With the nursing profession expected to shrink by 40% during the next three years, supporters are urging the defeat of a proposed U.S. rule that would limit financial aid available to nurses who seek to further their professional education. Photo by Karola G/Pexels
A Trump administration recommendation that higher education for nurses should not qualify as a “professional degree” has sparked a backlash and warnings that the ongoing U.S. nursing shortage will worsen as a result.
The recommendation, made by members of a key Department of Education “negotiated rulemaking” committee in November, is part of an effort the administration says is meant to drive down college tuition costs under the provisions of last year’s One Big Beautiful Bill Act and to “protect” students from paying for graduate degrees that “don’t pay off.”
But it has kindled outrage among nursing groups and their supporters, who claim the profession is being unfairly devalued and warn that limiting loan programs for graduate training will only worsen a quickly accelerating nursing workforce crisis.
Nurses, many of whom are women and people of color hailing from lower-income backgrounds, need graduate degrees to become nurse practitioners, nurse midwives and certified registered nurse anesthetists — all of which are much-needed healthcare positions.
The controversy arose after the Nov. 6 meeting of the Department of Education’s Reimagining and Improving Student Education, or RISE, Committee, when the panel opted to exclude post-baccalaureate nursing degrees from the list of studies defined as “professional” rather than “graduate” degrees.
If ultimately adopted, the omission means that nurses seeking a higher degree will have their access to low-cost federal financial aid capped at $20,500 annually and $100,000 in aggregate, rather than up to $50,000 annually and $200,000 in aggregate available for nearly a dozen other “professional” healthcare fields, such as pharmacy, dentistry, medicine and clinical psychology.
The median average annual cost of post-baccalaureate nursing education is $37,040, according to an American Association of Colleges of Nursing survey released last month.
The new rules, prompted by last year’s One Big Beautiful Bill Act, were pushed through by congressional Republicans and signed by President Donald Trump. They are to take effect in July.
The bill’s higher education section for the first time creates a distinction among professionals, mandating lower loan caps for graduate programs but granting two-times-higher levels for students in what are designated as “professional” programs.
The recommendations are to be adopted by the Department of Education after a “notice of proposed rulemaking” is published in the Federal Register, which is expected within weeks. A subsequent 60-to-90-day period for public comments will follow, during which critics hope to rally opposition.
At the conclusion of the Nov. 5 meeting, Undersecretary of Education Nicholas Kent called the committee’s efforts “an opportunity to rise out of a broken system that has failed too many students for far too long.
“I also asked you to consider how history will view this moment. Will they say that we simplified, empowered and made college more affordable, or that we preserved a broken and bloated system? It is undeniable that you did the former,” Kent said.
In a statement, he characterized the decisions as “commonsense limits and guardrails on future student loan borrowing” and as a means to “simplify the federal student loan repayment system.”
“The consensus language agreed upon by the negotiators today will help drive a sea change in higher education by holding universities accountable for outcomes and putting significant downward pressure on the cost of tuition,” Kent said. “This will benefit borrowers who will no longer be pushed into insurmountable debt to finance degrees that do not pay off.”
Reaction to the rulemaking outcome was immediate.
Nursing groups strongly criticized it as devaluing the profession and potentially worsening a shortage that has seen more than 138,000 nurses leaving the workforce since 2022 due to stress, burnout and retirement, according to the 2024 National Nursing Workforce Study issued by the National Council of State Boards of Nursing.
This study also predicted that by 2029, almost 40% of nurses intend to leave the workforce.
The effect of the move could be particularly hard on the pipeline of nurse practitioners, which in turn could degrade the overall quality and availability of primary healthcare, warned Mary Turner, a registered nurse and a president of National Nurses United.
“Nurse practitioners currently provide much-needed primary care, particularly in rural and underserved areas where there is a shortage of physicians,” she told UPI in a statement.
“If this rule goes into effect, we could have fewer nurse practitioners, which means patients will face delays in care, long wait times to get appointments and less access to primary care.”
Patients now are treated by nurse practitioners during many of their primary care visits, said Chris Rubesch, a registered nurse at Essentia Health St. Mary’s Medical Center in Duluth, Minn., and president of the Minnesota Nurses Association.
