Among the many poison pills hiding in the “One Big Beautiful Bill Act” (OBBBA) were a series of federal student loan policy changes that are now being made real. Among these changes, the Department of Education is proposing to re-classify a number of degrees out of eligibility to receive more loan money, including advanced training for nursing, social work, and public health.
If you know any nurses or follow healthcare social media, you have been hearing the alarms bells ringing frantically. Like the major funding cuts and policy changes made across federal science agencies, these new policies are continuing attacks on science-based professions, the entire healthcare system, and women workers in particular.
What is a professional degree?
For those not familiar with higher education funding, students enrolled in most accredited programs can qualify for federally administered student loans. For graduate students in what are considered “non-professional” programs (like many master and PhD students in academic disciplines), the limit, or cap, on the maximum amount you can borrow will soon be lower than for “professional practice” degree programs. Traditionally these degrees include medicine, nursing, social work, law, and others who will go on to practice a profession requiring additional licensing.
In the past, students pursuing doctorates have been able to rely on additional funding sources for PhD degrees, especially in the sciences, since the US government and universities have seen PhDs as investments in research and development. However, professional degrees are less likely to come with scholarship and fellowship opportunities, so higher loan caps can allow a broader range of folks to earn those degrees. In principle, many licensed healthcare professionals have greater long-term earning potential than PhDs who choose research and academic careers, enabling them to pay off those loans (though for some fields like social work, this may not be as likely). Licensed professionals in many disciplines who choose more public service oriented jobs have often qualified for a variety of loan forgiveness programs, including the federal Public Service Loan Forgiveness program. (At the same time, even that program is under attack by this administration.)
The destructive swath cut by the Trump administration through science and medical research, data maintenance, and funding has been carefully catalogued by UCS across every federal agency. Cuts to the National Science Foundation (NSF) and the National Institutes of Health (NIH) will devastate our science and health infrastructure for years, if not decades, to come. Those same PhD students supported by research and training grants will dwindle, especially first-generation students pursuing a graduate degree their parents and grandparents might never have imagined.
This is not a solution to our healthcare crisis
Now the draconian, anti-science, anti-education policy changes are coming for nurses, physician assistants, social workers, and other healthcare professionals on the front lines of caring for children, elderly people, rural populations, and those with the greatest needs. For years. the country has been in an accelerating healthcare crisis, with nursing shortages that mean there is an average of only 9 nurses for every 1,000 people in the United States. By 2030, projections from the Bureau of Labor Statistics show that 42 out of 50 states will have nursing staff shortages. Both urban and rural areas have drastic shortages of social workers, especially in schools.
According to the National Center for Health Workforce Analysis, demand in the behavioral health professions (roles often fulfilled by social workers) is also projected to widely outstrip supply in the next 10-12 years. In one example from the dataset, mental health counselors are projected to have a 42% increase in demand between 2025 and 2037. Specialists in most allied health fields would be impacted, severely harming the pipeline of professionals that provide services for students, elderly, and throughout the systems protecting our health and well-being. The proposed borrowing limits would reduce financial support for those training in public health, physical therapy, occupational therapy, speech therapy, audiology, and social work, to name a few. Women of color, who already face a range of challenges to accessing professional training programs, would be especially hard-hit—further hampering the needed diversification of the professional health fields.
So, what gives? Cutting the legs out from under programs that support the training of these vital professions seems so counterintuitive as to be nonsensical. The soon-to-be-defunct Department of Education claims that the new rules will “drive a sea change in higher education by holding universities accountable for outcomes and putting significant downward pressure on the cost of tuition. This will benefit borrowers who will no longer be pushed into insurmountable debt to finance degrees that do not pay off.”
Let’s take a closer look: Among the “professions” that will still qualify for the higher loan caps are… medicine, pharmacy, dentistry, optometry, law, veterinary medicine, osteopathic medicine, podiatry, chiropractic, clinical psychology and… theology? According to the University of San Diego’s theology program pages, starting salaries for graduates with theology master’s degrees range from $20,000 to over $150,000—but the professions listed in that higher range typically require additional degrees (e.g. a law degree!) or many additional years of experience in a given field (e.g. Foreign Service officer). Jobs most closely related to the actual training in theology (e.g. youth minister or chaplain) are likely to start in the $30-$40,000 range.
So, what other variables are significant to training programs no longer to be deemed “professional,” if not earning potential? A peek at the data tables from the Association of Theological Schools reveals that enrollment in theology degree programs is consistently dominated by men, who consistently represent nearly twice the number of students over the past five years. According to the American Association of Colleges of Nursing, nursing is the largest healthcare profession, and 88.8% of nurses are women. According to the Bureau of Labor Statistics, 69.6% of workers in community and social service occupations are women: among healthcare social workers, that portion rises to 85.3%. The funding landscape for Black and first-generation professional students is especially challenging.
What we can do now
This capricious rule change not only lets the federal government off the hook in securing educational loans and increasing the privatization of the student loan system. It gives massive tax cuts to the wealthiest—one of several ways the so-called OBBBA guts our already struggling healthcare system. But more than that, it is a direct attack on professions in which women dedicate their careers to the service of saving and improving lives, and those communities where the impact will hit hardest. Do not let the administration silence your voices on these attacks: you can let the federal government know that this rule will devastate our healthcare system even more. The Department of Education will post the opportunity for public comments on this proposed rule soon. Check out our resources for public participation and get ready to submit your comments opposing this proposal to weaken the healthcare workforce.