I have been thinking a lot about pathways lately.
Which doors are open to our kids.
Which ones are quietly closing.
And who decides which careers are worth supporting.
Right now, one of those doors is nursing.
Earlier this year, Congress passed the One Big Beautiful Bill Act, and the Trump administration's Department of Education has been busy translating that law into actual student loan rules. One of the biggest changes is how the Department now defines a "professional degree" and who gets access to higher federal loan limits. Nursing did not make the list. Neither did physician assistants, physical therapists, occupational therapists, audiologists, social workers, many counseling and education programs, or architecture and accounting.
Under the new structure, which is scheduled to take effect for new borrowing starting July 1, 2026, federal loans work like this:
Students in professional degree programs can borrow up to 50,000 dollars per year for graduate school, with a 200,000 dollar lifetime cap.
Students in any other graduate programs can borrow up to 20,500 dollars per year, with a 100,000 dollar lifetime cap.
The Grad PLUS program, which used to allow borrowing up to the full cost of attendance, is being eliminated for graduate and professional students.
The eleven "professional" fields that qualify for the higher cap are:
Medicine, Dentistry, Pharmacy, Veterinary medicine, Law, Optometry, Podiatry, Chiropractic, Osteopathic medicine, Theology, and Clinical psychology.
Advanced nursing programs and several other licensed, graduate-only careers are on the outside looking in.
Here is the first thing that jumped out at me.
According to the 2024 National Nursing Workforce Survey, about 10 percent of registered nurses identify as male, which means roughly 90 percent of the nursing workforce is female.
Zoom out, and women hold about 76 percent of all healthcare jobs in the United States.
So when you reduce federal borrowing limits for nursing students, you are mostly reducing access to graduate education for women in a field that already struggles with shortages.
The administration's argument is that tighter loan caps will push universities to lower tuition and reduce "unsustainable" borrowing. Whether that actually happens is an open question. What happens immediately is simpler:
Students who planned to use federal loans above 100,000 dollars to pay for graduate nursing programs will not be able to.
They will either walk away, take on private loans with worse terms, or rely on family wealth.
This is framed as a policy about fiscal responsibility. In practice, it is about who can afford to keep going.
Graduate nursing programs are not cheap. Many Master of Science in Nursing (MSN) and Doctor of Nursing Practice (DNP) programs run well into the tens of thousands of dollars, and some programs cross the six-figure mark, especially at private universities.
The American Association of Colleges of Nursing has reported that median federal student loan debt for graduate nursing students often falls in the 40,000 to 55,000 dollar range, and a significant share borrow more than that for graduate education alone, on top of whatever they already owe from their bachelor's degree.
Under the new caps:
A student in medical school can still borrow up to 200,000 dollars in federal loans for their professional degree.
A student in a graduate nursing program is capped at 100,000 dollars, even if their total tuition and fees exceed that amount.
If that student does not come from a family that can cover the gap, they are pushed toward private loans at higher interest rates, or out of the program entirely. Private credit checks and co-signer requirements add another filter. This is where "access" stops being a nice word and becomes a very practical barrier.
From a financial perspective, I see three broad paths for these students: do not go to graduate school and stay at the RN level; take on private debt at higher interest rates, with fewer protections and fewer options for income-driven repayment; or rely on family wealth to fill the gap between federal caps and actual program costs.
That third path is not evenly distributed. It is not designed to be.
Student loan burdens are not spread evenly across race and gender. Research from the Center for Economic and Policy Research shows that among U.S. adults who have ever attended college, 43.3 percent of Black women carry student loan debt, compared with 19.9 percent of white women and 15.7 percent of white men. Black women also carry some of the highest average balances.
In November 2025, the Philippine Nurses Association of America and other Nursing Organizations of Color released a joint statement warning that the new "professional degree" definition would create, in their words, "insurmountable financial obstacles for aspiring nurse leaders of color who are essential to providing care in medically underserved communities."
Their argument is straightforward: Nurses of color already carry higher student loan debt than their white counterparts. Advanced practice nursing programs meet every criterion the Department of Education says defines a professional degree: rigorous post-baccalaureate education, licensure, independent practice, and leadership roles. Excluding graduate nursing degrees from the professional list narrows the pipeline of nurse practitioners, nurse anesthetists, nurse midwives, and nurse faculty of color, particularly in underserved areas.
Pair that with the broader trend: medical school enrollment for Black and Latino students has already faced headwinds since the Supreme Court's 2023 decision limiting race-conscious admissions. For students who might have turned to nursing as another path into healthcare leadership, the financial door is now smaller.
We are not just talking about who gets a credential. We are talking about who ends up caring for which communities, and what kinds of providers are actually available.
This is not an abstract workforce question for my family. My kids have not seen their named physician for a well-visit in years. They see nurse practitioners. They are excellent. We do not feel like we are getting "lesser" care. We are getting care from someone with time to sit, listen, and explain.
That is not unusual. Advanced practice registered nurses (APRNs), including nurse practitioners, nurse anesthetists, nurse midwives, and clinical nurse specialists, increasingly serve as primary care providers, particularly in rural and underserved areas where physicians are scarce. These roles require graduate degrees.
At the same time, the Bureau of Labor Statistics projects 193,100 job openings for registered nurses every year through 2032, when retirements and workforce exits are included. The RN workforce is expected to grow from 3.1 million to 3.3 million over that period, an increase of about 177,440 nurses. That is less than a single year of projected openings. Recent national reports show hospital RN vacancy rates near 10 percent on average, with a large share of hospitals reporting double-digit nurse vacancies.
