Tomekia Luckett’s journey to becoming a mental health nurse practitioner — pursuing a bachelor’s, master’s and doctorate degree while raising triplets — was made possible by federal student loans and scholarships. But she fears proposed new caps on those loans could make the path she took more treacherous for the next generation of nurses.
Beginning in July, graduate students across all disciplines will face stricter limits on federal loans under a provision in last summer’s One Big Beautiful Bill Act.
The law directed the U.S. Department of Education to identify “professional degree” programs, which will be eligible for higher loan caps. A draft rule released by the agency excludes graduate nursing programs from the designation, a decision that could subject such students to tighter borrowing limits. These programs train nurse practitioners and certified nurse anesthetists, professionals who help fill critical gaps in Mississippi’s physician workforce.
“I am very concerned as a person who was a first-generation college student,” said Luckett, who treats patients across rural southwest Mississippi and has taught nursing for more than a decade. “If those caps had been in place, there would very likely not be a Dr. Luckett today.”
Luckett, who spoke to Mississippi Today in a personal capacity, serves as the associate dean for nursing continuing professional development at Walden University and as director of the Mississippi Nurses’ Association’s Council on Nursing Education.
The federal Department of Education plans to finalize the rule classifying professional degree programs “early this year,” according to its website. But experts and advocates warn that the draft rules — which halve the amount of federal student loans nursing students can receive compared to doctors, dentists and lawyers — could create barriers for nurses seeking advanced education and threaten the stability of the nursing workforce nationwide.
“By limiting the loans, that will make it more difficult for people who come from economically disadvantaged backgrounds to be able to afford going to nursing school and a career in nursing,” said Vincent Guilamo-Ramos, a nurse practitioner and executive director of the Johns Hopkins School of Nursing Institute for Policy Solutions.
Under the draft rules, “professional degree” programs will be capped at a $200,000 borrowing limit. Nursing graduate students would be capped at half that amount — a maximum of $100,000, or $20,500 a year. Current borrowers will be permitted to continue receiving loans under existing rules for three years or the length of their program.
The Trump administration said not classifying graduate nursing as a “professional degree” — a decision that has caused outrage among some nurses — is a technical and regulatory decision, not a “value judgement about the importance of programs,” according to a post on the U.S. Department of Education website.
The department said the new caps on loans won’t have a widespread impact, noting that 95% of nursing students borrow below the annual loan limit, according to the agency’s data, and that 80% of the nursing workforce does not have a graduate degree.
Since 2007, graduate and professional students have been allowed to borrow up to the full cost of attendance through the federal Graduate PLUS program. These changes have allowed schools to inflate their tuition and saddle students with debts, the Trump administration said.
The changes could make the nursing workforce less representative of the people they serve, and contribute to existing health care workforce shortages, Guilamo-Ramos said. Studies show that a representative and diverse health care system improves health outcomes and access to care for patients. Researchers have shown that patients are more likely to receive preventive care they need and agree to recommended care when their doctors have a similar racial or cultural background to them.
Antonia M. Villarruel, the dean of the University of Pennsylvania School of Nursing, said in a statement to Mississippi Today she expects the new loan caps to have “devastating effects” on the preparation of graduate-level nurses and nursing educators, and that these limits will contribute to increased shortages of primary care providers, especially in rural areas.
“This impacts both access to care for all Americans and the ability of schools and universities to continue to educate this group of professionals that will result in faculty shortages,” Villarruel said.
Crystal Joslin, a registered nurse from Corinth who works at a rural hospital and a nursing home, said she aims to advance her career by becoming a psychiatric nurse practitioner. Working shifts at the hospital’s medical-surgical unit and emergency room, she often sees patients with serious mental health needs, and she hopes to further her education to assist her community.
News of the proposed federal loan caps made her second guess her plan to attend a master’s program at the University of North Alabama later this year. She considered delaying her career plans to save up. But she said she has decided to persist — and will pay the portion of her tuition that is not covered by loans out-of-pocket — in order to help her community and advance her career.
