242 
TITLE XI—INCENTIVES TO 
REDUCE PHYSICIAN SHORTAGES 
Subtitle 
A—Federally 
Supported 
Student Loan Funds for Medical 
Students 
SEC. 1101. FEDERALLY SUPPORTED STUDENT LOAN FUNDS 
FOR MEDICAL STUDENTS. 
(a) PRIMARY HEALTH CARE MEDICAL STUDENTS.— 
Subpart II of part A of the Public Health Service Act (42 
U.S.C. 292q et seq.) is amended— 
(1) by redesignating section 735 as section 729; 
and 
(2) in subsection (f) of section 729 (as so redes-
ignated), by striking ‘‘is authorized to be appro-
priated to be appropriated $10,000,000 for each of 
the fiscal years 1994 through 1996’’ and inserting 
‘‘are authorized to be appropriated such sums as 
may be necessary for fiscal year 2010 and each fis-
cal year thereafter’’. 
(b) OTHER MEDICAL STUDENTS.—Part A of title VII 
of the Public Health Service Act (42 U.S.C. 292 et seq.) 
is amended by adding at the end the following: 
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‘‘Subpart III—Federally Supported Student Loan 
Funds for Certain Medical Students 
‘‘SEC. 730. SCHOOL LOAN FUNDS FOR CERTAIN MEDICAL 
STUDENTS. 
‘‘(a) FUND AGREEMENTS.—For the purpose de-
scribed in subsection (b), the Secretary is authorized to 
enter into an agreement for the establishment and oper-
ation of a student loan fund with any public or nonprofit 
school of medicine or osteopathic medicine. 
‘‘(b) PURPOSE.—The purpose of this subpart is to 
provide for loans to medical students who would be eligible 
for a loan under subpart II, except for the student’s deci-
sion to enter a residency training program in a field other 
than primary health care. 
‘‘(c) COMMENCEMENT
OF REPAYMENT PERIOD.— 
The repayment period for a loan under this section shall 
not begin before the end of any period during which the 
student is participating in an internship, residency, or fel-
lowship training program directly related to the field of 
medicine which the student agrees to enter pursuant to 
subsection (d). 
‘‘(d) REQUIREMENTS FOR STUDENTS.—Each agree-
ment under this section for the establishment of a student 
loan fund shall provide that the school of medicine or os-
teopathic medicine will make a loan to a student from such 
fund only if the student agrees— 
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‘‘(1) to enter and complete a residency training 
program (in a field of medicine other than primary 
health care) not later than a period determined by 
the Secretary to be reasonable after the date on 
which the student graduates from such school; and 
‘‘(2) to practice medicine through the date on 
which the loan is repaid in full. 
‘‘(e) REQUIREMENTS FOR SCHOOLS.—The provisions 
of section 723(b) (regarding graduates in primary health 
care) shall not apply to a student loan fund established 
under this section. 
‘‘(f) APPLICABILITY OF OTHER PROVISIONS.—Ex-
cept as inconsistent with this section, the provisions of 
subpart II shall apply to the program of student loan 
funds established under this section to the same extent 
and in the same manner as such provisions apply to the 
program of student loan funds established under subpart 
II. 
‘‘(g) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there are authorized to be appro-
priated such sums as may be necessary for fiscal year 
2010 and each fiscal year thereafter.’’. 
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Subtitle B—Loan Forgiveness for 
Primary Care Providers 
SEC. 1111. LOAN FORGIVENESS FOR PRIMARY CARE PRO-
VIDERS. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall carry out a program of entering into 
contracts with eligible individuals under which— 
(1) the individual agrees to serve for a period 
of not less than 5 years as a primary care provider; 
and 
(2) in consideration of such service, the Sec-
retary agrees to pay not more than $50,000 on the 
principal and interest on the individual’s graduate 
educational loans. 
(b) ELIGIBILITY.—To be eligible to enter into a con-
tract under subsection (a), an individual must— 
(1) have a graduate degree in medicine, osteo-
pathic medicine, or another health profession from 
an accredited (as determined by the Secretary of 
Health and Human Services) institution of higher 
education; and 
(2) have practiced as a primary care provider 
for a period (excluding any residency or fellowship 
training period) of not less than— 
(A) 5 years; or 
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(B) 3 years in a medically underserved 
community (as defined in section 799B of the 
Public Health Service Act (42 U.S.C. 295p)). 
(c) INSTALLMENTS.—Payments under this section 
may be made in installments of not more than $10,000 
for each year of service described in subsection (a)(1). 
(d) APPLICABILITY OF CERTAIN PROVISIONS.—The 
provisions of subpart III of part D of title III of the Public 
Health Service Act shall, except as inconsistent with this 
section, apply to the program established under this sec-
tion in the same manner and to the same extent as such 
provisions apply to the National Health Service Corps 
Loan Repayment Program established in such subpart. 
TITLE XII—OFFSETS 
Subtitle A—Enforcing 
Discretionary Spending Limits 
SEC. 1201. ENFORCING DISCRETIONARY SPENDING LIMITS. 
(a) DISCRETIONARY SPENDING LIMITS.—Sections 
251(b) and (c) of the Balanced Budget and Emergency 
Deficit Control of Act of 1985 are amended to read as 
follows: 
‘‘(b) DISCRETIONARY SPENDING LIMIT.—As used in 
this part, the term ‘discretionary spending limit’ means— 
‘‘(1) 
with 
respect 
to 
fiscal 
year 
2010, 
$1,173,000,000,000 in new budget authority of 
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