FOR IMMEDIATE RELEASE: Graduate Loan Cap Changes Threaten the Future of Nursing in Hawaiʻi and Across the Nation
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Hawaii-American Nurses Association
on
Hawaii
Hawaiʻi-American Nurses Association Calls on U.S. Department of Education to Classify Registered Nurses and APRNs as “Professional Students” Under the One Big Beautiful Bill Act
HONOLULU, HI — The Hawaiʻi-American Nurses Association (Hawaiʻi-ANA) is sounding the alarm over forthcoming federal student loan policy changes that could devastate the nursing workforce and jeopardize patient safety in Hawaiʻi and nationwide.
The U.S. Department of Education (DOE) is moving forward with provisions from the One Big Beautiful Bill Act (OBBBA) that would sharply limit how much graduate and professional students can borrow. Under the current framework developed through negotiated rulemaking, only physicians, psychologists, and theologians would qualify for higher “professional” loan caps of $50,000 annually and $200,000 total.
All other graduate students—including registered nurses (RNs) and advanced practice registered nurses (APRNs)—would be restricted to $20,500 annually and $100,000 total, regardless of degree level or stringent credentialing requirements.
DOE is expected to issue a Notice of Proposed Rulemaking in early 2026 that reflects this structure. As it stands, nursing is excluded from the professional category—an omission Hawaiʻi-ANA warns will have immediate and severe consequences for the islands’ already strained healthcare system.
“Nursing is not a support role—it is a rigorous, licensed, scientific profession,” said Denise Cohen, PhD, RN, APRN, FNP-BC, President of Hawaiʻi-ANA. “Excluding RNs and APRNs from the professional category ignores the reality of modern healthcare and will worsen an already critical workforce shortage, particularly here in Hawaiʻi.”
A Workforce in Crisis
The United States is already experiencing a deep shortage of RNs entering the workforce. Research consistently shows that:
- When RN staffing is inadequate, mortality and complications rise.
- When RN staffing improves, patients live longer, recover faster, and experience fewer adverse events.
Cost of education is repeatedly cited as the top barrier to entering and advancing in nursing. Restricting access to adequate federal loans for professional-level nursing education will further shrink the pipeline at the very moment when the nation needs more—not fewer—highly educated nurses at the bedside.
Why the DOE’s “Nursing Is Not a Professional Degree” Rule Will Deepen Hawaiʻi’s Nursing Crisis
Hawaiʻi is already facing one of the most severe nursing shortages in the nation, with 1,500–3,000 vacant RN positions statewide at any given time. Yet the U.S. Department of Education’s proposed rule—classifying nursing as non-professional for the purposes of graduate loan limits—would directly worsen this crisis by blocking the very graduate-prepared nurses the state relies on to teach the next generation.
Under Hawaiʻi law, and under national accrediting bodies, nursing faculty must hold a minimum of a master’s degree (MSN) to teach, even at the ADN level. Cutting graduate-level loan eligibility for nurses means fewer nurses will be able to earn those degrees. And without qualified faculty, Hawaiʻi’s nursing pipeline collapses.
Hawaiʻi is already seeing the impact:
- The University of Hawaiʻi system receives hundreds of qualified applicants every year but cannot admit them all—not because of a lack of demand, but because there are not enough graduate-prepared nursing faculty.
- Across Hawaiʻi’s community colleges and universities, faculty shortages—not student interest—are the primary bottleneck in producing more local nurses.
By restricting graduate loan access for nurses, the DOE is:
- Reducing the number of faculty eligible to teach,
- Shrinking Hawaiʻi’s nursing pipeline,
- Prolonging the statewide shortage, and
- Driving up reliance on costly traveler nurses, draining public and private healthcare budgets.
This rule does not reflect the reality of nursing education, the legal requirements in Hawaiʻi, or the workforce needs of the state. It will cut off qualified future educators, disproportionately harm rural and neighbor island communities, and delay Hawaiʻi’s ability to build a sustainable local nursing workforce.
“When federal policy makes it harder for nurses to become faculty, it directly limits how many local students we can train,” Cohen said. “That is a recipe for a long-term crisis in Hawaiʻi’s health system.”
Crushing Costs Drive Americans Out of Health Careers
Across healthcare—medicine, nursing, dentistry, psychology, social work, physical therapy—students assume substantial debt to serve their communities. In many regions, especially rural and underserved states like Hawaiʻi, health systems already rely heavily on foreign-trained professionals to fill gaps.
