC translate into direct benefits for communities, addressing workforce shortages in regions that would otherwise remain underserved with little or no access to care for those in the community. It is an established, proven solution to a problem that transcends political divides.
Paragon’s assertion that the need for additional public funding for NHSC is “questionable” ignores decades of data showing the program’s effectiveness in improving health outcomes and reducing costs. Such claims dismiss the critical role the NHSC plays in connecting providers to underserved communities – particularly rural areas – and supporting the nation’s broader healthcare infrastructure.
Impact on Patients, Providers, and Communities
As ACU details in our recent white paper, more than 20 million Americans rely on NHSC-supported providers for care annually. These clinicians often serve as the sole healthcare professionals in their communities, ensuring access to preventive services, chronic disease management, and behavioral health treatment. Eliminating or reducing support for the NHSC would devastate these vulnerable populations.
Key Outcomes:
- Improved Access to Quality Care: NHSC placements prioritize underserved and rural communities, addressing systemic gaps in care for low-income populations.
- Economic Efficiency: Like Community Health Centers (CHCs), NHSC-supported providers reduce healthcare costs by increasing access to preventive care and decreasing reliance on emergency services.
- Workforce Sustainability: Nearly 85% of NHSC participants continue working in underserved areas after fulfilling their service obligations, creating lasting improvements in healthcare access.
Paragon’s suggestion that other workforce solutions, such as expanding the roles of non-physician providers or relying on technology, could replace NHSC funding is both shortsighted and insufficient. While such strategies may play a supportive role, they cannot substitute for the comprehensive impact of the NHSC. Further, Paragon’s suggestion also ignores the fact that more than 100 million Americans still lack ongoing access to primary care – specifically medical, dental and behavioral health – because they live in health professional shortage areas (HPSAs). The NHSC hasn’t only been a proven solution to addressing access to care in HPSAs: without the NHSC, many of these communities and millions of Americans would go entirely without access to care.
Mandatory Funding Is Essential
Paragon’s proposal to oppose increasing mandatory NHSC funding is a direct threat to the program’s stability and compromises the program’s effectiveness. For NHSC participants, this instability discourages applications and creates challenges in fulfilling service commitments. For communities, it means prolonged vacancies in critical healthcare roles and lack of access to care. Mandatory funding ensures predictability, enabling strategic planning, recruitment, and retention efforts that align with the urgent needs of underserved areas. Without access to care enabled by providers of the NHSC, the alternative is total lack of access, or care via emergency rooms at the highest, and most unnecessary, cost to the individual and the system.
Existing funding cuts have already begun to erode the NHSC’s field strength, which declined from a historic high of 20,215 providers in FY22 to 18,335 in FY23 and most recently to 17,419 in FY24. This troubling trend of decreasing field strength comes at a time when underserved communities desperately need more clinicians, not fewer. The NHSC cannot fulfill its mission under shrinking funding levels that undermine the program’s ability to effectively recruit providers and serve patients in HPSAs.
Economic and Public Health Justifications
The NHSC’s value extends beyond direct patient care. It also offers significant cost savings for taxpayers and strengthens the nation’s public health infrastructure:
- Reduced Costs: By increasing access to primary care, the NHSC helps prevent costly hospitalizations and emergency room visits, particularly for Medicare and Medicaid populations.
- Pandemic Response: NHSC-supported providers were instrumental during the COVID-19 pandemic, serving on the front lines in some of the hardest-hit areas. Maintaining robust funding ensures the program can respond to future emergencies and public health crises.
- Provider Retention: The NHSC pathway is a proven model for training and retaining clinicians in underserved areas, addressing long-term workforce challenges.
Paragon’s recommendation to prioritize deficit reduction over investing in NHSC funding disregards these broader economic and public health benefits. Cutting funding for a program that reduces overall healthcare costs is not fiscal responsibility—it is negligence.
A Flawed Vision for Workforce Development
Paragon’s advocacy for alternative workforce solutions, such as easing training bottlenecks and expanding the roles of non-physician providers, ignores the realities on the ground. While innovations in healthcare delivery are important, they cannot replace the comprehensive support that the NHSC provides. These proposals, in isolation, fail to address the structural challenges that underserved communities face.
The NHSC is a proven solution for addressing provider shortages in areas that would otherwise lack access, ensuring care for underserved populations in both rural and urban communities, and improving access to quality care for all. Paragon’s attempt to undermine this program is a step backward in the fight for healthcare access.
A Call to Action: Congress Must Protect and Expand NHSC Funding
The growing provider shortages across the nation, especially in behavioral health, make the NHSC more essential than ever. Congress must support bipartisan efforts to reauthorize and increase NHSC funding. Earlier this month, NHSC advocates, joined by nearly 320 state and national primary care and community health stakeholders, called on lawmakers in a letter to approve $950 million annually in mandatory NHSC funding for three years and $300 million annually for five years for Teaching Health Centers Graduate Medical Education (THCGME). These levels align with the Bipartisan Primary Care and Health Workforce Act (S. 2840), proposed by Senators Bernie Sanders (I-VT) and Roger Marshall (R-KS), which has stalled since its advancement through the Senate health committee in September 2023.
The Paragon Health Institute’s proposals fail to acknowledge the critical role that the NHSC plays in the healthcare safety net. Congress must reject these recommendations and instead focus on strengthening the program for the millions of Americans who rely on it.
Protecting the NHSC: A Lifeline for Millions and a Pillar of Accessible Healthcare
The NHSC is not merely a program—it is a lifeline for millions of Americans who would otherwise go without care. Its track record of improving health outcomes, reducing costs, and fostering workforce sustainability is irrefutable. Paragon’s call to reduce or alter its funding structure ignores the evidence, the stakes, and the human impact of such decisions.
As advocates for the underserved, we must rally against these harmful proposals and fight for the NHSC’s future. Protecting and expanding NHSC funding is about more than policy—it is about preserving the promise of accessible, quality healthcare for all. Congress must act decisively to ensure that the NHSC remains a pillar of the nation’s healthcare infrastructure.
Jordan Marshall, Your ACU Advocacy Contact
Jordan Marshall is leading ACU’s grassroots advocacy to secure long-term funding for the National Health Service Corps (NHSC). Contact Jordan with any questions regarding policy analysis or if ACU can be of assistance with your own organizational or individual advocacy.
