President Donald Trump’s executive orders and other actions by his administration have devastated public health, clinical health services provision, federal funding for research, and now education of the health professions in profound ways that will ripple far into the future.
As signed into law in July 2025, H.R.1 mandates setting caps on loans for graduate students and eliminates the Graduate PLUS Loan Program that has provided essential loans for graduate and professional education, including health professions. These provisions are set to begin July 1, 2026.
Soon after H.R.1 passed, the Department of Education (DOE) created the "Reimagining and Improving Student Education [RISE] Committee,” charged with addressing federal student loan regulations on the amount of loans available to students in graduate programs. The Committee defined “professional” degree programs that qualify for a lifetime cap of $200,000, while students in other graduate programs are limited to $100,000 lifetime cap. The approved list of professional degrees in health care include: medicine, osteopathy, dentistry, veterinary, pharmacy, chiropractors, optometry, and clinical psychology. nursing (as well as degree programs in physical therapy, occupational therapy, audiology, social work, physician assistant, and public health) is excluded from the list and, as such, students pursuing graduate education in nursing will be limited to $100,000 lifetime maximum for federal loans.
The irony is the federal government is devaluing nursing at the very moment the profession’s updated Code of Ethics—released only once each decade—reaffirms nurses’ ethical commitment to serving the public. The Code outlines obligations such as patient advocacy, safety, equity, and advancing evidence-based care. Like all recognized professional degrees, nursing education is explicitly tied to these ethical duties, making its exclusion from DOE’s “professional program” list both inconsistent and damaging.
Read more from AcademyHealth’s Spring health policy fellow in her recent blog detailing changes to the definition of “professional degree” and the implications for the broader health workforce here.
Consequences
The exclusion of nursing and other health professions from the DOE list of professional programs may result in a deprivation of the future braintrust, the exacerbation of health workforce shortages, and worsening of a nursing faculty shortage.
Depriving future students of the essential dollars needed for financial aid, loans, and scholarships will continue to push nursing education beyond the reach of those most willing and worthy to serve the public as members of the health professions. The average cost of a baccalaureate education in nursing ranged from $10,000 per year at public universities to over $60,000 for private universities. In 2020, the average annual cost of DNP program tuition ranged from $23,390 to $43,070, depending on public or private universities.
Advanced degrees are essential for nursing educators, further reducing our ability to train a workforce with the capacity and skills necessary to serve patients and communities, including as essential providers of primary care exacerbating the nursing shortage at a time of increasing need and rising costs is a recipe for poorer, less accessible, and more expensive care for all Americans.
If the DOE definition remains, it could also become a potential reference point for future federal rulemaking for Nursing. This sets up a dangerous precedent in which agencies could begin structuring eligibility for workforce development programs, grants, licensure pathways, and even impact full practice authority for advanced practice registered nurses. The impact could influence regulatory and nursing accreditation bodies that use these classification definitions, which ultimately could destabilize nursing education, research, and practice as we know it.
Nursing is tethered to a written social contract that has not changed despite the political environment where we attempt to do our work. As authors and contributors to the forthcoming 9th edition of Policy and Politics in Nursing and Healthcare, we take seriously the role that policy and politics play in the provision of nursing care and more broadly health services provision. It is deeply frustrating that nursing’s professional organizations have not been invited into dialogue with the administration to discuss these changes and more deeply disturbing to endure the silence of our health professions colleagues about the impact of deprofessionalizing nursing on their care, practice, and work.
Make no mistake, decisions made now will have ripple effects at a time when nurses are most needed, and when our population is aging. Most importantly, it will be the patients who need health care, their family members, and the public at large who will suffer from worsening shortages of health care professionals and a lesser educated workforce.
Response
The proposed rule/definition is not final. The authors of this post call upon our medicine, pharmacy and other allied health professionals to contact their Senators and Representatives and stand up with and for nursing and other health professions that are in jeopardy if the DOE definition of professions does not change, as well as to call for an elimination of all caps on educational loans for the health professions. A public comment period is expected to be open in early 2026 and provides an opportunity to share the consequences of this assault on the education of health professionals. Next, we call upon philanthropy to prepare to develop innovative workforce initiatives to educate new Nurses and prepare faculty to meet our social contract and mission. Finally, we call upon employers, insurers, payers, and states to enact provisions for funds to backfill currently enrolled students to allow for them to complete their education as promised.
The inability to understand the consequences of these decisions jeopardizes the health and well-being of the public while simultaneously compromising the social contract that serves as a foundation for health care in the United States. We call upon all citizens to demand that the future includes the profession of nursing and all health professionals who devote their lives to caring for the public at home and abroad. You can make your voices heard by signing the petition to include nursing in the proposed “professional degree” program definition, and advocating for all health professions to be included, submitting comments to the DOE during the public comment period before the final rule is adopted.