Found some information to answer my own inquiries, just posting for posterity:
20/220 pathway- a provision that allowed most residents to defer student loan debt for up to three years while in training. The elimination of this repayment option, effective July 1, 2009, requires most residents to begin unaffordable monthly payments on their loans. An amendment offered in the Senate to the Affordable Health Care Choices Act that would reinstate the 20/220 pathway without eliminating IBR (i.e. residents would have two options to repay their loans) was included in the bill passed out of the Senate HELP (Health, Education, Labor and Pensions) Committee.
Income Based Repayment plan (IBR)- IBR took effect on July 1, 2009; at this time, the old 20/220 pathway is no longer available. IBR is not a loan deferment program. Instead, IBR provides for reduced payments (i.e. partial deferment) for borrowers who demonstrate partial financial hardship. Only individuals earning less than 150% FPL (100% FPL = $10,830 per year for an individual) are eligible for full deferment. Consequently, under IBR, unlike with 20/220, nearly all residents with student loans are required to make monthly payments starting in their first year of residency.