While internationally educated colleagues are essential to care delivery, Hawaiʻi-ANA stresses that the U.S. cannot build a resilient, culturally responsive healthcare system if qualified local candidates—who bring cultural competence and deep community knowledge—are priced out of nursing degrees.
“Local nurses bring cultural competence, language skills, and deep community trust,” Cohen added. “When education is financially out of reach, our communities lose the very professionals best equipped to care for them, and Hawaiʻi’s unique healthcare needs are particularly vulnerable.”
APRNs and PAs Are Essential to Access—Especially in Hawaiʻi
In Hawaiʻi alone, there is a shortage of more than 800 physicians. Nurse practitioners (NPs) and physician assistants (PAs) are critical to closing this gap, providing safe, effective primary and specialty care. In communities where patients already wait weeks for basic appointments, delayed care can mean preventable complications—or even death.
APRNs routinely make the high-stakes clinical assessments that keep patients safe:
- Identifying when a sore throat is progressing toward life-threatening rheumatic fever
- Recognizing that a “stomach bug” is actually lymphoma in a young adult
- Sending a college student with undiagnosed diabetes to the emergency department minutes before a fatal collapse
These are examples of the expert, assessment-driven decision-making that defines advanced nursing practice. Restricting graduate loan access for RNs and APRNs will reduce precisely the workforce that protects patients in physician-short environments, a situation acutely felt across the Hawaiian Islands.
Nursing Is a Profession—and Must Be Treated as One
Professional nursing is a licensed, regulated practice grounded in science, complex clinical judgment, and continuous patient assessment. Nurses must be prepared to intervene in seconds when a patient deteriorates.
Career-ladder nursing programs—such as CNA → LPN → RN → BSN → MSN/APRN—are an especially effective, equity-focused model used by many Hawaiʻi programs and across the country. These pathways expand opportunity, diversify the workforce, and produce high-quality clinicians. Imposing bachelor-level loan caps on graduate-level nursing degrees would undermine these proven models and disproportionately harm students from low-income communities.
Every year, qualified, passionate candidates abandon or delay nursing careers because they cannot afford tuition, books, supplies, and lost wages during demanding clinical training. Reducing access to graduate-level borrowing will push even more of these future nurses out of the pipeline.
Nursing Is Science. Excluding Nurses From STEM or Professional Categories Is Illogical and Harmful
Excluding nursing from either STEM or “professional” policy categories fundamentally misrepresents what nurses do. On any given shift, nurses:
- Manage complex fluid, electrolyte, and medication regimens
- Interpret laboratory and diagnostic results
- Apply principles of microbiology and infectious disease control
- Administer and titrate IV medications
- Identify early sepsis and other time-sensitive emergencies
- Perform complex wound care
- Initiate life-saving code responses
- Recognize subtle clinical deterioration long before machines alarm
During the COVID-19 pandemic, physicians newly assigned to intensive care units repeatedly expressed astonishment at the depth of nursing expertise. Experienced RNs often knew more about real-time, moment-to-moment patient management than early-career physicians—because nurses are continuously present at the bedside, where every minute matters.
Patients frequently assume that physicians are available around the clock; in reality, it is nurses who monitor, intervene, and advocate 24/7. As countless patients and families have said: “The nurses saved my life.”
If every American will eventually depend on a nurse—and they will—then federal policy must strengthen, not weaken, the educational pipeline that produces them.
Policy Request
Nurses and APRNs are professionals. They provide scientific, life-saving, assessment-based care that is indispensable to public health and patient safety. The proposed DOE loan caps, as currently structured, will:
- Make nursing education less accessible
- Exacerbate existing workforce shortages
- Directly and negatively impact patient care outcomes
Therefore, the Hawaiʻi-American Nurses Association urgently calls on the U.S. Department of Education to:
- Classify Registered Nurses and Advanced Practice Registered Nurses as “Professional Students” eligible for the higher loan caps under the One Big Beautiful Bill Act.
This is not a request for special treatment. It is a request for accurate classification of a profession that forms the backbone of the U.S. healthcare system.
Protecting the public means protecting the pathway to nursing.
Respectfully,
Denise Cohen, PhD, RN, APRN, FNP-BC
President
President
Hawaiʻi-American Nurses Association