H.R. 2314 (119th)Bill Overview

FAIR Act

Health|Health
Cosponsors
Support
Lean Republican
Introduced
Mar 25, 2025
Discussions
Bill Text
Current stageCommittee

Referred to the House Committee on Ways and Means.

Introduced
Committee
Floor
President
Law
Congressional Activities
01 · The brief
Plain-English summaryWhat this bill actually does

Requires hospitals with Medicare‑approved residency programs to submit annual counts of applicants and accepted applicants by osteopathic (DO) and allopathic (MD) schools, and to affirm nondiscriminatory consideration and acceptance of COMLEX or USMLE scores when exams are required. The Department of Health and Human Services must publish the submitted data publicly.

Why people may split

Progressives emphasize equity for DO applicants and transparency benefits.

Watch point

Relative to its intended legislative type, this bill is a targeted statutory amendment that clearly defines required data elements, a publication requirement, and a monetary enforcement mechanism.

Requires hospitals with Medicare‑approved residency programs to submit annual counts of applicants and accepted applicants by osteopathic (DO) and allopathic (MD) schools, and to affirm nondiscriminatory consideration and acceptance of COMLEX or USMLE scores when exams are required.

The Department of Health and Human Services must publish the submitted data publicly.

Hospitals that fail to submit the information for prior fiscal years (beginning FY2025) face a 2% Medicare payment reduction per missing year, effective for discharges on or after October 1, 2026.

Passage35/100

Content is narrow and non-ideological but attaches financial penalties to hospitals, inviting organized opposition and implementation scrutiny.

CredibilityPartially aligned

Relative to its intended legislative type, this bill is a targeted statutory amendment that clearly defines required data elements, a publication requirement, and a monetary enforcement mechanism. It integrates directly into the Medicare hospital payment statute and includes timing and an explicit penalty formula.

Contention66/100

Progressives emphasize equity for DO applicants and transparency benefits.

02 · What it does

Who stands to gain, and who may push back.

Likely benefits vs burdens50% / 50%
SchoolsFederal agencies

These are examples from the analysis, not a ranked list of the most-affected groups.

Likely helped
  • SchoolsIncreases transparency of residency applicant and acceptance patterns between osteopathic and allopathic schools.
  • Potential benefitEncourages hospitals to accept COMLEX, potentially reducing applicants' need to take multiple licensing exams.
  • Potential benefitMay improve employment opportunities and match rates for osteopathic medical graduates.
Likely burdened
  • Potential burdenCreates additional administrative reporting burden for hospitals and residency program staff.
  • Potential burdenMedicare payment reductions for noncompliance could reduce hospital revenues and affect budgets.
  • Federal agenciesTying payment adjustments to reporting may influence program autonomy despite the non‑federalization clause.
03 · Why people split

Why the argument around this bill splits.

Progressives emphasize equity for DO applicants and transparency benefits.
Progressive85%

Likely views the bill positively as promoting transparency and reducing bias against DO applicants in residency selection.

Sees public reporting and acceptance-of-exams affirmation as steps toward equity in graduate medical education.

Leans supportive
Centrist65%

Generally supportive of promoting fairness and transparency, but cautious about penalty design and implementation.

Would favor clarifications, verification processes, and safeguards for small or resource-limited hospitals.

Split reaction
Conservative25%

Likely views the bill skeptically as federal overreach and a burdensome reporting mandate tied to Medicare penalty cuts.

Appreciates stated nondirective language, but opposes micromanaging residency programs.

Likely resistant
04 · Can it pass?

The path through Congress.

Introduced

Reached or meaningfully advanced

Committee

Reached or meaningfully advanced

Floor

Still ahead

President

Still ahead

Law

Still ahead

Passage likelihood35/100

Content is narrow and non-ideological but attaches financial penalties to hospitals, inviting organized opposition and implementation scrutiny.

Scope and complexity
24%
Scopenarrow
24%
Complexitylow
Why this could stall
  • CBO cost and budgetary score unknown
  • Strength of hospital/provider group opposition
05 · Recent votes

Recent votes on the bill.

No vote history yet

The bill has not accumulated any surfaced votes yet.

06 · Go deeper

Go deeper than the headline read.

Included on this page

Progressives emphasize equity for DO applicants and transparency benefits.

Content is narrow and non-ideological but attaches financial penalties to hospitals, inviting organized opposition and implementation scrut…

Unlocked analysis

Relative to its intended legislative type, this bill is a targeted statutory amendment that clearly defines required data elements, a publication requirement, and a monetary enforcement mechanism. It integrates directly…

Go beyond the headline summary with full stakeholder mapping, legislative design analysis, passage barriers, and lens-by-lens tradeoff breakdowns.

Perspective breakdownsPassage barriersLegislative design reviewStakeholder impact map
Open full analysis