A new student loan rule, set to take effect on July 1, 2026, will constrain the pipeline to practice for nurses and other health professionals.
The implications for the nursing workforce are significant. The policy will impact advanced practice nurses, including nurse practitioners, who play a critical role in delivering primary and community-based care, particularly in underserved areas. It will also affect nursing faculty, who are essential to preparing registered nurses and advanced practice nurses alike-at a time when health care access is already under strain.
Johns Hopkins University and Medicine have submitted formal comments opposing the legislation. Maryland Attorney General Anthony Brown has also led a coalition of states in opposition.
In a Q&A, Natalia Barolin, RN, Senior Health Policy Advisor at the Johns Hopkins School of Nursing, addresses and fact-checks key points of the proposal.
The Department of Education has said that 80% of the nursing workforce does not hold a graduate degree and therefore will not be affected by the proposed rule. From your perspective, does that reflect today’s workforce needs? Not really. That statistic is misleading and overlooks where the greatest need is growing. The healthcare system is increasingly dependent on nurses with graduate training-especially advanced practice registered nurses (APRNs), faculty, and leaders. These are the roles that expand access to care, train the next generation, and help lead health systems. The policy has major implications for the future pipeline.
Why is graduate education so important to the nursing workforce today? We cannot train any nurses without graduate degree prepared nurse instructors and faculty. Advanced practice nurses like nurse practitioners are diagnosing, treating, and managing patient care across settings, and helping fill gaps in acute care specialties as well as in primary care where there are not enough clinicians. We also need graduate degree prepared nurses to educate future clinicians. Limiting access to graduate nursing education adds further strain on a system already experiencing strain across the board-from care delivery to workforce training.
What does demand for advanced practice nurses look like right now? The demand is already very strong. For our advanced practice students, employment rates are high-most go directly into healthcare (82.1%), with others entering teaching roles (5.1%). Nationally, the Bureau of Labor Statistics projects a 38% increase in demand for advanced practice nurses like nurse practitioners over the next decade. Primary care is a clear area of need, particularly in underserved communities, but APRNs are also critical across specialties and care settings.
The Department also states that 95% of nursing students borrow below the proposed annual cap of $20,500. How does that compare to actual costs? That figure is difficult to reconcile with reality. The average cost of attendance for graduate nursing education exceeds $30,000 per year. In practical terms, that gap means many students would not be able to fully finance their education through federal loans. State schools may be less expensive, but they do not have enough capacity to meet demand. Without adequate financing options, fewer students will be able to enroll-and that directly affects workforce supply.
How could this disproportionately affect students from lower- and middle-income backgrounds? Many of our students are deeply committed to serving underserved and rural communities-and they often come from those communities themselves. In our current MSN (Entry Into Nursing) cohort, 37% of students were Pell Grant recipients as undergraduates. These are students with the greatest financial need. If access to funding is reduced, we risk losing a significant portion of future nurses who are most likely to return to and serve high-need areas. That has real implications for equity and access to care.
What can healthcare professionals and stakeholders do now? Our focus will now need to be on legislative solutions. There are already several bills introduced in Congress that aim to expand or restore loan access for graduate and professional students, including nursing. Healthcare professionals and concerned individuals can play an important role by reaching out to their elected officials and urging support for these efforts. Aligning student loan policy with workforce and patient care needs is critical-and there’s still an opportunity to get that right.
Natalia Barolín, BA, BSN, RN is the Senior Health Policy Advisor at the Johns Hopkins School of Nursing. She leads the school’s initiatives to improve health through policy and elevate the expertise of nurses in advocacy and policy.
