We’re Getting It All Wrong: Why Lowering Federal Loan Limits Is the Only Way Tuition Will Ever Come Down

For decades, we’ve been fighting the wrong battle when it comes to the cost of higher education, especially in professional health programs like nursing, PA, NP, and advanced allied health. We’ve blamed administrators, shortages of faculty, accreditation pressures, clinical-site competition, even inflation.

But the uncomfortable truth is this:

Schools charge what they charge because the federal government allows students to borrow unlimited amounts to pay for it.

If an NP student can borrow $200,000, schools will set their tuition at, or very near, $200,000. If the cap were $100,000, schools would charge $100,000. If the cap were $60,000, institutions would simply rebuild their programs to fit the new ceiling.

This isn’t speculation. It’s the operating logic of modern graduate education.

And now, with the Department of Education signaling changes to loan limits and “professional program” classification, the system is finally being exposed.

We’ve Also Missed a Bigger Issue: The Definition of “Professional Program” Has Become Absurd

There are two major problems here. One is financial—loan limits have enabled runaway tuition inflation. But the second is definitional, and it reveals just how distorted the conversation has become.

We’ve allowed the definition of “professional program” to drift so far from common reality that it no longer matches the disciplines it’s supposed to represent.

By what conceivable standard would nursing, physical therapy, or audiology not be considered professional? How could any framework ignore that these programs require clinical hours, scientific rigor, licensure, and national competency standards?

If definitions appear to contradict common sense, then the definitions—not the disciplines—are what need to be reexamined.

Because it should be self-evident: Nursing and allied health programs prepare students for the healthcare professions. They always have. They always will.

A policy built on a flawed definition will inevitably produce flawed outcomes—and that is exactly what has happened.

This Isn’t Just a Nursing Issue — It Affects Everyone

Though many nurses understandably feel targeted by the policy shift, this change does not single out nursing. It affects an entire ecosystem of graduate students, including fields that have long depended on Grad PLUS access to finance high-cost degrees.

When the federal government tightens Grad PLUS lending, every discipline that depends on it feels the impact.

Nursing is reacting loudly because the consequences are immediate and deeply intertwined with a strained workforce. But this is not a nursing problem. It is a graduate education problem with ripple effects across medicine, law, engineering, architecture, counseling, psychology, and allied health.

The common thread is simple: If a profession relies on expensive graduate education and federal loans have historically subsidized that cost, any change to loan limits will reshape the entire economic structure of that field.

Graduate Education Has Become Financially Decoupled from Reality

The most uncomfortable truth in this debate is that the cost of graduate education has drifted so far from actual economic value that the numbers no longer make sense—not for students, not for the workforce, and not for the public footing the bill through federal loan programs.

Graduate degrees in the United States routinely cost $80,000 to $220,000, regardless of discipline. The pricing barely changes whether you’re pursuing a hybrid occupational therapy degree, an online MSN, a brick-and-mortar PA program, an SLP master’s, or a Master of Architecture.

Why? Because for years, tuition has been locked to borrowing capacity, not academic value.

Graduate tuition has been priced according to what students can borrow, not what the degree is worth.

When Grad PLUS removed borrowing caps for tuition and living expenses, universities responded predictably: expand enrollment, create high-fee online programs, increase marketing, and match tuition to the maximum available loan amount.

This inverted economic structure created a marketplace with:

• No price competition

• No connection between tuition and expected earnings

• No incentive for cost control

• No consumer protections around pricing

• No external restraint on institutional growth

Students are not selecting between rational price points. They are selecting between the amount they must pay and the amount they are allowed to borrow.

We have normalized price structures that would collapse instantly if they were subjected to true market forces.

And because of this disconnect, we’ve created entire professions, nursing, allied health, education, counseling, architecture, social work, public health, where the required graduate degrees cost more than the lifetime earning capacity of many practitioners.

Loan reform isn’t an attack. It is the first serious attempt to force higher education to price degrees based on economic reality instead of unlimited federal credit.

The Price Mirrors the Loan Limit—Not the Value of the Degree

Once Grad PLUS loans created the ability to borrow virtually unlimited funds, tuition migrated toward those ceilings. Programs that once cost $40,000 now routinely exceed $120,000–$200,000.

