\n<\/p>\n
The Education Department has faced significant pushback since it dug its heels in on proposed caps for graduate student loans in the fall, only allowing students in select programs to borrow up to $200,000. <\/p>\n
And now, as the department enters the last stage of finalizing that proposal, a new coalition of health-care organizations is seeking to change the agency\u2019s mind.<\/p>\n
Formally launched Feb. 10, the coalition known as the Alliance for Healthcare Access and Workforce Development is composed of a variety of professional associations, colleges and universities, health systems, and patient advocacy groups. Yet they all share one goal\u2014to head off a loan-limit policy that they say could have disastrous implications for the medical field.<\/p>\n
\u201cFederal student loan policy should strengthen, not weaken, the education pipeline into essential health-care professions,\u201d said Katie Jordan, CEO of the American Occupational Therapy Association (AOTA), the group that spearheaded the alliance. \u201cAHAWD will allow policymakers to hear directly from the broad range of communities impacted by these decisions.\u201d<\/p>\n
The loan limits\u2014which were prompted by congressional legislation and fleshed out through a contentious rule-making process\u2014cap the amount a graduate student can borrow based on the type of program they enroll in. If their program is deemed \u201cprofessional,\u201d they can borrow up to $50,000 a year or $200,000 total; meanwhile, students in programs labeled \u201cgraduate\u201d can only take out half that\u2014$20,500 a year or $100,000 total. Under the proposed regulations, only 11 degree programs are considered professional.<\/p>\n
In addition to the caps, the legislation also ended the Grad PLUS program, which allowed students to borrow up to the cost of attendance.<\/p>\n
And while Republicans argued that capping loans was a logical way to address a national debt crisis and drive down college costs, many say the limits are too low and the caps could lead to shortages in critical professions. <\/p>\n
In the wake of the department\u2019s proposal, which is now open for public comment until March 2, several associations have sought to raise awareness about the caps and their concerns. For health care specifically, an industry with many high-cost, high-demand programs that didn\u2019t make the cut, pushing for a broader definition has become a top priority.<\/p>\n
For more information on how to submit a public comment, check out a recent story from Inside Higher Ed<\/em>.<\/p>\n And that\u2019s where the alliance comes in. Inside Higher Ed<\/em> spoke with Abe Saffer, AOTA\u2019s senior legislative representative, and Heather Parsons, the group\u2019s vice president of federal affairs, to learn more about why the coalition was developed and what it hopes to accomplish in the year ahead. <\/p>\n The conversation has been edited for length and clarity.<\/em><\/p>\n Q: I\u2019m curious; what led to the formation of the Alliance for Healthcare Access and Workforce Development? Was there one specific event that served as a tipping point?<\/strong><\/p>\n Abe Saffer<\/p>\n Saffer:<\/strong> It was the loan limits completely. When [the One Big Beautiful Bill Act] was first passed, we thought, based on the text of the bill, that it was going to be very broad. We thought it was going to be fine. So it didn\u2019t really begin until about two months after the bill passed when we started getting inklings from the Department of Education that this definition of professional programs was going to be interpreted in an extraordinarily narrow manner. That was different from what everyone was expecting based on the bill text and what we all thought congressional intent was. <\/p>\n But the real catalyst that made us go from just a loose coalition to something more formal was when the rule got consensus from the rule-making committee and it became clear that the narrow definition was going to be in the proposed rule. <\/p>\n We\u2019ve been very up front about this from the beginning: This is only about loan limits.<\/p>\n Heather Parsons<\/p>\n Parsons: <\/strong>I can add a little bit into that history. <\/strong>The One Big Beautiful Bill had so many different provisions. And while this loan limit was one that we were watching, this was definitely not top tier\u2014at least in the groups, the coalitions that I work with. Medicaid cuts were definitely the biggest thing that [the health-care groups] were tracking. So once it passed, and once the negotiated rule making started, and it was looking like the narrow definition was coming, that\u2019s when those health-care groups started talking about it more.<\/p>\n Q: You both have touched on<\/strong> this idea that a narrow definition of professional wasn\u2019t anticipated. Why was that? <\/strong><\/p>\n Saffer: <\/strong>When OBBBA was passed, it referenced a specific regulation [34 CFR 668.2(b)] that is technically still in effect. It was a very broad definition that was meant to have what we call this three-part test. It says that: <\/p>\n Then it went on to say that professional degrees \u201cinclude but are not limited to\u00a0\u2026\u201d and listed off 10 professions. And, frankly, if you look at a lot of health-care professions, including occupational therapy, we are three for three. So I think everyone internally was like, \u201cI don\u2019t know how we wouldn\u2019t fit into this.\u201d <\/p>\n Q: OK, so I hear loud and clear that this narrow definition is a concern, but why is that the case? What consequences could it hold for health-care professions?<\/strong><\/p>\n Parsons: <\/strong>I mean, I think you know this very well, but <\/strong>one of the other things that we haven\u2019t discussed is that OBBBA put an end to the Grad PLUS loan program. So as long as Grad PLUS had existed, these definitions of graduate and professional didn\u2019t really matter. It was ending that program that definitely put so much more focus on this definition.