The New Repayment Assistance Plan (RAP): What Doctors Need to Decide

The Repayment Assistance Plan is the federal government's new income-driven repayment plan, available starting July 1, 2026. It replaces the older menu of income-driven plans for new borrowers and reshapes the choices for everyone else.

How the payment is calculated

RAP scales with what you earn. Monthly payments run from 1% to 10% of your income, graduated so that higher earners pay a larger share. Your payment drops by $50 for each dependent, and the lowest-income borrowers pay a $10 minimum. For an attending whose income jumped overnight, the payment climbs with that income.

The borrower-friendly features

• Unpaid interest is canceled. Your balance does not balloon from interest your payment didn't cover that month.
• Principal match up to $50. If your on-time payment doesn't reduce principal by at least $50, the Department adds up to $50 toward principal.
• A long runway. RAP carries a repayment period that ends in forgiveness of any remaining balance after the plan's full term.

Who is affected, and how

For loans first borrowed on or after July 1, 2026, RAP is the only income-driven option. Borrowers with existing loans who take no new loans can stay on their current plan or switch to RAP. That choice deserves careful thought rather than a default.

The caution for physicians

RAP looks borrower-friendly on the surface, and for many people it is. For physicians, the picture is more nuanced. A high balance relative to income, paired with payments that scale up as your attending income grows, can mean paying more over the life of the loan than you would under an older plan or a payoff strategy. If you are pursuing PSLF, the calculation changes again, because the goal is the lowest qualifying payment rather than the fastest payoff.

This is the seed-and-harvest idea applied to debt. A smaller payment today can feel like a win while enlarging what you pay across the full term. Smaller now is not always cheaper overall.

The behavioral note

Present bias makes the lowest monthly payment look like the obvious choice, because the relief is immediate and the long-term cost is invisible. The better question is not which plan costs the least this month. It is which plan costs the least across the life of the loan, given your path. Those are often different answers.

What to do

1. Confirm whether your loans fall before or on or after the July 1, 2026 borrowing line. That determines your options.
2. If you can choose between your current plan and RAP, compare total cost across the full term, not the monthly payment alone.
3. Tie the decision to your forgiveness-or-payoff path before you enroll.

Your next step

RAP is new, and the right answer depends on your balance, your income trajectory, and your path. If you want to compare your options against your actual numbers, book a 15-minute complimentary discovery call.