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Forbes - Innovation

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As Nurses Lose Student Loans, Your Healthcare Could Suffer
Lisa Chambers · 2026-06-20 · via Forbes - Innovation

Rebecca Greenawalt is working full time as a mental health nurse in a Connecticut prison as she studies for a master’s degree at Quinnipiac University that will qualify her as a psychiatric mental health nurse practitioner, able to prescribe medicine and practice on her own. Meanwhile, she and her fiancé, a firefighter, are planning a fall wedding and would like to start a family. But that will have to wait. Greenawalt, now 31, won’t complete her master’s until August of 2027. “It’s just not feasible to talk about starting our family while I’m also working what feels like 10 bajillion hours a week,” she says.

Why not take a break from her studies? A new law that kicks in on July 1 sharply limits the amount graduate students can borrow from Uncle Sam, but grandfathers in those like Greenawalt who are already in (and stay in) a graduate program. After she earns her master’s, she wants to start a Ph.D. program so she can teach and do research. Now she’s unsure how she’ll finance it. Under the new rules, graduate nursing students will be limited to borrowing $20,500 a year and $100,000 over the life of their graduate studies. By contrast, grad students studying to be optometrists, podiatrists, chiropractors, pharmacists, clinical psychologists, medical doctors, veterinarians, lawyers and clergy will be able to borrow $50,000 a year ($200,000 total) for their “professional” degrees. Greenawalt’s state employer offers generous education benefits, but only if she keeps working full time while she studies.

As the U.S. population ages, the country faces a growing shortage of doctors and nurses, exacerbated by the Trump Administration’s attempts to limit the influx of educated immigrants. Now, the Department of Education’s decision that the 200,000 students in graduate nursing programs aren’t eligible to borrow as much as other aspiring healthcare professionals threatens to make the shortage even worse for several reasons.

First, over the last 25 years, the explosion of graduate-trained nurse practitioners (NPs) has eased a shortage of primary-care doctors in rural and underserved communities, and in such specialties as geriatrics and psychiatry. According to the U.S. Bureau of Labor Statistics’ Occupational Outlook, the nation had 382,700 NPs, nurse midwives and nurse anesthetists working in 2024, earning a median of $132,050 per year. Demand for NPs is projected to grow 40% by 2034, the highest growth rate for almost any job. With younger medical doctors gravitating to higher-paid specialties, there are now more NPs than doctors providing primary care, the federal Health Resources and Services Administration reports.

Paul Smith, dean of nursing at Linfield University in Portland, Oregon, says he’s particularly worried about the impact of the loan limits on healthcare equity. “When you look at diverse student populations that could go back and be primary-care providers within their community, are they not going to be able to move forward if they’re not able to obtain funding?” he asks.

Mahlon Mathieson, a 32-year-old nurse from New York City now pursuing a doctorate at Columbia University, echoes that worry. “The people who are able to afford [the degrees] don’t necessarily represent the communities they’re going into, and so you’re just having that domino effect of disadvantage, and the inequities are just becoming more systemic,” says Mathieson, who works as a teaching assistant but is mostly financing her degree with loans.

Nurses with graduate degrees are also needed to train other nurses. The American Association of Colleges of Nursing (AACN) reports a 7.2% faculty vacancy rate—1,588 unfilled full-time positions at 863 schools, with nearly 30% vacant for more than a year. The result, the AACN says, is that 93,000 qualified applicants to undergraduate nursing programs are being turned away each year because there aren’t enough teachers. In a separate AACN survey conducted in November 2025, 78% of deans at 469 schools expected graduate enrollment to drop as a result of the new limits.

A third big impact could be the hit to career switchers—college-educated folks who might find nursing a compelling option as artificial intelligence threatens desk jobs. They often enter the field through graduate degrees. For example, in 2023, the University of Pennsylvania (widely considered to have one of the top nursing schools in the world) launched an intensive 15-month Master of Professional Nursing program for folks who have a bachelor’s degree in another subject and plenty of science credits, but no hands-on experience in patient care. Graduates can become NPs or take administrative and research roles in healthcare. Including living expenses, the program now costs about $200,000. Linfield started its own program for career switchers in 2023–a 15-month Master’s Entry into Professional Nursing degree that runs about $150,000, all costs considered.

Penn Dean of Nursing Antonia Villarruel acknowledges the crash program was structured as a master’s degree in part because until this year, graduate students were able to borrow that full cost from Uncle Sam. “I’m not sorry we moved in that direction. I am sorry that the financial aid they would have been able to get isn’t available,” she says. She’s now working to line up private lenders for Penn graduate nursing students, but notes that borrowers will likely have to pay higher rates and get cosigners. Plus, private loans have less flexible repayment terms.

Interested in a career switch into nursing? See the tips at the end of this article.

The Grad PLUS Loan Wipeout

The Grad PLUS Loan program was a ripe target for Republicans. Since 2007, it has allowed grad students to borrow the full cost of attendance, without any need for cosigners, any analysis of the ability to repay, or a minimum credit score. (Bankruptcies or serious delinquencies could block a loan.) Repayment could be made on an income-based schedule, with those working for government or nonprofits eligible for income-tax-free Public Service Loan Forgiveness after 10 years of payments.

The allure of unlimited graduate student loan money tempted universities to launch a slew of expensive master’s programs, some more useful than others. According to a study by a conservative-leaning think tank, 40% of all master’s programs produce no net financial return for students once program costs are taken into account. Nursing master’s do produce a high payback—more than MBAs, the study concludes.

