Introduced in House

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7198 Introduced in House (IH)]

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119th CONGRESS
  2d Session
                                H. R. 7198

To amend the Public Health Service Act with respect to the designation
       of general surgery shortage areas, and for other purposes.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                            January 22, 2026

    Mr. Bera (for himself, Mr. Bacon, Mr. Peters, and Mr. Joyce of
Pennsylvania) introduced the following bill; which was referred to the
                    Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL

To amend the Public Health Service Act with respect to the designation
       of general surgery shortage areas, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Ensuring Access to General Surgery
Act of 2026''.

SEC. 2. FINDINGS.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) According to the Bureau of Health Workforce, the United
        States faces a shortage of physicians.
            (2) A 2016 study entitled ``Supply and Demand of General
        Surgeons: Projections From 2014-2030'', prepared by the
        University of North Carolina at Chapel Hill for the American
        College of Surgeons, found that the supply of general surgeons
        will grow slightly by 2030 but will not keep up with overall
        growth in the United States population or demand for surgical
        services.
            (3) A 2021 report released by the Association of American
        Medical Colleges projects shortages in all surgical specialties
        of between 15,800 and 30,200 surgeons by 2034.
            (4) A 2020 report prepared by the Health Resources and
        Services Administration for the Committee on Appropriations of
        the Senate found a maldistribution of general surgeons
        nationwide, with rural areas having only 69 percent of the
        general surgeons needed to meet demand for care.
            (5) In order to accurately prepare for future physician
        workforce demands, comprehensive, impartial research and high-
        quality data are needed to inform dynamic projections of
        physician workforce needs.
            (6) A variety of factors, including health outcomes,
        utilization trends, growing and aging populations, and delivery
        system changes, influence workforce needs and should be
        considered as part of flexible projections of workforce needs.
            (7) Given the particularly acute needs in many rural and
        other surgical workforce shortage areas, additional efforts to
        assess the adequacy of the current general surgeon workforce
        are necessary.

SEC. 3. STUDY ON DESIGNATION OF GENERAL SURGICAL HEALTH PROFESSIONAL

SEC. 3. STUDY ON DESIGNATION OF GENERAL SURGICAL HEALTH PROFESSIONAL
              SHORTAGE AREAS.

    Part D of title III of the Public Health Service Act (42 U.S.C.
254b et seq.) is amended by adding at the end the following:

             ``Subpart XIII--General Surgery Shortage Areas

``SEC. 340J. DESIGNATION OF GENERAL SURGERY SHORTAGE AREAS.

    ``(a) General Surgery Shortage Area Defined.--For purposes of this
section, the term `general surgery shortage area' means, with respect
to an urban, suburban, or rural area in the United States, an area that
has a population that is underserved by general surgeons.
    ``(b) Study and Report.--
            ``(1) Study.--The Secretary, acting through the
        Administrator of the Health Resources and Services
        Administration, shall conduct a study on the following matters
        relating to access by underserved populations to general
        surgeons:
                    ``(A) Whether current shortage designations, such
                as the designation of health professional shortage
                areas under section 332, results in accurate
                assessments of the adequacy of local general surgeons
                to address the needs of underserved populations in
                urban, suburban, or rural areas.
                    ``(B) Whether another measure of access to general
                surgeons by underserved populations, such as one based
                on general surgeons practicing within hospital service
                areas, would provide more accurate assessments of
                shortages in the availability of local general surgeons
                to meets the needs of those populations.
                    ``(C) Potential methodologies for the designation
                of general surgery shortage areas, including the
                methodology described in paragraph (2).
            ``(2) Methodology for the designation of areas.--Among the
        methodologies considered under paragraph (1)(C) for the
        designation of general surgery shortage areas, the Secretary
        shall analyze the effectiveness and accuracy of the following
        methodology:
                    ``(A) Development of surgery service areas.--
                Development of surgery service areas through the
                identification of hospitals with surgery services and
                the identification of populations by ZIP Code areas
                using Medicare patient origin data.
                    ``(B) Identification of surgeons.--Identification
                of all actively practicing general surgeons.
                    ``(C) Surgeon to population ratios.--Development of
                general surgeon-to-population ratios for each surgery
                service area.
                    ``(D) Thresholds.--
                            ``(i) In general.--Determination of
                        threshold general surgeon-to-population ratios
                        for the number of general surgeons necessary to
                        treat a population for each of the following
                        levels:
                                    ``(I) Optimal supply of general
                                surgeons.
                                    ``(II) Adequate supply of general
                                surgeons.
                                    ``(III) Shortage of general
                                surgeons.
                                    ``(IV) Critical shortage of general
                                surgeons.
                            ``(ii) Considerations.--In determining the
                        thresholds under clause (i), the Secretary
                        shall not assume that the current supply of
                        general surgeons nationwide is the optimal or
                        adequate level and shall consider additional
                        factors such as wait times, health outcomes,
                        ground transportation time to the nearest
                        health care center with a general surgeon,
                        critical access hospitals with surgical
                        capabilities but lacking a general surgeon, and
                        patient experience.
            ``(3) Report.--Not later than 1 year after the date of the
        enactment of this subpart, the Secretary shall submit to
        Congress a report on the study conducted under this subsection.
            ``(4) Consultation.--In conducting the study under
        paragraph (1), the Secretary shall consult with relevant
        stakeholders, including medical societies, organizations
        representing surgical facilities, organizations with expertise
        in general surgery, and organizations representing patients.
            ``(5) Publication of data.--The Secretary shall
        periodically collect and publish in the Federal Register--

``(A) data comparing the availability and need of
                general surgery services in urban, suburban, or rural
                areas in the United States; and
                    ``(B) if the Secretary designates one or more
                general surgery shortage areas under subsection (c), a
                list of the areas so designated.
    ``(c) Designation of General Surgery Shortage Areas.--
            ``(1) Methodology developed through regulation.--Based on
        the findings of the report under subsection (b)(3), the
        Secretary may establish, through notice and comment rulemaking,
        a methodology for the designation of general surgery shortage
        areas under this section.
            ``(2) Requirements.--If the Secretary elects to develop
        methodology under paragraph (1), the following shall apply:
                    ``(A) Using the methodology established under
                paragraph (1) and taking into consideration the data
                referred to in subsection (b)(5), the Secretary shall--
                            ``(i) designate general surgery shortage
                        areas in the United States;
                            ``(ii) publish a descriptive list of the
                        areas; and
                            ``(iii) review annually, and, as necessary,
                        revise such designations.
                    ``(B) The Secretary shall follow similar procedures
                with respect to notice to appropriate parties,
                opportunities for comment, dissemination of
                information, and reports to Congress in designating
                general surgery shortage areas under this section as
                those that apply to the designation of health
                professional shortage areas under section 332.
                    ``(C) In designating general surgery shortage areas
                under this subsection, the Secretary shall consult with
                relevant stakeholders, including medical societies,
                organizations representing surgical facilities,
                organizations with expertise in general surgery, and
                organizations representing patients.''.
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