A provision in last summer’s One Big Beautiful Bill Act — President Donald Trump's signature budget legislation — limits the amount of money students can take out in federal student loans while they're pursuing certain advanced degrees. It places even stricter borrowing limits on those not earning “professional” degrees, which are expected to include advanced degrees in fields such as nursing and public health.
Now, research from the University of Michigan has found that high nursing school debt, coupled with the proposed caps on student loans, may force nurses out of the profession and put access to health care in jeopardy. The study, published in the journal Health Affairs Scholar, found almost a third of registered nurses and advanced practice nurses have student loan debt that could influence their decision to leave the profession.
“We often hear the term nursing shortage. It's really not a shortage of nurses. It's really a vacancy problem, which speaks to the need to make sure that our workplaces are strong and healthy, that nurses have the support they need,” said Christopher Friese, principal investigator of the study, and a professor of nursing and health policy at the University of Michigan.
The study analyzed responses from the 2022 Michigan Nurses Study, which surveyed 13,687 nurses with Michigan licenses.
Researchers found about 28% of registered nurses and 33% of advanced practice nurses hold student loans. Among nurses who have recently left or plan to leave their positions, 51% of those who carried student loan debt cited inadequate pay and benefits as the reasons for their departure. That compares to only 10% for nurses without debt.
Friese said keeping nurses in the field and encouraging them to pursue advanced degrees is important to health care access across the state. New student loan caps may make this more difficult.
“If nurses are carrying substantial debt for their basic RN program and they run up against this cap, they're not going to be able to borrow enough money to actually pay for graduate school,” Friese said. “So what we're really worried about is, placing this cap of $100,000 for debt for student loans would likely have fewer nurses pursuing advanced practice degrees.”
Nurses with advanced degrees have a wider variety of career options, serving as nurse practitioners, nurse midwives and nurse anesthetists who “deliver vital care that Michiganders need,” Friese said, adding that they also teach in nursing schools.
Of advanced practice nurses that have student loan debt, almost 30% already exceed the proposed $100,000 limit, which Friese said could drive them to seek another job. “It's hard to see how we could produce the number of advanced practice nurses that Michigan needs if we don't have that flexibility," Friese said.
