For years, picking a federal repayment plan meant wading through an alphabet soup: IBR, PAYE, ICR, SAVE. As of July 1, that menu is collapsing to two lanes, and if you were parked on SAVE, the ground just moved under you. One note first: this is all federal loans. If you've already refinanced to a private lender, none of it touches you.
SAVE is over. Enrollment closed in early 2025, and the millions it held have been sitting in a forbearance where interest accrues and forgiveness months don't count. PAYE and ICR are being retired too, gone by July 1, 2028. Going forward, income-driven repayment comes down to two options.
The first is IBR, the plan you already know, still open to anyone whose loans predate July 1, 2026 — most residents, since you borrowed in medical school. The second is new: the Repayment Assistance Plan, or RAP, the only income-driven option for new loans from July onward, and open to everyone else who wants it. RAP sets your payment at 1% to 10% of your income (technically your AGI), never below $10 a month, lowers it by $50 for each dependent, waives any interest your payment doesn't cover so the balance can't grow, and forgives the rest after 30 years.
Here is the part that matters most, the good news in the noise: Public Service Loan Forgiveness did not change. Still 120 payments, still 10 years, still tax-free if your employer qualifies, which most (not all) teaching hospitals do. Both IBR and RAP count toward it, and the SAVE months you already earned carry over to whichever plan you pick.
So the move is simple. Don't sit in SAVE forbearance waiting; those months do nothing while interest builds. When your servicer sends the notice, you'll have about 90 days to choose before you're auto-enrolled in a costlier plan. Pick IBR or RAP, and run both, since RAP is figured on your AGI and IBR on your discretionary income, so the cheaper payment depends on your numbers. Recertify your income (low now, low payment), and keep your employer certification current so every qualifying month is banked.
One caveat: "let the clock run" is PSLF math. If you're bound for private practice and won't chase forgiveness, RAP's 30-year forgiveness is taxable and its months don't count toward IBR's shorter timeline, so the smarter play is often to pay down or refinance instead (its own issue, soon). But if you're on the public-service track, the names changed and the strategy didn't: pay little, work public, and let the clock do the work.