Student Loan Caps, Professional Degree Categorization, and New Challenges
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“Authoritarianism does not reject expertise; it reconstructs it. And it does so most effectively by capturing the institutions that define who is authorized to know, to teach, and to practice.”
Sara Farhan, PhD, Assistant Professor of History, University of Northern British Columbia
The One Big Beautiful Bill Act (OBBB), signed into law in July 2025, was a sweeping Republican bill that made historic cuts to healthcare, food assistance, and higher education, including imposing strict caps on student loans.
That fall, a government committee met to begin the law’s implementation. This included determining which graduate programs would be classified as “professional” and therefore eligible for higher student loan limits. Nursing—along with many other female-dominated professions—was notably excluded, sparking widespread backlash and advocacy from the nursing community.
In the months since, nurse influencers and professional organizations have weighed in through social media campaigns, position statements, and press releases. Some nurses see the decision as a direct attack on the profession, while others dismiss it as a semantic distinction that does not undermine nursing’s professional standing.
But history raises a deeper question: how have terms like “professionalism” and “skilled labor” been redefined and weaponized in the past—and who benefits when they are?
The Dollars and Cents of Nursing Education
The OBBB made sweeping changes to the amount of government student loans that graduate students could access, which makes it much more difficult for non-wealthy students to advance their careers.
These loan caps depend on whether the degree is classified as a graduate or professional program. Under these new caps, students pursuing a graduate degree can borrow only half as much as students pursuing a professional degree ($100,000 program total vs. $200,000 program total).
In November of 2025, the RISE committee decided unanimously that professions such as medicine, law, dentistry, veterinary medicine, and theology would qualify as professional, but countless predominantly women-led healthcare professions would not.
This list excludes nurse practitioners (NPs), certified registered nurse anesthetists (CRNAs), midwives, certified nurse specialists (CNSs), social workers, teachers, physical therapists, speech-language pathologists (SLPs), and more.
The Impact of the OBBB on Nursing
Glenn Sanger-Hodgson, AFC, CSLP—a financial planner and educator with Student Loan Planner—shared his concerns for borrowers and the fate of graduate education:
“With the reduction in borrowing limits for all graduate borrowers, students are going to need to rely more on alternative sources of funding. While cash, scholarships, and grants would be the ideal solution, the reality is that many borrowers will have to turn to private student loans to fund a portion of their graduate school education.”
According to Protect Borrowers, a leading nonprofit organization and advocacy group dedicated to eliminating financial abuses in the lending system, the private student loan industry has long had weak borrower protections and predatory lending practices. This makes them risky prospects, especially for low-income students without family support and high credit scores.
And that’s not all: according to Sanger-Hodgson, the OBBB also eliminated Grad PLUS loans and closed-school discharge protection, which protects students in case their school closes abruptly while they are enrolled.
Nurses Push Back on Project 2025
The proposed changes stunned the nursing community and caused a fierce backlash when the changes were made public.
One nurse who was not surprised, however, is Cambria Nwosu, DNP. Dr. Nwosu is a healthcare executive, legal nurse consultant, and influencer who has been raising the alarm about how dangerous the Trump Administration would be to US healthcare and the nursing profession since Project 2025 was released.
Project 2025 is a 900-page policy playbook written by the ultra-conservative think tank The Heritage Foundation. Despite repeated denials, the Trump administration has completed more than 50 percent of the documents goals.
The latest addition, Project 2026, outlines a clear vision for women of America, which, in their own words, includes “Reclaiming higher education from the radical left” and “prioritizing the role of women as mothers and wives within the nuclear family.”
“As a nurse, if you’re standing around asking, ‘How did we get here?’ you have no excuse. Trump and his backers published a 900-page document outlining exactly what they planned to do. And now we’re here,” she says. She continues, “[Nurses] got very caught up on the semantics of ‘professional’ and what that means, but they were completely underreacting to this presidency, this bill, and what they mean for nurses.”
Dr. Nwosu warns that if these changes aren’t immediately reversed, the long-term consequences will be dire: “Under the guise of ‘fiscal responsibility,’ these policies will cause enrollment to plummet, which will cause some programs to close, initiating a domino effect. Eventually, this will create care deserts, and patients will die.”
The Trump Administration attempted to do some damage control by claiming that, according to their data, “95 percent of nursing students borrow below the annual loan limit and therefore are not affected by the new caps.”
But the nation’s nursing educators say that simply isn’t the case.
Kim Dupree Jones, PhD is the senior associate dean for academic advancement and innovation at the Nell Hodgson Woodruff School of Nursing at Emory University and she’s very worried about the impact of these student loan caps: “Here at Emory, up to 80 percent of our nursing students will be negatively impacted by these proposed borrowing limits if they are finalized,” she says.
Despite what the Trump Administration may claim, this bill impacts many undergraduate nurses, too.
According to Dr. Jones, “There are two categories of undergraduate nursing students: traditional and second career. Second-career nurses are incredibly important as they come to the profession with more maturity and rich life experience. But they are at a significant disadvantage when it comes to student loans, as they have often exceeded their lifetime government loan amount and must borrow from the increasingly predatory private student loan world.”
The Trump administration claims these changes are meant to “help drive down the cost of graduate programs and reduce the debt students have to take out,” but nursing experts say that is a fantasy.
Dr. Jones states, “Healthcare and its delivery are increasingly complex. The idea that we can provide students with less education to care for patients who require more care and certainly more knowledge doesn’t seem logical to me.”
