Five nursing and physician associate associations said they are “profoundly dismayed” and “deeply concerned” by the Education Department’s ruling to cap student loans and classify nursing and PA degrees as graduate, instead of professional degrees.
On April 30, the Education Department finalized the Reimagining and Improving Student Education rule. The rule, effective July 1, carries out provisions from the Working Families Tax Cuts Act that cap federal loans for graduate and professional students. It also established formal definitions for “graduate student” and “professional student,” which has implications for higher federal loan limits. Under the framework, healthcare fields, such as physician assistants and some advanced practice nurses, were classified as graduate programs, which has a lower loan cap of $20,500 annually.
When the rule was proposed in February, several health systems urged the department to reconsider the changes, citing workforce and financial challenges. In response to the proposed rule, on Feb. 10, more than 75 health systems and organizations formed a national coalition. Industry associations also warned that the changes could restrict access to education and worsen workforce shortages.
Here are five associations’ reactions to the ruling.
1. The PA Education Association and the American Academy of Physician Associates plan to challenge the rule in federal court. They argue excluding PAs from federal professional student loans will create unnecessary barriers to education and undermine workforce efforts, and seek to overturn the rule and restore the previous definition of professional student, according to an April 30 joint news release.
2. The American Nurses Association said the ruling will “severely restrict access” to loan support for post-baccalaureate nursing education and undermine the nursing workforce. It will also have a negative impact on patient care, as hospitals and clinics increasingly rely on advanced practice registered nurses to provide primary care and other specialty healthcare services.
“This final rule will limit baccalaureate-prepared nurses’ ability to pursue advanced degrees, including the Master of Science in Nursing, Doctor of Nursing Practice, Doctor of Nurse Anesthesia Practice, and Doctor of Philosophy in Nursing, the very degrees that produce the advanced practice nurses and educators our country so desperately needs,” Jennifer Mensik Kennedy, PhD, RN, president of the American Nurses Association, said in an April 30 association news release. “Make no mistake, this is not a technicality or a footnote. This rule will be felt in real communities, for example, in rural areas where nurse practitioners, midwives, and nurse anesthesiologists are often the only providers of core care services.”
3. The American Association of Nurse Anesthesiology said that the Education Department acknowledged that nurse anesthesia programs meet the requirements for professional student inclusion, but the rule excludes future CRNAs “based on a fundamental misunderstanding of physician supervision requirements and fails to consider the impact on the workforce and access to care,” President Jeff Molter, MSN, CRNA, said in an April 30 statement. This could restrict the anesthesia workforce pipeline, which could impact access and increase delays for procedures, including cancer screenings, childbirth and surgery.
“These impacts will be felt most acutely in rural and underserved communities where CRNAs are often the primary or sole anesthesia providers,” Mr. Molter said. “On average, students in doctoral-level nurse anesthetist programs will be forced to find more than $77,000 in additional private loans — funding that some will be unable to secure at all. The data is clear: 75% of prospective nurse anesthesia applicants said that education would no longer be financially feasible under the loan caps, and 80% were very concerned about securing private loans to complete their training. For many qualified nurses, that simply will not be an option.”
4. The American Association of the Colleges of Nursing said it firmly opposes the ruling and the “rationale used to legitimize this arbitrary and capricious decision.” It noted that more than 3,000 comments were submitted to the Education Department and more than 150 members of Congress from both parties also pushed back on the changes.
“AACN, our member schools, and nurses across the country are angered by the Department of Education’s failure to support the nursing profession as the demand for patient care services rises,” an April 30 association news release said. “We will continue to lead the academic nursing community and actively pursue all available avenues to address the harmful implications of this ill-advised decision.”
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