On July 1, a change in federal student lending redraws the map of who gets to finance graduate education on favorable terms. It is already being debated in Congress, in court, and in hospital boardrooms, in the language of borrowing caps, program classifications, and federal exposure.
Graduate students now face lower federal borrowing limits than students in programs designated as “professional,” and new Grad PLUS loans disappear for new borrowers starting this summer. Professional students can borrow up to $50,000 per year and $200,000 in aggregate federal loans, while other graduate students are capped at $20,500 per year and $100,000 in aggregate federal loans.
While this sounds like a technical policy distinction, for healthcare workers, it is anything but and because many of the affected healthcare fields are overwhelmingly female, this policy has real consequences for the workforce keeping America’s hospitals running.
We analyzed all 19,620 public comments submitted on this rule. More than 98% opposed it. Healthcare workforce shortages were the most cited concern. What emerged from that data is a clear signal that this policy will make an existing crisis worse.
America has created a hierarchy of “serious” professional training. Law and medicine are easily recognized as professional degrees. They are expensive, rigorous, and socially important and they come with the kind of financing flexibility that reflects their status. But many of the pathways that keep the healthcare system functioning like advanced nursing, physical therapy, physician assistant programs, and other allied health fields are being pushed into a more constrained category.
The issue is not that lawyers and doctors receive too much support. The issue is that America already knows how to finance strategically important professions and then proceeds to apply that logic unevenly. A definition of “professional” that recognizes the courtroom but not the bedside reflects an older hierarchy of labor, prestige, and gender.
This is not as simple as saying male-dominated degrees are funded and female-dominated degrees are not. Law and medicine have changed; women now make up the majority of entering law students and medical students per the ABA and AAMC, respectively (let’s go, girls). But the policy architecture still appears to favor older definitions of professional status, while many care-centered healthcare pathways remain easier to classify as ordinary graduate education.
HRSA’s 2025 State of the U.S. Health Care Workforce report shows that care work remains heavily female. Consider the professions excluded from the higher “professional degree” borrowing category ($50,000 per year, $200,000 lifetime) versus those that kept it. Among those excluded, the numbers are stark. Registered nurses are 87.9% female. Advanced practice registered nurses such as nurse practitioners, CRNAs, and nurse midwives are 84% female. Physician assistants are 78% female (BLS, 2025). Occupational therapists are 92% female. Speech-language pathologists are 97% female. Dietitians are 92% female. These professions are central to how care gets delivered, and our healthcare system cannot function without them.
Now look at who kept the higher borrowing limits. Surgeons are 74% male. Clergy, yes, theology qualifies as a professional degree are 76% male. Chiropractors are 69% male. Lawyers are 57% male. These are not the professions the country is running short of.
The Bureau of Labor Statistics projects that employment for nurse anesthetists, nurse midwives, and nurse practitioners will grow 35% from 2024 to 2034, far faster than the average projected for all occupations (which sits just over 3% over the same period, per BLS). Physician assistant employment is projected to grow 20% over that same period, while physical therapist employment is projected to grow 11%. HRSA also projects national nursing shortages through 2038, including a shortage of 108,960 registered nurses and 245,950 licensed practical nurses. Rural areas will be hit harder, with an 11% RN shortage in nonmetropolitan areas compared with a 2% shortage in metropolitan areas.
This means that the country is tightening the financing path into healthcare at the same time it needs more healthcare workers.
The practical effect of lower borrowing caps is that more of the cost gets pushed somewhere else: private loans, family wealth, employer support, delayed enrollment, or abandonment of the path altogether. This does not affect every nursing pathway in the same way; LPN and RN programs are not typically graduate programs. But the policy pressure lands directly on the next rung of the ladder: the mid-career nurse pursuing an advanced practice degree, the working parent trying to become an NP, or the future nurse educator whose graduate degree is what enables the next generation of nurses to be taught at all. If fewer nurses can afford to advance, the result is fewer providers and ultimately a weaker workforce pipeline.
This is where the gendered nature of the policy becomes visible. America has no shortage of language for celebrating care work. We call nurses heroes. We call clinicians “essential workers” and we used to bang pots and pans to celebrate them during Covid. Our legislators call healthcare a national priority. But when the question becomes whether their training deserves the same financing flexibility as other high-cost professional pathways, the answer becomes less generous.
Hospitals and health systems will inherit the consequences. Federal policy may classify degrees on paper, but employers experience the result as another hard-to-fill role, another rural vacancy, more expensive and unsustainable temporary labor. The financing gap becomes a staffing gap, and that staffing gap becomes worse healthcare outcomes for our country.
NSI Nursing Solutions’ 2026 retention report found that each RN turnover costs hospitals an average of $60,090, and that the average hospital loses $5.19 million annually to RN turnover. A single percentage-point change in RN turnover can cost or save the average hospital nearly $295,000 per year. As the education pipeline narrows, those numbers get worse.
The answer is not unlimited debt or ignoring tuition inflation. But it is equally unserious to treat healthcare training as a private consumer choice when the public consequences are this obvious. If the country needs more clinicians – especially in shortage areas – financing the path into those professions has to be part of the strategy.
That means policymakers must revisit which healthcare programs qualify as professional training, particularly when they lead to licensure, advanced clinical responsibility, and shortage roles. It also means healthcare employers must stop treating student loan support as a benefit and start treating it as workforce infrastructure. The health systems already doing this by committing to pay down a clinician’s loans over time, tied to tenure, before a role ever goes vacant are not being generous. They are being strategic.
The July 1 changes are being framed as student loan policy. But they raise a larger question about what kind of labor, and whose labor, America is willing to invest in. If the people keeping patients alive, clinics open, rural communities served, and hospitals staffed are not treated as professionals for financing purposes, then everyone suffers. The problem is a financing system that still treats care work, much of it performed by women, as essential in crisis and secondary in policy.
Author bio:
Tess Michaels is the CEO of Clasp, a workforce platform that helps health systems recruit and retain clinicians through its Healthcare ROTC model, which connects student loan repayment to long-term employment pathways. A Forbes 30 Under 30 honoree and recent TedX speaker on the topic of ‘Stop Paying Nurses to Quit’, Tess works directly with hospitals and health systems across the country to address clinical staffing shortages through strategic loan repayment design. Her work sits at the intersection of healthcare workforce policy, employer strategy, and the student debt crisis reshaping who enters, and stays in, the clinical workforce.
Photo: franckreporter, Getty Images
Tess Michaels is the CEO of Clasp, a workforce platform that helps health systems recruit and retain clinicians through its Healthcare ROTC model, which connects student loan repayment to long-term employment pathways. A Forbes 30 Under 30 honoree and recent TedX speaker on the topic of ‘Stop Paying Nurses to Quit’, Tess works directly with hospitals and health systems across the country to address clinical staffing shortages through strategic loan repayment design. Her work sits at the intersection of healthcare workforce policy, employer strategy, and the student debt crisis reshaping who enters, and stays in, the clinical workforce.
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