Under changes proposed in the One Big Beautiful Bill Act, “professional degrees” have been redefined. Included in the OBBBA are
• Pharmacy (Pharm.D.)
• Dentistry (D.D.S. or D.M.D.)
• Veterinary Medicine (D.V.M.)
• Chiropractic (D.C. or D.C.M.)
• Law (L.L.B. or J.D.)
• Medicine (M.D.)
• Optometry (O.D.)
• Osteopathic Medicine (D.O.)
• Podiatry (D.P.M., D.P., or Pod.D.)
• Theology (M.Div., or M.H.L.)
They now exclude nursing, physician assistant, nurse practitioner, physical therapy, occupational therapy, public health, audiology programs, speech-language pathology, counseling and mental health therapy, social work, and Health Administration.
The new bill puts limits on loans for graduate student degrees. Loans will be capped at $20,500/year and $100,000 total. But for programs designated as “professional,” the limits are $50,000/year and $200,000 total. Previously, student loans could cover the full cost of attendance.
The Department of Education claims that their “rulemaking will eliminate the Grad PLUS program, which has fueled unsustainable student loan borrowing, cap Parent PLUS Loans, sunset the confusing maze of student loan repayment plans created by the Obama and Biden Administrations, and create a new and simplified Repayment Assistance Plan.” The administration claims that borrowing up to the cost of attendance (currently allowed) could have “a negative return on investment.” Now, they say, students will no longer be pushed into insurmountable debt to finance degrees that do not pay off.”
The DoEd further states that assertions that not classifying nursing as a “professional degree” means they don’t view them as professionals is a myth. Instead, they suggest, “The definition of a ‘professional degree’ is an internal definition used by the Department to distinguish among programs that qualify for higher loan limits, not a value judgement about the importance of programs.” They further justify the change in definition noting that only 20% of nurses hold advanced degrees.
Experts in many fields are pushing back against the plans, saying they will devastate a variety of health-related fields. The Association of Schools and Programs of Public Health recently co-led a coalition letter to the DoEd’s RISE Committee. Their coalition includes the American Nurses Association and groups representing pharmacy, nurse practitioners, osteopathic medicine, veterinarians, marriage and family therapy, dentists, occupational therapy, physical therapy, speech-language-hearing therapy, public health, social work, health administration, and many others.
The ASPPH letter stresses the need for the definition of “professional” to be inclusive rather than restricting it more, as is the proposed plan.
Nursing
The American Nurses Association president, Jennifer Mensik Kennedy, PhD, MBA, RN, NEA-BC, FAAN, responded, stating, “Nurses make up the largest segment of the healthcare workforce and the backbone of our nation’s health system.” Kennedy added, “At a time when healthcare in our country faces a historic nurse shortage and rising demands, limiting nurses’ access to funding for graduate education threatens the very foundation of patient care. In many communities across the country, particularly in rural and underserved areas, advanced practice registered nurses ensure access to essential, high-quality care that would otherwise be unavailable.
Russ Francis, an APRN in Nebrask and member of Defend Public Health emphasized, “This decision devalues the extensive education and critical expertise of the very providers who are the backbone of our healthcare system. The impact will be felt most acutely in rural and underserved areas, where NPs, and PAs are often the primary—and sometimes only—access point to high-quality care. This policy is a direct threat to the health of our most vulnerable communities.” The proportion of care provided by advanced care practitioners appears to be growing, particularly in rural areas.
Another concern some raise is that funding cuts and fewer students will force some degree programs to close. Others note that federal loan limits might force students to take more expensive private loans.
The “Relentless School Nurse,” Robin Cogan, MEd, RN, NCSN, FNASN, FAAN, describes the entire effort as undermining nursing as a profession, despite the DoEd’s claim. She adds that this move threatens broader equity efforts in nursing, noting that the loans are critically important to many with underrepresented and economically disadvantaged backgrounds. If the federal government implements this plan, students will face reduced access to loans and loan forgiveness, making it impossible for many to continue their studies.
Public Health
There have been devastating cuts to the CDC and USAID, and restructuring that places vaccine opponents in prominent roles. This week, for example, Dr. Ralph Lee Abraham was named the CDC’s Principal Deputy Director. As Louisiana’s Attorney General, Abraham ended mass vaccination campaigns, such as media campaigns or health fairs, against preventable infectious diseases in the state.
Many state and local health departments require MPH or DrPH degrees. Public health professionals are generally paid less than workers in the same jobs in other sectors. “In a time in which we have a shortage of front-line public health workers, nurses and other health professionals, this move by the DoEd will choke off the supply of new recruits to help fill these gaps. It is a thoughtless move in the context of the workforce problems we have in health in America,” Gregg Gonsalves, a professor at Yale and co-founder of Defend Public Health, commented via email.
“Some people wait weeks to months for a primary care visit as we already have a shortage of health professionals,” said M. Michele Manos, a retired public health researcher and professor. “We don’t have enough outbreak investigators to keep us safe,” she continued. “Shutting down the pipeline for new nurses, other healthcare professionals, and essential public health workers, as the DoEd intends to do, is dangerous and will only make these shortages worse.”
Action:
The Department of Education is expected to release a Notice of Proposed Rulemaking (NPRM) within the next few weeks. Prepare to submit public comment (however you feel about this plan) to the online Federal eRulemaking Portal.
You can call your Congressional representatives via USA.gov or 5Calls.org
