S. 632, IHS Workforce Parity Act of 2025

July 30, 2025

Cost Estimate

As reported by the Senate Committee on Indian Affairs on May 12, 2025

S. 632, IHS Workforce Parity Act of 2025 As reported by the Senate Committee on Indian Affairs on May 12, 2025
By Fiscal Year, Millions of Dollars		2025	2025-2030	2025-2035
Direct Spending (Outlays)		0	0	0
Revenues		0	0	0
Increase or Decrease (-) in the Deficit		0	0	0
Spending Subject to Appropriation (Outlays)		0	17	125
Increases net direct spending in any of the four consecutive 10-year periods beginning in 2036?	No	Statutory pay-as-you-go procedures apply?		No
	No	Mandate Effects
Increases on-budget deficits in any of the four consecutive 10-year periods beginning in 2036?	No	Contains intergovernmental mandate?		No
	No	Contains private-sector mandate?		No

S. 632 would modify two workforce development programs aimed at recruiting health professionals for the Indian Health Service (IHS). The IHS Scholarship Program provides grants to current students who are members of federally recognized tribes and working toward degrees in the health professions. The awards cover tuition and education-related expenses in exchange for a two-year, full-time commitment to work for IHS after certification as a health professional. The Loan Repayment Program pays current health professionals up to $25,000 annually to cover student loan repayments and up to $6,000 a year to cover the associated income tax liability in exchange for a two-year, full-time commitment to work for IHS.

S. 632 would modify both programs by allowing recipients to work part-time in exchange for the financial assistance. Under the bill, Scholarship Program recipients could work 20 hours a week for four years, and Loan Repayment Program recipients could work either part-time at IHS for four years for the full amount of loan and tax assistance or part-time for two years in exchange for a 50 percent reduction in their loan assistance.

CBO estimates that implementing S. 632 would result in more students and health care professionals receiving financial assistance by agreeing to work with IHS. CBO expects that the number of grants would increase by about 1 percent in 2027 and continue to grow thereafter. By 2031, and for the remainder of the 2025-2035 period, the number of grants is projected to increase by 5 percent relative to current law. Using information from IHS about average scholarship and loan amounts and information on the cost of part-time employment at IHS, CBO estimates that implementing the bill would cost $17 million over the 2025-2030 period and $125 million over the 2025-2035 period. Any related spending would be subject to the availability of appropriated funds.

The costs of the legislation, detailed in Table 1, fall within budget function 550 (health).

Table 1. Estimated Spending Subject to Appropriation Under S. 632
	By Fiscal Year, Millions of Dollars
	2025	2026	2027	2028	2029	2030	2031	2032	2033	2034	2035	2025-2030	2025-2035
Estimated Authorization	0	*	1	2	5	9	14	18	22	26	28	17	125
Estimated Outlays	0	*	1	2	5	9	14	18	22	26	28	17	125
* = between zero and $500,000.

The CBO staff contact for this estimate is Robert Stewart. The estimate was reviewed by Emily Stern, Senior Adviser for Budget Analysis.

Phillip L. Swagel Director, Congressional Budget Office

Phillip L. Swagel

Director, Congressional Budget Office

Data and Supplemental Information

Table 1