Dr. Nwosu agrees: “The notion that these schools will get together and do the right thing is absurd. There is no precedence, and there is no incentive under our current economic system of capitalism.”
To understand the current moment and what is at stake, it’s crucial to study the past—particularly, how fascist regimes have historically handled academia, especially the fields of nursing and medicine.
Fascism and Nursing in the Modern Era
The attempt to redefine the concept of “professionalism” and determine which professions are “skilled” is not new; in fact, it has a long historical precedence in authoritarian movements.
Sara Farhan, PhD is an assistant professor of history at the University of Northern British Columbia and is a cultural and social historian, specializing in the histories of medicine, professionalization, and education.
Dr. Farhan notes that while authoritarian regimes throughout history have used slightly different approaches, there are common strategies: “What remains consistent is their preoccupation with the control, redefinition, and instrumentalization of expertise,” she says.
She continues,
“What we are witnessing under the Trump administration reflects a model of delegitimization followed by conditional reintegration. Rather than immediately absorbing professions, they undermine long-standing expert authorities across multiple fields, implicitly demanding that they rejustify their legitimacy in terms of service to state priorities. This is a classic authoritarian maneuver: weaken institutional credibility, destabilize professional gatekeeping, and compel academic and professional bodies to align their standards with political power in order to survive.”
In other words, fascist governments take over institutions of learning and make it clear that their legitimacy is now contingent upon regime approval. In this instance, while the Trump administration claims that these changes are merely semantics, they have now made it much harder to create more graduate-prepared nursing professionals—particularly for working-class people.
So whether or not they claim to be attacking the nursing profession’s status and legitimacy, it’s a distinction without a difference.
This strategy can be clearly seen in countless other moves made by the administration, from gutting funding for medical research to laying off thousands of critical health jobs at the NIH and CDC, and most recently, withdrawing the US from the World Health Organization—all despite vehement opposition from the experts and scientists who lead those fields.
Perhaps the best illustration of this war on expertise and learning is the appointment of Robert F. Kennedy, Jr. to lead the U.S. Department of Health and Human Services. He has no medical expertise or education.
In addition to this latest move to limit higher education for women-dominated professions, the Trump administration’s war on education and expertise can be seen in these many other initiatives, including:
- Disbanding the department of education
- Withholding funds from schools that disagree with his policies
- Defunding public education and pushing vouchers for private religious schools
- Attacking DEI initiatives
- Promoting white Christian nationalist ideology in public education through PragerU
- Attacking LGBTQIA+ freedoms
- Censoring books
The pattern is clear: institutions of learning and authority are undermined, attacked, or disbanded. Confusion and chaos result. Then, the Trump administration tells their base that only they should be trusted as the sole source of truth.
“Authoritarianism does not reject expertise; it reconstructs it. And it does so most effectively by capturing the institutions that define who is authorized to know, to teach, and to practice,” Dr. Farhan says.
The Choice Ahead: Resistance or Compliance
While the situation in the US is increasingly dire, it is far from over. Dr. Farhan shares a cautionary tale for nurses regarding the two paths laid out before them and the ramifications of compliance that could echo for decades to come. She shares two different stories regarding how nurses have reacted to fascism across the globe throughout history:
“In Germany, the Nazi regime did not initially abolish the medical and nursing professions but instead absorbed them into the machinery of the state. The regime conferred legitimacy upon nurses insofar as they demonstrated utility to state goals. In turn, the profession reciprocated this legitimacy through compliance.”
She continues, “Crucially, this mutual reinforcement was forged pedagogically: educational institutions became sites where professional identity was reshaped to serve authoritarian ideology, illustrating how academia can function as a conduit for expertise-making in the service of state violence.”
Conversely, nurses under the Pinochet regime in Chile emerged as a fierce center of resistance. This resistance–led in large part by nursing students–felt that compliance with state violence stood in direct opposition to the ethics of the profession: “Here, pedagogy became a space of moral and political clarity, demonstrating that academic formation can also cultivate professional autonomy capable of resisting authoritarian encroachment,” Dr. Farhan says.
She issues this warning:
“The nursing profession now stands at a crossroads. It may follow the Chilean example, preserving ethical autonomy and resisting political capture, or it may repeat the more familiar Western European pattern of capitulation, seeking renewed legitimacy through compliance with state authority.
History suggests that professions often choose survival over resistance, allowing regimes to reshape expertise from within. The danger of such capitulation is devastating and long-lasting. Once professional authority is weakened, regulatory boundaries collapse, enabling unqualified actors to occupy roles formerly governed by rigorous academic and professional standards.”
The Fight Isn’t Over
The US Department of Education just opened the Federal Register for public comment. Nurses, their organizations, and allies are free to submit a public comment to let the US government know how they feel about these proposed caps on student loan amounts and nursing not being categorized as a professional degree program.
The US nursing profession has a clear choice before them: they can fight for their professional autonomy and for the integrity and ethics, or they can comply in advance and reap the consequences.
Meg Lambrych, RN
WriterMeg Lambrych is a registered nurse, writer, and nursing advocate from Upstate New York.
After leaving clinical care due to burnout, she dedicated her life to covering issues in healthcare, nursing, and health in the digital space. She reports on nursing culture, policy, and history and interviews nursing innovators and leaders shaping the profession and challenging the status quo.