This phenomenon extends across the healthcare spectrum. Some of the most debt-heavy programs include:

• Physician Assistant (PA)

• Occupational Therapy (OT)

• Physical Therapy (PT)

• Speech-Language Pathology (SLP)

• Audiology (AuD)

• Respiratory Therapy (graduate-level)

• Genetic Counseling

• Nutrition/Dietetics (graduate degree now required for RDN)

These fields are undeniably professional, and undeniably overpriced. Not because the education suddenly became more valuable, but because the lending system allowed institutions to charge whatever students could borrow.

Debt Is Becoming the Hidden Cause of Workforce Instability

Burnout, staffing ratios, moral injury, administrative burden—these shape our workforce.

But here’s the issue no one wants to talk about:

We are training clinicians who cannot afford to work in the jobs they trained for.

A PT making $72,000 cannot service $145,000 of debt. An NP making $95,000 cannot manage $200,000. An SLP earning $68,000 cannot reasonably pay off $115,000. A PA buried under six-figure debt struggles under the same math.

These are not emotional arguments—they’re basic math.

When the economics don’t work, people leave.

Cutting Loan Limits Forces Schools To Finally Cut Tuition

Universities will adapt to financial constraints the same way every other sector does:

• Tuition will fall

• Programs will restructure

• Administrative bloat will shrink

• Online and hybrid programs will be priced realistically

• Institutions will prioritize efficiency over marketing

When the revenue stream contracts, cost structures change. This isn’t a threat to healthcare education—it’s the first meaningful step toward sustainability.

Lower Loan Limits Will Not Harm the Professions

Reduced loan availability will not:

• Devalue nursing, PA, PT, SLP, OT, or counseling

• Weaken clinical rigor

• Undermine accreditation

• Destroy the professional identity of any discipline

These fields are not defined by their price tags. They’re defined by competence, ethics, evidence-based practice, and outcomes. The only thing loan reform threatens is the assumption that tuition should rise in lockstep with federal borrowing capacity.

We Don’t Have a Tuition Problem—We Have a Lending Problem

We have misdiagnosed the crisis for decades. We blamed the wrong forces. We chased the wrong solutions.

Here’s the truth:

Tuition rises because loan limits rise. Tuition stops rising when loan limits stop rising. Tuition falls when loan limits fall.

And definitions matter. When the Department of Education misclassifies entire clinical disciplines as something less than professional, the policies based on those definitions lead us here—sky-high tuition, suppressed wages, and unsustainable workforce debt.

This is not the end of professional healthcare education. It is the beginning of accountability.

The Rage-Bait Narrative: How Social Media Is Undermining Professionalism

If you scroll through social media, you’ll notice a predictable pattern emerging. A handful of rage-bait accounts have seized on this loan-limit change and turned it into a spectacle—an opportunity to stir outrage, harvest clicks, and grow followings. These narratives are designed to provoke, not inform, and they are doing real damage to how the public views professional education.

Several themes are circulating:

• “This targets professions dominated by women—to push them back into the home.”

• “This weakens professions that monitor and report child abuse, making children more vulnerable.”

• “This proves nursing isn’t a real profession—so anyone can treat nurses however they want.”

These arguments are not only manipulative, they’re strategically engineered to inflame. They collapse under even basic scrutiny, but that’s not their purpose. Their purpose is virality.

And while most clinicians can recognize these as bad-faith talking points, the larger consequence is more insidious:

Every time these narratives spread, they make our professions look less grounded, less evidence-based, and less professional.

We cannot afford that.

Nursing, allied health, social work, education, architecture, counseling, physical therapy, law, engineering, these are not fringe disciplines. They are the backbone of public safety, public health, and public infrastructure. When we respond to a policy debate with rage rather than reason, we allow our detractors to define us.

This policy conversation deserves clarity, not conspiracy. It deserves expertise, not algorithms. And it deserves professional discourse—not bait designed to go viral.

Loan-limit reform has nothing to do with gender policing, silencing mandated reporters, or devaluing a profession. It has everything to do with an unsustainable financial model that has inflated graduate tuition to levels disconnected from reality.

When we respond thoughtfully and professionally, we protect the integrity of our fields. When we respond emotionally to rage bait, we lose control of the narrative.

Why I Wrote - The Shift Worker’s Paradox

This book exists because nurses, and all shift workers, deserve more than advice to “hydrate” or “adjust your sleep.” They deserve research-driven strategies to mitigate risk, preserve health, and understand the exposures they shoulder in service of others.

Author: R.E. Hengsterman, MSN, MA, M.E., RN

Registered nurse, night-shift administrator, and author of The Shift Worker’s Paradox

Nursewhowrites.com

For educational purposes only. Not medical advice.