In other words, we already do not have enough nurses, especially in the places that struggle most to attract providers.
Living in Tennessee, that tracks with what I see around me. Rural communities are constantly trying to recruit anyone who can staff a clinic. Families drive long distances for routine care. Kids grow up in towns with one urgent care and no pediatric specialist.
When you make graduate nursing education harder to finance, you are not just making life harder for individual students. You are tightening the bottleneck in a system that is already stretched.
The Department of Education has leaned on a definition of "professional degree" that was first written into regulation in 1965. Back then, the rule listed certain professions (medicine, dentistry, law, theology, and others) and noted that the list was "not limited to" those examples.
What is happening now is different.
To implement the One Big Beautiful Bill Act, the Department and its rulemaking committee agreed to treat that list, with a few tweaks, as exclusive. Only a narrow set of doctoral-level programs with specific classification codes qualify as "professional" for the higher loan caps. Nursing, physician assistant programs, physical therapy, occupational therapy, audiology, architecture, accounting, social work, and teaching programs did not make the cut.
The American Nurses Association and the American Association of Colleges of Nursing have both argued that, by the Department's own criteria (advanced study, licensure, independent practice), graduate nursing absolutely functions as a professional discipline and should be treated as such for loan purposes.
What this looks like from the outside is less a neutral classification and more a prestige map. Historically prestigious degrees with high earning potential and political clout were kept in the "professional" bucket. Other licensed, graduate-only fields, heavily populated by women and people of color, serving children, patients, and communities, were placed in the lower cap bucket.
For a rule written in 2025, that says a lot about whose expertise is recognized in policy.
I run a website strategy business, not a policy shop. So why am I writing about federal loan caps?
Because policy is a design system. And the choices embedded in this rule follow the same patterns I see in digital spaces every day.
Someone decides who counts as "professional" and who does not. Which pathways are "worth" higher borrowing limits. Which careers get full-cost federal backing and which are left to private lenders and family money. Those choices shape the structure of opportunity, even when the language looks neutral.
Websites do the same thing in a different medium. Every site draws a map: who gets named on the homepage and who gets buried three clicks deep; which services are treated as core and which are framed as "extras"; which audiences we write for in plain language and which we assume will "figure it out."
For the kinds of clients I work with, therapists, coaches, tutors, neurodivergent-affirming providers, and others in health and education, their websites often sit in the same quiet, under-resourced bucket as nursing in this policy debate. The work is essential. The impact is clear. The structures that support it are outdated.
If you are a service provider building a website in this environment, you are designing in a world where the cost of training is going up for many helping professions, where the people most likely to do this work are also the people most likely to carry heavy student debt, and where your future clients may have less financial flexibility, more anxiety about debt, and more skepticism about traditional career paths.
That context matters when you decide how to talk about your work online, how you frame accessibility, and how much you assume your audience already knows.
Here is what keeps circling in my mind: we are using definitions from 1965 to decide who gets full federal support for education in 2030. Our kids are being asked to make huge bets. Pick a career based on a job market we cannot accurately describe. Take on debt inside a loan system that was built for a different economy. Train for roles that may evolve faster than the institutions teaching them.
We do not have tidy answers. What we do have is a responsibility to be honest about uncertainty, whether we are writing policy, building a website, or guiding a teenager who is trying to figure out if nursing school is even realistic.
Old systems hang on longer than they should. New realities show up before we create new maps. The people with the least room for error absorb the impact first.
Policy makers have opened a public comment process for these rules. Designers, educators, healthcare workers, and parents are allowed to have opinions about how those rules define "professional" and who that definition serves.
And in our own work, including something as seemingly mundane as a website, we can ask sharper questions: Who am I quietly de-prioritizing by how I structure this information? Who has to work harder to understand what I offer or whether it is for them? Where am I still using categories I inherited instead of ones that match the world my audience actually lives in?
None of that will fix federal loan policy. But it might make it a little easier for the people already carrying its weight.
American Association of Colleges of Nursing. Nursing Shortage Fact Sheet (2024), summarizing Bureau of Labor Statistics Employment Projections 2022–2032.
American Association of Colleges of Nursing. Policy Watch: Updates on Student Loans and Nursing Programs (Oct. 22, 2025).
American Nurses Association. Congressional priorities and workforce letters discussing nursing workforce needs and projected RN openings.
Center for Economic and Policy Research. Student Loan Debt is Common Across All Race and Gender Groups, Especially for Black Women (2024).
National Council of State Boards of Nursing & National Forum of State Nursing Workforce Centers. 2024 National Nursing Workforce Survey (Journal of Nursing Regulation).
Philippine Nurses Association of America & Nursing Organizations of Color. Joint Statement: Nursing Organizations of Color Respond to Proposed Federal Limitation of Student Loan Access for Nursing (2025).
U.S. Census Bureau. Women Hold 76% of All Health Care Jobs (2019).
U.S. Department of Education & negotiated rulemaking coverage: Inside Higher Ed, How the Loan Cap Committee Reached Consensus and What to Know About the Definition of Professional Degree (Nov. 2025).
Nurse.org. Nursing Excluded as "Professional" Degree by Department of Education (Nov. 20, 2025).
Newsweek. List of Degrees Not Classed as "Professional" by Trump Admin (Nov. 2025).
One Big Beautiful Bill Act: statutory summary and loan provisions as summarized by NAICU, Wikipedia, and financial aid offices.