“Making it harder for people to receive the education needed to provide this care is exactly the opposite of what we need,” Rubesch told UPI. “This will disproportionately affect rural and lower income communities in a country that already has difficulty attracting and retaining primary care providers.
“Our healthcare system needs every nurse and provider possible. This decision, sadly, will only reduce this critical workforce,” she said.
The Trump administration, however, disputes this assertion, calling it a “myth” that the proposed rule would contribute to the nationwide nursing shortage.
Instead, Education Department officials claim in a fact sheet that data shows 95% of nursing students borrow below the annual loan limit, “and therefore are not affected by the new caps.”
Further, they assert placing caps on loans “will push the remaining graduate nursing programs to reduce their program costs, ensuring that nurses will not be saddled with unmanageable student loan debt.”
Also, the loan limits won’t have any impact at all on undergraduate nursing programs, they contend — an idea dismissed by pro-education groups who claim that if schools lose graduate students or are forced to lower graduate tuition to meet the new loan limits, they may have less revenue to spend on making undergraduate schooling more affordable.
Meanwhile, nurses are also crying foul over the how the proposed aid caps could disproportionately affect women and nurses of color, who would need to turn to private lenders that charge higher interests rates and employ stringent lending qualification standards.
“Women and borrowers of color often rely the most on graduate loans to cover the cost of attendance,” Turner said. “Without access to federal loan assistance, many women and students of color will be forced into the private loan market, where many will not qualify for financing.
“Students of color and those from lower-income families will disproportionately struggle to get private loans, due to credit and income disparities. Some may not be able to get a private loan, or if they do, they will be burdened with high-interest loans.”
She pointed to research showing that Black and Latino student borrowers have more difficulty repaying their loans than White students and face more financial challenges, putting them at risk of default.
In addition, restricting access to graduate nursing loans will make it more difficult to find nursing faculty with advanced degrees to teach in nursing programs, Turner said.
Similarly, the American Association of Colleges of Nursing, which establishes quality standards for nursing education, has issued an alarm over the financial aid moves.
“Lowering federal student loan limits creates a barrier for many nurses seeking to advance their education to fill essential clinical and teaching roles,” group President and CEO Dr. Deborah Trautman told UPI.
According to the organization’s latest annual survey, 183,466 students are enrolled in master’s and doctoral programs at U.S. nursing schools, with more than two-thirds of them relying on student loans to finance their education.
“AACN data show that more than 75% of nursing students in graduate programs are women, and more than 43% are from underrepresented groups in nursing,” she said. “Nurses prepared at this level are needed to serve as advanced practice nurses, researchers and in other critical positions.”
The group also worries that a graduate loan cap could trigger declines in the nurse faculty population, which would “directly affect” nursing schools already struggling to meet the demand for registered nurses.
“The national faculty vacancy rate is 7.2%,” Trautman said. “Alleviating that shortage of faculty is key to preparing enough graduates to ease the U.S. nursing shortage.”
Her concerns are receiving some high-profile political backing.
On Dec. 12, a bipartisan group more than 140 members of Congress from both chambers, led by Sens. Jeff Merkley, D-Ore., and Roger Wicker, R-Miss., signed a letter addressed to Kent urging the Trump administration to reconsider its omission of nursing from the “professional” degree classification.
“Nurses and nurse faculty make up the backbone of our health system, and post-baccalaureate nursing degrees lead to demonstrated outcomes, with a recent study from the Foundation for Research on Equal Opportunity showing that nursing was one of the top three master’s degrees for return on investment,” they wrote.
“As such, post-baccalaureate nursing degrees should be treated equally to other accredited post-baccalaureate health profession degrees.”
Trautman predicted nursing advocates from across the country will rally against the proposed rule when the comment period is set out.
“We are preparing comments supportive of nursing as a professional degree and will lead the effort to encourage all nurses to submit comments to help influence the final rule,” she said.
She added she expects “a robust response … given the widespread support for including nursing on the list of professions from our colleagues in medicine and across the health professions, leaders of health systems and universities, members of Congress and the public.”
