The federal student loan landscape for healthcare students is in flux heading into July 1, when the Education Department’s Reimagining and Improving Student Education rule takes effect.
The rule implements borrowing caps from the One Big Beautiful Bill Act, eliminates the Grad PLUS loan program and — most controversially — defines which degree programs qualify for higher “professional student” loan limits. Most healthcare fields outside medicine, law and dentistry did not make that list.
Here are 10 notes on where things stand:
1. The caps take effect July 1. Under the RISE rule, finalized April 30, graduate students are capped at $20,500 annually and $100,000 over a lifetime in federal loans. Students in programs classified as “professional degrees” — a list that includes medicine, law, dentistry, pharmacy and a handful of others — can borrow up to $50,000 annually and $200,000 over a lifetime.
Nursing, physician associate and most other advanced healthcare programs were placed in the lower graduate tier.
2. At least six medical groups have voiced pushback. When the Education Department finalized the RISE rule April 30, six nursing and physician associate associations condemned the decision. The American Nurses Association said the ruling would “severely restrict access” to loan support for post-baccalaureate nursing education. The American Association of Nurse Anesthesiology said CRNA programs were excluded “based on a fundamental misunderstanding of physician supervision requirements.” The American Association of the Colleges of Nursing noted that more than 3,000 public comments were submitted opposing the rule, and more than 150 members of Congress from both parties pushed back on the changes before the department finalized it anyway.
3. The rule has real dollar consequences for CRNAs. AANA President Jeff Molter, MSN, CRNA, said doctoral-level nurse anesthesia students will on average need to find more than $77,000 in additional private loans to cover their education under the new caps — funding some will be unable to secure at all.
He added that 75% of prospective CRNA applicants said education would no longer be financially feasible under the loan caps, and 80% were very concerned about securing private loans. “For many qualified nurses, that simply will not be an option,” Mr. Molter said.
4. The caps are reshaping physician career decisions too. For medical students, the RISE rule caps federal borrowing at $200,000 and eliminates Grad PLUS loans, which previously allowed borrowing up to the full cost of attendance including living expenses. Medical students who graduated in 2024 left with an average of $212,341 in educational debt — already above the new cap. Only 47% of physicians said they would still choose medicine again under the new federal loan cap policy, 27% said they would not and 26% were unsure, according to new data from Panacea Financial shared with Becker’s. Healthcare groups warn the limits could push graduates toward higher-paying specialties, worsening shortages in primary care, pediatrics and other fields.
5. Twenty-five states and D.C. filed suit in May. A coalition of 25 state attorneys general filed a federal lawsuit in May challenging the Education Department’s exclusion of nursing from the professional degree designation. The states argued the rule would worsen the nursing shortage by making graduate education unaffordable for prospective advanced practice nurses.
6. The ANA and 10 nursing organizations filed their own suit May 29. Led by the ANA and joined by the American Association of Nurse Anesthesiology, the American College of Nurse Midwives, the Association of Women’s Health, Obstetric and Neonatal Nurses and seven other national nursing organizations, the coalition filed a lawsuit asking a federal court to block the rule before July 1. Neither case has been ruled on and no court has issued a preliminary injunction blocking the rule from taking effect.
7. PA groups sued June 3. The American Academy of Physician Associates and the PA Education Association filed a lawsuit in the U.S. District Court for the District of Columbia on June 3, challenging the RISE rule ahead of its July 1 effective date. The groups also filed a motion for a preliminary injunction seeking to block the rule for PA students before the start of summer and fall programs. More than three-quarters of PA student borrowers required federal loans above the $20,500 annual cap in the 2023-24 academic year, according to the PA Education Association. The average cost of a 27-month PA program is approximately $98,075 for in-state students and $107,288 for out-of-state students.
8. The House Appropriations Committee passed a bipartisan fix June 9 — but it won’t arrive in time. The House Appropriations Committee advanced a fiscal year 2027 appropriations amendment in a 34-28 vote that would classify graduate nursing programs as professional degrees, restoring access to $200,000 in federal loans. The amendment still must pass the full House and Senate. Even if signed into law, it would not take effect until Oct. 1 at the earliest — meaning nursing borrowers entering fall 2026 programs will still face the lower caps on July 1.
9. ANA is on Capitol Hill June 25. Nearly 500 nurses are converging on Capitol Hill today for the ANA’s annual Hill Day, pushing Congress to act before the July 1 implementation date.
10. Health systems are responding with their own loan repayment programs. Saint Alphonsus Health System, part of Livonia, Mich.-based Trinity Health, launched a student loan repayment initiative in partnership with recruitment platform Clasp, offering structured repayment support over a three-year employment period for nurses, CRNAs, surgical technologists and radiologic technologists. Separately, Hawaii is launching a $28 million full-tuition program for healthcare students who commit to practicing in rural communities for five years following graduation, backed by federal funds.