Undermining Nursing Will Cost Americans Far More Than It Saves

Byline: Omid Razmpour, BSN, RN, PhD/MBA (c), Chelsea OP Hagopian, DNP, APRN, AGACNP-BC, Jeannie P. Cimiotti, PhD, RN, FAAN, Jacqueline Nikpour, PhD, RN

>> Submit a Public Comment Here!

For 24 straight years, nurses have been ranked the nation’s most trusted profession. But now, the federal government doesn’t consider them “professionals” at all.

On the heels of the “One Big Beautiful Bill Act,” the United States Department of Education is setting new limits on the amount of federal loans that students can borrow. For most graduate students – that is, students pursuing higher education beyond a four-year college degree – those limits are $20,500 annually with a lifetime cap of $100,000, far below the realistic costs of graduate nursing education. But for students pursuing specific professional graduate degrees, those limits jump to $50,000 annually with a $200,000 lifetime cap.

And it’s that one word – professional – that has catapulted America’s nursing community into a deep sense of frustration. Because the Department of Education has released a list of professions that qualify as “professionals,” and nursing is not on it.

At the heart of this proposed ruling seems to be a profound lack of curiosity or understanding about the realities of nursing and nursing education. There are over five million actively licensed nurses working in the U.S., according to 2024 data from the National Council of State Boards of Nursing. That number far outweighs those of other professions included on the Department of Education’s list, including optometrists, veterinarians, podiatrists, chiropractors, and theologians.

But we now have an opportunity to address that knowledge gap, and it’s time to lift our collective voices.

A formal public comment period has opened at the federal level, and decision-makers must review what is submitted before final action is taken. This is one of the few moments when frontline nursing experience can be placed directly into the official record. Here’s the context you need to know, why this moment matters, and what is at stake should nurses and professional allies remain silent.

Why Are Nurses Not Considered “Professionals”?

The rationale for this policy traces back to a federal professional degree list established in 1965, when medicine, dentistry, law, and pharmacy were explicitly named, while nursing was not. Using a sixty-year-old framework to govern today’s health workforce is not policy rigor. It is a misalignment with reality.

This student loan policy is being framed as fiscal discipline, but it would make the education required for advanced nursing roles harder to access, precisely when the country cannot afford to narrow the pipeline of nurses graduating into practice. When nursing education pathways tighten, the downstream impact is predictable: fewer nurses move into advanced practice, fewer nurses are prepared to teach, and fewer communities can sustain the services they rely on.

This is not an abstract concern about tuition. It is about whether hospitals can staff advanced clinical roles, whether health systems can build and retain faculty, and whether patients can access care without delays that become dangerous. Graduate education is the pathway into essential positions across complex settings, particularly in rural areas. Furthermore, it is also the pipeline for the professors who teach new nurses. When fewer nurses can afford advanced preparation, nursing schools lose future faculty, class sizes – including those in undergraduate nursing programs – shrink, and shortages deepen across bedside care and specialty services.

Bad Business, Real Impacts

Every practice setting, clinician, and patient will feel the effects of this ruling. From the ICU nurses who begin their noisy shifts without enough hands on deck, to the midwives delivering babies and supporting families through pregnancy and childbirth, to the nurses providing end-of-life care in our homes. From the nurse practitioners working to keep blood glucose levels and blood pressure stable across rural American towns, to the nurse anesthetists sprinting to keep pace with the demand for lifesaving surgeries. And in our classrooms and simulation labs, where nurse educators shape the next generation of the nursing workforce.

If you are a nurse, you understand the breadth and depth of the work that these federal dollars enable. These scenes are the reason why this moment matters.

The administration may describe the shift as responsible budgeting, but nurses understand how health care costs will shift in actuality. A policy that reduces spending on paper can still generate higher costs in practice. When fewer people can advance in nursing education, fewer care technicians can become registered nurses, and fewer registered nurses can become APRNs. Without a robust pathway of new graduates into practice, organizations will have to rely on costly temporary staffing, service lines will become fragile, and access will erode in the places already operating on the edge.

Patients will not experience this ruling as a technical change. They will experience it as longer wait times, fewer available appointments, delayed procedures, and closed units. Nurses will experience it as unsafe ratios, moral distress, and fewer resources to meet rising complexity.

Broader Economic Realities

In addition, broader communities will experience this ruling in the form of weakened local economies.

To be clear, loan caps at this level strike directly at the roles that help keep hospitals stable. Many hospitals already function one staffing vacancy away from operational instability. Restricting graduate preparation makes that instability more likely, not less. The warning signs are already visible. Since February 2023, dozens of medical centers have closed departments or ended services. Hundreds of rural hospitals have been identified as “at immediate risk” of closure. When a hospital falters, the damage spreads quickly: jobs disappear, small businesses lose an anchor institution, and entire regions become less viable for families and employers. A federal policy that constricts the nursing pipeline will push vulnerable systems closer to the edge.

What You Can Do

Nursing is not a peripheral profession in American health care. It is the clinical backbone, the patient safety infrastructure, and the workforce that keeps care accessible across settings. Restoring nursing to the professional degree category for federal loan purposes is a practical correction with significant consequences. It is also a statement of truth about what nursing is and what it requires.

This is a public comment moment, and nurses should use it. Put your experience into the record by telling your story. Describe what this policy would mean in the real world for patients, for education, for staffing, and for safety.

Here are three concrete steps you can take today:

• Submit a public comment (takes minutes)
• Find your U.S. House Representative
• Find your U.S. Senators and Representatives

How to Write an Effective Public Comment

A recorded session from Emory University’s Federal Comment Workshop is available to support nurses and advocates who want to participate in the public comment period. The session offers practical guidance on crafting clear, substantive, and impactful comments that reflect frontline experience and policy realities.

>> Watch the recorded session here: How to Write an Effective Public Comment

🤔 We would love to hear from you, too! Please share any other strategies for impact and engagement in the comments section below.