Health workers sound alarm on Trump loan caps

• It's the latest fallout from Republicans' sweeping tax-and-spending law, which eliminated a federal loan program for graduate students and put a lifetime limit on student loan borrowing starting in the middle of next year.
• The cap is $200,000 per student in degree programs considered professional, but just $100,000 for other graduate programs.

State of play: An administration-convened panel charged with implementing the law last month proposed to adopt a narrow definition of graduate health care programs meeting the definition "professional."

• On the list: M.D.s, osteopathic doctors, veterinarians, pharmacists, optometrists, podiatrists, chiropractors and clinical psychologists.
• Not on the list: advanced degree nurses, PAs, physical therapists, nutritionists, audiologists and other categories of health workers.

What they're saying: "This is going to critically decrease the amount of health care professionals entering the workforce at a time where we know that more care is going to be needed," said Sondra DePalma, vice president of reimbursement and professional practice at the American Academy of Physician Associates.

The other side: The Trump administration said it expects student loan limits to push down the cost of graduate programs.

• The proposal shouldn't worsen the nursing shortage because it won't affect bachelor's or associate nursing programs, an administration fact sheet notes.
• The Education Department referred Axios back to the fact sheet when asked about professional groups' concerns about the limits.

Health providers are ramping up pressure to expand the list.

• More than 224,000 people signed a petition from the American Nurses Association and other groups calling on the administration to add advanced nursing to the list of eligible programs.
• AAPA's DePalma said tens of thousands of current and prospective students and their families have called the organization with concerns about the proposal's impact.

Public health leaders have also sounded alarms, saying the new borrowing restrictions could leave the U.S. less prepared for crises.

• "At a time when threats to public health are escalating, leaving out the very degrees that train our frontline leaders is both short-sighted and dangerous," the Association of Schools and Programs for Public Health said in a statement.

Congress has also started to weigh in — including at least one member who voted for the reconciliation law.

• Rep. Jen Kiggans (R-Va.), a nurse practitioner, is urging the administration not to exclude nurses from the professional degrees list.
• "At a time when our nation is facing a critical nursing shortage, we should make it easier — not harder — for the next generation of nurses to step forward," Kiggans said in a statement to Axios.

By the numbers: The average debt for a medical school graduate in 2024-2025 is estimated to be about $236,000, according to data analyzed by the Education Data Initiative.

• Graduates of other professional health science doctoral programs have an average of about $299,000, per EDI.

What we're watching: Whether the Education Department bows to the pressure campaign before the new restrictions take effect on July 1.

• "[T]he Department has not prejudged the rulemaking process and may make changes in response to public comments," the agency's fact sheet reads.
• The AAPA told Axios that it's prepared to pursue every available option, including litigation, if the administration finalizes the current plan.