An analysis by two nursing professors published in March in the New England Journal of Medicine found graduate-trained nurse practitioners, nurse midwives and nurse anesthetists have a higher return on their educational investment than other “professions” based on the cost of degrees and subsequent earnings. They also earn more than chiropractors, psychologists or veterinarians.

*Data on median salary and projected employment growth are from the U.S. Bureau of Labor Statistics,' except for data for clergy, which are from o,',NET Online (https://www.onetonline .org/link/summary/21-2011.00). Tuition midpoints were derived from tuition ranges for U.S. programs required for practice and exclude living expenses, interest, and opportunity costs. Google Gemini was used to synthesize tuition costs for all relevant graduate programs to calculate tuition midpoints. Debt-to-earnings ratios were calculated as the tuition midpoint divided by the median annual salary and don't represent actual debt loads.

SOURCE: NEJM

But the One Big Beautiful Bill Act that Republicans passed on a party-line vote in the summer of 2025 made no attempt to differentiate between grad programs that pay off (for either students or society) and those that merely fatten universities’ coffers. Instead, Congress simply killed the Grad PLUS program entirely for those starting their studies after July 1, 2026, and set fixed borrowing limits, with much higher limits for those in professional programs.

So What’s A Profession?

Congress didn’t tell the Department of Education to consider economic returns of degrees, let alone the healthcare needs of the public, when deciding what qualified as a profession. Instead, the exclusion of nursing hinges on technicalities and an antiquated conception of the field.

For decades, nurses were trained in hospitals under an apprentice model. Then came associate degrees, followed by a sustained push starting in 1965 to make the bachelor’s degree the entry-level standard for becoming a registered nurse (RN). “You want the most educated person who understands who you are in the context of everything going on with you physically, in the context of your environment, and someone who’s able to advocate for you,” says Penn’s Villarruel.

Today, a majority of nurses entering the workforce hold a bachelor’s or graduate degree, and the role has expanded far beyond what policymakers originally envisioned. “There weren’t even nurse practitioners when the original classifications of professional degrees were put in place,” Villarruel observes.

In January, the Department of Education issued a proposed rule that designated 11 professions and excluded graduate training for nurses. “Social media went viral with people upset about the word ‘profession,” says Leslie Bilbro, who is finishing her Doctor of Nursing Practice (DNP) in health policy in North Carolina and studying the nursing workforce. “That’s missing the issue. It’s less about what we’re called, more about what this means.”

Whether inspired by social outrage or the big economic impact of the decision, more than 80,000 comments flooded in, most protesting the nurses’ exclusion. But when the final regulations were published on May 1, the DOE was unmoved. The fact that NPs might be essential to primary care wasn’t relevant, the final rule explained. “Never with that kind of overwhelming support would you see no movement on an issue,” says Deborah Trautman, president and CEO of the AACN. “It defies logic.”

So what was relevant, according to bureaucrats at the DOE? One factor that did in the nurses was that NPs can only operate under the supervision of physicians in some states. Currently, 27 states and Washington, D.C., grant NPs full practice authority, according to the American Association of Nurse Practitioners.

In a statement to Forbes, DOE press secretary, Ellen Keast, offered a more substantive defense: The borrowing caps were needed and are working. She pointed to a 29% cut in the cost of credits for graduate nursing degrees at Neumann University, in Aston, Pennsylvania.

The Nurses Aren’t Giving Up

A coalition of nursing and healthcare organizations—including the AANP and AACN—filed suit in federal court in Washington on May 21, arguing the rule exceeds the DOE’s statutory authority and violates the Administrative Procedure Act. Twenty-five states and Washington, D.C., filed a separate lawsuit in Maryland making similar claims. A third action was brought by the American Nurses Association and allied organizations. Each is seeking to block the rule before July 1.

Meanwhile, several bipartisan groups in Congress are also pushing legislation to halt the caps. On June 9, the House Appropriations Committee adopted a bipartisan budget amendment that would bar the DOE from administering federal student aid “in a manner that does not designate advanced nursing programs as professional degree programs.” But whether and when that ever becomes law is an open question.


Advice For Would-Be Nurses

Thinking about a career in nursing? The decisions you make early can shape everything that follows, especially now that there’s a strict borrowing limit.

Start with the role, not the credential. Most nursing careers begin with a Bachelor of Science in Nursing (BSN), but where you see yourself in five or 10 years determines how much education you’ll need. A BSN qualifies you to become a registered nurse after passing a licensing exam, but RNs cannot independently diagnose patients or prescribe medications. If you want to do that—as a nurse practitioner (NP), nurse anesthetist or nurse midwife—plan on graduate school. If research or teaching is your speed, consider a Doctor of Nursing Practice (DNP) or Ph.D. program, rather than using up your graduate borrowing capacity to become an NP.

Be prepared to work as you learn. Many hospitals and health systems offer tuition reimbursement, loan repayment assistance and scholarships for nurses getting advanced degrees. Federal tax law allows employers to provide up to $5,250 per year in educational assistance tax-free—but many healthcare employers offer more. States often have their own programs, too, and the federal government offers loan repayment assistance for nurses who work in underserved communities.

Compare earnings across specialties. Nursing salaries vary widely depending on specialty, location and education level. Before taking on private or federal loans, look at what graduates are actually earning. The U.S. Department of Education’s College Scorecard lets you search schools by field of study—including nursing—and see real earnings data.

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