<\/p>\n Saffer: <\/strong>That was definitely very concerning because Grad PLUS not only would have higher limits, but the limits were not based on tuition. They were based on cost of attendance. <\/p>\n If you look at the annual limit [of $20,500], I have been able to find only a handful of programs\u2014literally, like three or four\u2014where the tuition itself is less than that amount. <\/p>\n A good example to look at would be the University of Oklahoma\u2019s [doctor of occupational therapy] program. The tuition itself is $21,000 or $22,000 a year, and that doesn\u2019t include fees and stuff that would be included. But the University of Oklahoma specifically has an estimated cost of attendance that\u2019s based on if you can\u2019t work\u2014which, if you\u2019re going to get your degree in occupational therapy or a lot of other health professions, you cannot work and go to school at the same time. So for rent, utilities, food, transportation, everything else that you need in order to get this degree, you\u2019re looking at almost two times the cap. A $22,000 tuition turns into roughly $60,000 of cost. <\/p>\n The concerning part for us is that, already, students are going to have to take out private loans that have much higher [interest] rates and are not as easy to get as federal loans just to fund the rest of their tuition [let alone their cost of attendance].<\/p>\n And so the concern for us when it comes to these loans is that there are going to be a lot of students [for whom] the idea of going into private debt by that much [makes them] very nervous. We\u2019re already hearing examples of that where they\u2019re delaying or deferring going to occupational therapy school until they figure out how this is going to actually impact them.<\/p>\n And so if a university looks at their enrollment and they see their entire health school is down whatever percent, and it\u2019s no longer profitable, they\u2019re going to [have to] look to figure out, how can we save money? Chances are it\u2019s closing those programs.<\/p>\n Q:<\/strong> We\u2019ve talked mostly about the concerns for students and institutions. Should the general public, as the people who then depend on those students to enter the workforce, be concerned?<\/strong><\/p>\n Saffer: <\/strong>I talk a lot about the student shortages and the student difficulties, because that\u2019s the clear and present danger. But the long term is absolutely the impact on health care in general. <\/p>\n If you start to have programs closed, which we believe will happen, you have far less students graduating. And the students that do graduate are going to have far higher debt and far higher loan payments. So the idea that they\u2019re going to work in some of the lower-paying-salary jobs, is just not going to happen. <\/p>\n Ultimately, not only are there going to be less practitioners around, the less you have of those folks, the more expensive everything else is going to be. And the ones that do exist will be working in settings that pay a little bit better.<\/p>\n I think there\u2019s gonna be a ton of unintended consequences that even I\u2019m still trying to wrap my head around. But ultimately, it\u2019s going to lower the number of folks entering a workforce that is already in severe shortage.<\/p>\n Parsons: <\/strong>I feel like this is coming at the worst of all times. We already have a challenge with burnout, with people leaving health care, with more stagnant wages in certain positions. <\/p>\n Q: Moving forward, what do you hope to accomplish as a coalition? <\/strong><\/p>\n Saffer: <\/strong>Short term, we\u2019re hoping that the department responds to the comments [on their proposed rule]. I would love to see the final rule being much broader and include professions like occupational therapy, physical therapy, nurse practitioners, physician associates\u2014all down the line. <\/p>\n In addition to that, Congress needs to act on a couple issues. The first is that there\u2019s no statutory mechanism for increases. When normal inflation takes place and $50,000 is not as much money as it is now, we would need to go back to Congress to get them to raise the cap, and that\u2019s going to be difficult. So I would love to see some type of way for it to be increased automatically without needing repeated congressional approval. <\/p>\n It also needs to be more inclusive of the cost of attendance versus just tuition. And that\u2019s because they\u2019re such intensive programs. They are essentially 9-to-5 jobs. So, if we get those three things done in the next year, that\u2019s fantastic. I\u2019m not anticipating it, but that\u2019d be great. Then we can shutter the coalition and go back to what we\u2019ve been doing. <\/p>\n Q: So far, the Trump administration has drawn a pretty hard line on how they\u2019re going to define \u201cprofessional.\u201d So what makes you think that you have the leverage to be able to make the change you\u2019re trying to make and develop a broader definition? <\/strong><\/p>\n Saffer: <\/strong>I mean, look, I share your outlook on everything. I think that the chances of the department making the changes are very unlikely. I wouldn\u2019t bet anything on it. But that all being said, the amount that we\u2019ve heard about this from the Hill and from the public outcry since we started advocating for change in August has increased our standing with policymakers. <\/p>\n And so even if the department comes out and says, \u201cThis definition is perfect. We\u2019re going to stick with it,\u201d at this point, we\u2019ve had five bills introduced in Congress that would address this in some way, including one that has eight Republicans on it. So there\u2019s a bipartisan desire to address this. And while I hope this doesn\u2019t come true, I do think that as workforce shortages increase and things become worse, the political will to fix this will increase with it.<\/p>\n","protected":false},"excerpt":{"rendered":" The Education Department has faced significant pushback since it dug its heels in on proposed caps for graduate student loans in the fall, only allowing students in select programs to borrow up to $200,000. 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