Nursing Is a Profession — And America Cannot Afford Otherwise

By Mary Okeiyi Ekpu, Esq., RN, BSN November 2025

The Department of Education’s proposed rule—one that excludes nursing from the federal definition of a professional degree—is more than a regulatory change. It is a structural demotion with economic, workforce, gender-equity, and public-health consequences that the nation simply cannot afford to ignore.

CBS News reports that the proposal stems from the new “One Big, Beautiful Bill Act,” which caps federal borrowing:

• $50,000 per year / $200,000 lifetime for professional degree programs

• $20,500 per year / $100,000 lifetime for all others—including nursing

This classification places nurses—the largest segment of the U.S. healthcare workforce—behind pharmacy, dentistry, veterinary medicine, podiatry, law, medicine, and even theology. Nursing, physical therapy, and physician assistant students, however, are relegated to dramatically lower loan caps… and dramatically lower access.

Allegedly, "95% of nursing students won’t be impacted.”

Why This Matters More Than the Headlines Admit.

The impact is not about the average. It is about the critical margin—the graduate students who pursue advanced training, the nurses who move into primary care roles, and the workforce pipelines that keep America’s hospitals functioning. Here is what the data already tells us - the Nursing Workforce is already in Crisis.

• The U.S. is projected to face a shortfall of 200,000–450,000 nurses by 2030 (AAMC, BLS).

• 1 in 5 nurses has left the workforce since 2020.

• 85% of hospitals report severe staffing shortages.

• More than 32 million Americans live in primary-care shortage areas where NPs carry the majority of the load.

  
  

Capping graduate nursing loans is not a neutral financial policy—it’s a direct hit to the workforce pipeline.

Economic Impact on America: This Will Raise Healthcare Costs.

Economists have been blunt. When you limit who can become a nurse practitioner or clinical nurse specialist, you limit:

• Access to primary care

• Chronic disease management

• Mental health services

• Emergency and rural health coverage

That scarcity has real costs:

• Areas with fewer NPs see 9–15% higher hospital utilization.

• Rural communities rely on NPs for up to 80% of primary care delivery.

• APRNs reduce healthcare spending by $2.8 billion annually through cost-effective care models (RAND).

If fewer nurses enter graduate programs, hospital labor costs rise, wait times increase, and patients pay more for everything—from ED visits to specialty referrals. Limiting APRN training is not cost containment. It's cost magnification.

Economic Impact on Women: A Gendered Consequence.

Let’s speak the truth plainly. Nursing is an 87% female profession. Deciding who “counts” as a professional—and nursing is excluded—the consequences fall disproportionately on women.

Consider the gendered impact:

• Women already hold two-thirds of all student debt in the U.S.

• Women in healthcare lose $1 million in lifetime earnings due to wage disparities.

• Graduate nursing programs cost $40,000–$120,000, far exceeding the proposed cap.

This rule effectively tells a woman pursuing an advanced nursing degree:

“Your education doesn’t qualify for the same investment.”

This is not neutrality. This is inequity.

What This Does to Nursing.

Nursing is the most trusted profession in America—for 22 consecutive years according to Gallup Polls. Nurses are:

• Licensed

• Regulated

• Ethically bound

• Competency tested

• Independently practicing (in 27 states + DC)

• Essential to national public health

To remove nursing from the definition of “professional degree” is to undermine:

• Our legitimacy;

• Our autonomy;

• Our public value;

• Our scope of practice; and

• Ultimately, our ability to serve the nation.

  
  

This is not a small administrative edit. It is a reclassification of an entire profession.

A Policy That Harms Communities It is Designed to Protect.

The rule is said to prevent “insurmountable debt for degrees that do not pay off.”

Let me be clear as both a nurse and an attorney - Nursing Degrees pay off for America.

NPs provide:

• High-quality, evidence-based care

• Lower-cost primary care

• Chronic disease management that reduces emergency utilization

• Services in communities where physicians will not practice

Reducing access to APRN education does not protect borrowers. It punishes communities with:

• Provider shortages

• Maternal mortality disparities

• Mental health crises

• Rural hospital closures

The 95% Argument

Officials say:

“95% of nursing students won’t be impacted.”

This statistic ignores:

• The fastest-growing segment of nursing is graduate education.

• APRN roles are the #1 most in-demand clinical position in America.

• Minority students—especially women—are disproportionately impacted by borrowing caps.

• Graduate nursing programs routinely exceed the $20,500 limit.

A 5% reduction in nursing graduate enrollment equals:

• 21,500 fewer APRNs by 2030

• Millions of Americans losing access to primary and preventive healthcare

• Entire rural counties without a single primary care clinician

Therefore, five percent in this context is not small. It is destabilizing.

What Nursing Actually Is: A Profession by Every Definition

Let the record reflect - a profession is defined by:

1. Advanced education

2. Ethical obligations

3. Independent judgment

4. Licensure

5. Public accountability

   
   

APRNs meet all five. Registered Nurses meet all five. Nurse faculty, policy leaders, researchers, and clinical specialists meet all five.

Nursing is not an auxiliary. Nursing is not vocational. Nursing is not “general graduate education.”

Nursing is a profession—one that keeps this nation alive.

What Happens if This Rule Stands?

The consequences will be immediate.

• Workforce collapse

Fewer graduate-prepared nurses in hospitals, clinics, schools, mental health, home care.

• Rural devastation

NPs leave, physicians do not replace them.

• Higher costs for Americans

Less access = more hospitalizations = higher premiums.

• Gender inequity deepens

Women lose educational access across a female-dominated profession.

• Public health risk escalates

Chronic disease and mental health crises worsen.

This is not just a financial issue. It is a national public safety issue.

Nursing’s Response: We Should Not Be Diminished

The proposed rule is “a gut punch,” as multiple experts described.

It is also:

• A reminder of what is a professional

• A wake-up call

• A legal issue

• A workforce issue

• A gender equity issue

• A public health emergency

And it is a moment for absolute unity across nursing, social work, physician assistant, and allied health groups—because multiple fields were excluded.

We must ensure that policymakers understand what this reclassification does—not in theory, but in real, every day American lives.

Final Word

Nurses are professionals. We always have been. We always will be.

Federal definitions don’t change reality—but they can change access, equity, and the future of healthcare.

And that is why we must respond.