Nursing Shortage Could Worsen Due to Limited Student Loans Save

In November, we reported on nursing groups that pushed back against a Trump administration proposal to de-list nursing as a professional degree for purposes of student borrowing. In this report, we look ahead to see what might happen as a result of the policy change.

On Nov. 6, a Department of Education (DOE) rule-making committee released a new proposed framework excluding nursing from the so-called "professional degree" category -- a plan which, if finalized, would limit nurses' access to certain student loans, while medicine, law, optometry, and theology would remain professional programs eligible for more education-related borrowing.

The fight is on for critics pushing back against the new student loan caps for nurses scheduled to take effect in July. And lawmakers have been drawn into the fray.

On Dec. 12, more than 100 members of Congress sent a letter to Under Secretary of Education Nicholas Kent arguing that the changes would exacerbate workforce challenges. They cited the 138,000 nurses who have left the workforce since 2022, and the 40% intending to leave by 2029. "[N]ow is not the time to cut off the student pipeline to these programs," they wrote.

The revised definition of "professional" would affect all advanced practice registered nurses (APRNs) including nurse practitioners (NPs), certified registered nurse anesthesiologists, clinical nurse specialists, and certified nurse midwives, explained Valerie Fuller, PhD, DNP, president of the American Association of Nurse Practitioners (AANP).

"We can't afford to lose future clinicians," Fuller said. Caps on loans would also affect patients, leading to longer wait times, she said. Rural communities would be particularly hard hit, as roughly two-thirds of those patients rely on NPs or physician assistants for their healthcare.

An underlying issue for nurses is that President Trump's One Big Beautiful Bill had established new federal loan limits for graduate students and a higher limit for professional students. The bill capped annual loans for graduate students at $20,500 annually and $100,000 in aggregate. For professional students, the cap is higher, at $50,000 annually and $200,000 in total.

The DOE is expected to formally issue a notice of proposed rulemaking and open a public comment docket sometime this month. The American Nurses Association (ANA) is encouraging nurses and patients to contact their members of Congress and to fully participate in the public comment docket, a spokesperson said. Asked whether ANA would sue if the framework proposed in November is finalized, a spokesperson said the group will not comment until the proposed rule is available.

The American Association of Colleges of Nursing (AACN) said it's "optimistic" the administration will reconsider the professional degree classification. Similarly, Fuller stressed that nothing is "written in stone" yet. "This policy can still be changed, and we are encouraging the Department of Education to change it," she said.

Cost of Graduate Degrees

The reasoning behind the proposed changes to "professional degree" programs is to put pressure on universities to lower tuition, and "benefit borrowers who will no longer be pushed into insurmountable debt to finance degrees that do not pay off," Kent said in a Nov. 6 agency press release announcing the proposal.

Nurses swiftly argued that the bill and the rulemaking committee's actions would not only limit access to loans for certain programs, but would have outsized impacts on the entire nursing field.

On Nov. 24, another DOE statement dismissed the nurses' claims as "misinformation." The agency argued that nurses would not have more difficulty securing federal student loans as a result of new lending limits. "Department of Education data indicates that 95% of nursing students borrow below the annual loan limit and therefore are not affected by the new caps," the press release stated.

If the DOE's figures are accurate, 5% of 5.5 million nurses is still a "substantial number," Judy Davidson, DNP, RN, clinical assistant professor at Ohio State University in Columbus, and a member of MedPage Today's editorial board, said in an email.

The AACN would not comment on the DOE's figures without access to its data. However, according to the AACN's own soon-to-be-released survey of more than 460 school administrators, conducted in late 2025, the average annual cost for post-baccalaureate nursing education across program types is $38,542 -- nearly double the DOE's proposed $20,500 annual loan limit.

Other evidence points to high sums borrowed for nursing education. Among the most expensive degrees, Certified Registered Nurse Anesthetist graduates would quickly reach the aggregate limit of $100,000, because they typically take on more than $200,000 in student loan debt, an AACN spokesperson said. Additionally, 48% of APRNs used federally assisted student loans to finance their education, while only 17% used other student loans, per national survey data from 2024.

Rayna Letourneau, PhD, RN, executive director of the Florida Center for Nursing, questioned the argument that restricting loan availability would encourage institutions to lower their tuition. Much of nursing education involves "experiential learning," including clinical rotations, which require smaller class sizes. All this makes lowering the costs of education difficult, she said.

"It is just a very, very expensive education, but the return on investment is exponential," Letourneau said.

Shrinking Nurse Pipeline

Lacking adequate financial support, "prospective students may opt to pursue other career options or forgo advancing their education to prepare for more advanced clinical roles," the AACN spokesperson said. What's more, the effects of the proposed limits on graduate funding extend beyond individual nurses to patients and whole communities, Davidson said. Without educators, for instance, "there is no pipeline of new nurses."

Academic educators are essential for producing the nurses providing bedside care, and nurse practitioners expand the primary care workforce, reducing delays in care. Clinical nurse specialists help advance clinical practice standards, and nurse scientists and professors produce research "integral to improving care quality, safety, and outcomes nationwide," Davidson said.

Nurses are required to have a Master of Science in Nursing degree to teach nursing, Fuller said. If would-be students can't afford master's degrees, there will be fewer faculty to teach undergraduate students, and faculty shortages are already an enormous problem, she stressed.

In 2023, U.S. nursing schools turned away 65,766 qualified applications for baccalaureate and graduate nursing programs due to faculty shortages, inadequate clinical sites, and other factors, according to the AACN.

Vincent Guilamo-Ramos, PhD, MPH, executive director of the Institute for Policy Solutions at the Johns Hopkins University School of Nursing in Baltimore, said nurses hurt most by the new policies will be those from underrepresented groups.

"We know that having a representative workforce improves health outcomes, not only at the individual level, but at the population level," Guilamo-Ramos said. "Having a provider that speaks your language, that shares your lived experience, that has a way of really ... building a connection, has a huge impact."

Nursing schools would also feel the loss of their professional designation. Guilamo-Ramos said although he does not agree with capping loans, the DOE's proposed changes send a message to the most costly nursing schools to expand financial aid options. In addition to merit-based scholarships, nursing institutions should create opportunities for students to work in underserved areas and pay down their loans, he suggested.