There is growing need for nurses in the United States – but not enough nurses currently working, or students training to become nurses, to promptly see all of the patients who need medical care.
Tens of thousands of nurses have left practice since the pandemic, and many more plan to leave within a few years, according to the 2024 National Nursing Workforce Survey, which reviews the number of registered nurses working in the U.S.
Meanwhile, the U.S. Bureau of Labor Statistics projects that there will be an average of 189,100 openings for registered nurses each year through 2032. In addition, there will be a need for approximately 128,400 new nurse practitioners by 2034 – making it the fastest-growing occupation in the country.
The tax and spending package signed into law in July 2025 will take effect on July 1, 2026. Among other things, it will likely make it even harder for people to take out loans and help pay for a graduate nursing degree.
We are nurses and professors who oversee large nursing programs at universities. We believe that new restrictions on how nursing students can take out federal loans to pay for their education are likely to prevent people from pursuing advanced nursing roles.
These new regulations will cause the shortage of practicing nurses to intensify – in turn, worsening the quality of care patients receive.
Clinics may offer fewer appointments, hospitals may be forced to reduce services, and nursing programs may have to accept fewer students. As a result, some patients will wait longer, travel farther, or not see nurses altogether.
Glenn Beil/Florida A&M University via Getty Images
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Paying for nursing education
Someone can become a registered nurse with an associate or bachelor’s degree. But a graduate-level degree is needed for other nursing roles – including nurse practitioners, nurse anesthetists and nurse midwives.
Nursing school costs vary greatly, depending on which degree students are seeking and whether they attend a public or private school. Roughly three-quarters of graduate nursing students rely on student loans and graduate with debt to pay for programs that can range from US$30,000 to $120,000 or more.
We have found that nursing students, unlike medical students, often work while enrolled in their programs, stretching their education over longer periods and accumulating additional costs.
The tax and spending law eliminates several federal grants and loan repayment programs for nurses and aspiring nurse educators – faculty members who teach nursing students in colleges and universities.
The law also sharply restricts how much money graduate nursing students can borrow through federal student loans.
Approximately 59% of 1,550 nurses surveyed in December 2025 said that they are now less likely to pursue a graduate degree with the new borrowing limit changes.
A fractured system
Nurse practitioners provide the majority of primary care in the U.S. – particularly in rural areas and communities with few physicians.
In addition, certified registered nurse anesthetists administer anesthesia for surgeries and procedures in many areas. Meanwhile, certified nurse-midwives deliver babies and provide prenatal and postpartum care, especially in areas where there are few obstetricians.
Long waits for new patient appointments are now common across the country, with national surveys showing that patients often wait weeks to months before they receive medical care.
About a decade ago, new patients could often book appointments within days to a few weeks; but today, there are fewer available medical appointments and medical professionals to treat them. This is particularly true for many medical practices serving women, older adults and rural communities.
One of us – Dr. Montgomery – is a women’s health nurse practitioner who routinely sees patients wait months for new appointments in the mid-Atlantic. These delays translate into postponed cancer screenings, delayed medication management and untreated chronic conditions.
Research consistently shows that nursing shortages are associated with worse patient outcomes, including higher mortality and delayed treatment.
Nursing left off the professional degree list
Under the new law, the Department of Education created a classification system that distinguishes professional from nonprofessional graduate degrees. Nursing is now considered a nonprofessional degree.
As a result, graduate nursing students will soon face lower borrowing limits than they currently do.
Previously, there was no need to label nursing as professional or not, because federal student loan borrowing was not capped in a way that required this distinction.
Now, students in professional graduate programs, such as medicine and law, may borrow up to $50,000 per year in federal loans and $200,000 in total.
Graduate nursing students, by contrast, will soon face a federal student loan cap of $20,500 per year and $100,000 total over the course of their education – a significant reduction from prior borrowing options.
The new law also eliminates the Direct PLUS Loan program. This separate, federal student loan program allows students to borrow up to the full cost of attendance of graduate nursing school after they reached annual loan limits on traditional federal loans.
More than 140 members of Congress from both political parties urged the Department of Education in December 2025 to reverse course and classify nursing as a professional degree.
The faculty bottleneck
Graduate loan limits will worsen another critical problem – the shortage of nursing faculty.
There are currently 1,693 full-time vacancies for nursing faculty positions, according to a survey in 2024 by the American Association of Colleges of Nursing. Of those open positions, 84% require or prefer a doctoral degree.
Universities cannot admit nursing students if there are not enough faculty to teach them.
Nursing programs in the U.S. turned away more than 80,000 qualified applicants to baccalaureate and graduate nursing programs in 2023, in part because they did not have enough faculty.
Better solutions exist
There are policy changes that could prevent this domino effect.
Policymakers could classify nursing as a professional degree for loan purposes, aligning borrowing limits with the documented costs of accredited programs.
Congress and individual states could expand scholarships and loan-repayment programs for nurses who teach or serve in rural and underserved communities.
Universities and governments could work together to share nurse training costs.
Graduate nursing education is not a luxury. It is a cornerstone of the country’s health care system.
Helping nurses afford an education is not just about nurses – it is about patients, communities and the future of medical care in the U.S.
