Phase 2: Wave 1: seniors, near-seniors, and children · Step 2.6

Expand capacity before demand peaks

Year 0 onward; continuous · HRSA; UHA; states (scope of practice)Discuss this step

Every concrete action this step requires, who is responsible, and when it happens relative to enactment.

#	Action	Owner	When	Trade-off
2.6.1	Fund 14,000 new residency positions over 5 years, prioritizing primary care, psychiatry, OB-GYN, and general surgery.	UHA / CMS GME	Years 0–5	New residency positions build supply but take 3–7 years after medical school to produce physicians.
2.6.2	Tuition-free medical, dental, and nursing school for graduates who serve 4 years in shortage areas (expanded National Health Service Corps).	HRSA	Year 1+	Service-tied scholarships send clinicians where needed but restrict graduates' choices.
2.6.3	Encourage states (via grants) to give nurse practitioners and physician assistants full practice authority, and dental therapists a defined scope.	States / HRSA	Years 1–3	Full practice authority expands capacity fast but faces physician opposition over quality.
2.6.4	Fund 1,000 new or expanded community health center sites, plus dental clinics.	HRSA	Years 1–5	New health center sites reach underserved areas but need staff who are already scarce.
2.6.5	Capital grants for ambulatory surgery, imaging (MRI, CT), and dialysis in regions with the longest waits.	UHA regional capital boards	Years 1–5	Capital grants for surgery and imaging centers cut waits but can create overcapacity if demand shifts.
2.6.6	Rural & safety-net capital fund for at-risk hospitals.	UHA	Years 1–5	Rural capital funds keep hospitals open but may preserve facilities with very low volumes and quality concerns.
2.6.7	Fast-track licensing for internationally trained physicians and nurses with supervised practice pathways (as Tennessee and others began in 2023–24).	States / Congress	Years 1–3	Licensing internationally trained clinicians adds capacity but draws health workers from countries that need them.
2.6.8	Raise home-care aide pay through the 5% HCBS rate increase, and fund aide training.	UHA / states	Year 1+	Raising aide pay improves recruitment but increases long-term care costs.