“I didn’t really want to wait the extra couple of years,” she said. “Of course, my work as an RN, I can definitely be doing that. But I feel like there’s nurses to educate out there, and there’s patients to help. …There’s more things that I could be doing with my education and my knowledge that I wouldn’t be getting to do.”
Critics of the caps argue that while the changes may limit students’ debt, they will also limit students’ access to education.
“It would be nice if I could have less debt, but at the same time, I wouldn’t have the education I have,” Luckett said.
Guilamo-Ramos said he does not expect universities to lower their tuition as a result of the changes. Nursing education must comply with strict requirements that make programs more costly to run, like student-to-faculty ratios.
“I think what will happen is that over time just people who can afford to attend will attend,” Guilamo-Ramos said. “And that’s bad for all of us.”
The draft loan caps have generated bipartisan dissent. In a Dec. 12 letter to U.S. Under Secretary of Education Nicholas Kent, a bipartisan group of nearly 150 congressional lawmakers expressed support for including nursing degrees in the department’s definition of “professional degree.” The effort was spearheaded by several lawmakers, including U.S. Sen. Roger Wicker of Mississippi, co-chair of the Senate nursing caucus.
“At a time when our nation is facing a health care shortage, especially in primary care, now is not the time to cut off the student pipeline to these programs,” wrote the group of U.S. senators and representatives.
Mississippi has one of the lowest rates of physicians per capita in the nation, and the gap is expected to grow over time. In rural areas, nurse practitioners often fill gaps left when there is not a physician.National research shows that the share of Medicare visits delivered by physician assistants and nurse practitioners nearly doubled between 2013 and 2019. Rural family physicians are more likely to partner with these clinicians to meet patient care needs.
Certified nurse anesthetists also help address critical care shortages, performing about 70% to 90% of procedures compared to their physician counterparts in Mississippi, according to Public Health and Human Services Chairman Rep. Sam Creekmore, a Republican from New Albany, speaking during a House floor session last year.
Mississippi is currently facing a shortage of nurse anesthetists, and that gap is expected to grow over the next decade, according to data from Health Resources and Service Administration. Today, Mississippi is lacking about 90 needed nurse anesthetists, but by 2035, that figure is expected to grow to 140 — meaning only 76% of needed positions will be filled.
Guilamo-Ramos said he hopes that the new student loan provisions will spur nursing schools to consider ways to make tuition costs affordable for more students apart from loans.
“Schools of nursing need to take a hard look at the cost of tuition and make it more affordable,” he said. “And we need to improve our scholarships, and we need to improve other kinds of aid besides loans.”
Graduate nursing programs in Mississippi range in cost. The Mississippi University for Women offers one graduate nursing program, for family nurse practitioners. The program costs about $4,300 per semester and takes about three semesters to complete, according to the school’s website. Because the cost of the program is below the cap, the draft rule would not impact students attending this program.
Brandy Larmon, the dean of the College of Nursing, said the school is assessing the potential risks of the loan caps, but is not currently concerned due to the short length of the program and low cost of attendance.
Other graduate nursing student programs, and especially nurse anesthesia programs, can be more costly and take more time to complete. The University of Southern Mississippi’s graduate nurse anesthesia program costs about $30,000 annually, according to a spokesperson, and takes three years to complete.
If enacted, Guilamo-Ramos said he expects the proposed caps on student loans to affect advanced practice nurse staffing levels and exacerbate faculty shortages as soon as within the next one to two years.
He added that the impact could be especially significant in Mississippi and across the South, where workforce shortages are already severe and health outcomes lag behind other regions.
“It worries me deeply that we would be losing nursing workforce in the very places that we need to have more people,” Guilamo-Ramos said.
Education reporter Candice Wilder contributed to this report.
This coverage is supported by a grant from Press Forward Mississippi, part of a nationwide philanthropic effort to strengthen local news so communities stay informed, connected and engaged.
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