New Student Loan Rule Could Dissuade People from Advanced Nursing Degrees

Introduction to the Issue

Zoe Clarke became a hospital registered nurse two and a half years ago, following in the footsteps of her mother and grandmother. Clarke, an ICU nurse in Asheville, North Carolina, wants to get her master’s degree to become a nurse practitioner or a certified registered nurse anesthetist — occupations in high demand — and eventually work toward a doctoral degree. But new borrowing limits on federal student loans may hinder her from reaching that goal.

The New Borrowing Limits

A provision in the federal One Big Beautiful Bill Act, the tax and spending law enacted this summer, overhauls the federal student loan program for graduate students in an effort to simplify the loan process and discourage colleges from raising tuition. To comply with the new law, the U.S. Department of Education recently issued a draft rule that would impose limits on how much graduate students can borrow — up to $20,500 per year and $100,000 in total for most students, but up to $50,000 a year and $200,000 in total for students in a new “professional” category. The category includes people studying to be medical doctors, dentists, veterinarians, pharmacists, and lawyers. Students pursuing advanced nursing degrees, however, are not included in the professional category.

Impact on Advanced Nursing Degrees

Advanced practice nurses, hospital associations, and other health groups say the rule will make it unaffordable for many nurses to advance their careers — disproportionately affecting communities, especially rural ones, that rely on them amid physician shortages. Advanced nurses can provide primary care, deliver babies as nurse midwives, and anesthetize surgery patients where there aren’t enough physicians to go around. They can also write some prescriptions. Advanced practice nurses also serve as college faculty in community colleges and nursing schools.

Demand for Advanced Nurses

The U.S. Bureau of Labor Statistics estimates the nation will employ an additional 134,000 nurse practitioners, nurse midwives, and nurse anesthetists in the next decade, 35% more than there are now. In high demand, nurse practitioners are one of the fastest-growing occupations in the nation, the bureau says. “We depend heavily on nurse practitioners,” said Sandy Reding, a president of the California Nurses Association and vice president of National Nurses United. “But if they don’t have access to getting further education, we’re not going to see additional nurse practitioners come into the field.”

Effects on Rural and Underserved Communities

Rural Communities

Advanced practice registered nurses, known as APRNs, fill gaps in rural communities where there aren’t enough clinicians. For example, nurses needed for surgeries — nurse anesthetists, or CRNAs — make up 80% of anesthesia providers in rural counties. About a fifth of APRNs nationwide worked in rural areas in 2022, according to one survey of more than 18,800 APRNs. “The nurse practitioners, APRNs, are a needed lifeline to help fill those gaps,” said Heidi Lucas, executive director of the Missouri Rural Health Association and former director of the state’s nurses association. “Putting barriers in the way to keep [nurses] from getting degrees — that’s just going to exacerbate the problems that we already have.”

Underserved Communities

The new rule cutting options for federal student loans would only worsen staffing shortages amid tenuous rural hospital budgets, said state-level observers. Hospitals already are grappling with millions of dollars in looming Medicaid cuts over the next 10 years, said Rich Rasmussen, president of the Oklahoma Hospital Association. Nurse practitioners often serve as primary care providers, writing prescriptions and managing patient care. About 80% of them see Medicaid and Medicare patients, according to the American Association of Nurse Practitioners, citing federal data from the Centers for Medicare and Medicaid Services.

Concerns and Criticisms

Clipping the Wings of Rural Obstetrics

Rasmussen, of the Oklahoma Hospital Association, said he is concerned about the effect the rule will have on the pipeline for certified nurse midwives and the state’s already dwindling rural maternal health care options. “We are clipping the wings of rural [obstetrics] to be able to blossom in our state if we’re going to put these types of restrictions on the borrowing capability of nurses who want to pursue obstetrical services in nursing as well,” he said. He added that the rules will force nurses to seek private sector loans — which don’t qualify for federal loan forgiveness programs that encourage clinicians to come work in rural areas.

Diversity and Opportunity

Diversity and opportunity for students from marginalized groups could also take a hit, said Teshieka Curtis-Pugh, executive director of the South Carolina Nurses Association, a registered nurse with a master’s of science in nursing. And for those going back to school while juggling parenting, federal loan dollars can help beyond tuition, she noted. “They help that mom be able to supplement child care for their child, so that they can have child care while they go to school,” she said. “There’s tuition, there’s books, there’s keeping the lights on. They’re feeding the family they’re getting to and from.”

Conclusion

The proposed rule has sparked widespread concern among nursing associations, hospital associations, and other health groups, who argue that it will disproportionately affect communities that rely on advanced practice nurses. The exclusion of advanced nursing degrees from the higher, “professional” category of student loan options is seen as a significant barrier to accessing further education and advancing careers. As the nation faces a growing demand for advanced practice nurses, the new rule may have far-reaching consequences for the healthcare workforce and the communities that rely on them.

FAQs

1. What is the new student loan rule?

   • The new rule imposes limits on how much graduate students can borrow, with most students limited to $20,500 per year and $100,000 in total, while students in certain professional categories can borrow up to $50,000 a year and $200,000 in total.

2. Why are advanced nursing degrees not included in the professional category?

   • The reason for the exclusion is not explicitly stated, but it has been met with criticism from nursing associations and health groups who argue that advanced practice nurses play a critical role in filling gaps in healthcare, especially in rural and underserved communities.

3. How will the new rule affect rural communities?

   • The rule is expected to worsen staffing shortages in rural areas, where advanced practice registered nurses (APRNs) often fill gaps in healthcare services. The lack of access to federal student loans may discourage nurses from pursuing advanced degrees, exacerbating existing healthcare workforce challenges in these communities.

4. What are the potential consequences for diversity and opportunity in nursing education?

   • The new rule may disproportionately affect students from marginalized groups and those who are returning to school while juggling parenting responsibilities, as federal loan dollars are often crucial for covering not just tuition but also living expenses and childcare.
5. When will the new limits take effect?
   • The new limits are set to take effect on July 1, 2026, although the Department of Education has indicated it may make changes in response to public comments.