View source for Opposition to Proposed Rulemaking: Reimagining and Improving Student Education

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[[Category:Policy]]
{{Policy
| type = proposed rule
| full_name = Reimagining and Improving Student Education
| jurisdiction = federal
| agency = Department of Education
| sub_agency = Office of Postsecondary Education
| action = Proposed rule
| status = open for comment
| comment_start = 30 January 2026
| comments_due = 2 March 2026; 

Submitted (mlk-sn3u-2yhp)
| comment_url = https://www.regulations.gov/commenton/ED-2025-OPE-0944-0001
| docket = ED-2025-OPE-0944
| related_to = Title IV of the Higher Education Act (HEA) of 1965, Big Beautiful Bill (P.L. 119-21)
| website = https://www.ed.gov/about/news/press-release/myth-vs-fact-definition-of-professional-degrees
| fr_url = https://www.federalregister.gov/documents/2026/01/30/2026-01912/reimagining-and-improving-student-education
| regulations_gov = https://www.regulations.gov/document/ED-2025-OPE-0944-0001
}}
Submitted to:

Office of Postsecondary Education

U.S. Department of Education

400 Maryland Ave. SW, 5th Floor

Washington, DC 20202

Submitted via: Federal eRulemaking Portal at www.regulations.gov

Re: Notice of Proposed Rulemaking, RIN 1840-AD98, "Reimagining and Improving Student Education," 91 FR 4254 (January 30, 2026)

== PART I: INTRODUCTION AND STATEMENT OF INTEREST ==
We, the undersigned nursing students, healthcare professionals, and concerned citizens, submit this comment in vigorous opposition to specific provisions of the proposed regulations implementing the One Big Beautiful Bill Act (OBBB) as published in the Federal Register on January 30, 2026. While we recognize that the Department of Education faces the complex task of implementing statutory changes enacted by Congress, we believe the Department has exercised its limited discretionary authority in a manner that will cause profound and lasting damage to the nursing profession, to nursing students across the nation, and ultimately to the American healthcare system that depends critically on an adequate supply of well-educated nurses at all levels of practice.

The primary author of this comment, Michael Moates, Ed.D., LBA, CEAP, is currently enrolled in a Master of Science in Nursing – Direct Entry (MSN-DE) program at Herzing University, pursuing entry level nursing and advanced practice nursing credentials including Psychiatric-Mental Health Nurse Practitioner (PMHNP) certification at St. Thomas University (Houston, Texas). Dr. Moates brings to this comment not only the immediate personal stake of a nursing student who will be directly affected by these proposed regulations, but also extensive professional experience in education, policy analysis, and behavioral health that informs his understanding of both the regulatory process and the healthcare workforce implications at issue. His academic credentials span multiple disciplines, and his current work includes serving as an adjunct professor while simultaneously completing his nursing education, a pathway that exemplifies the kind of career transition these regulations will make financially impossible for future students.

The additional signatories to this comment represent nursing students at various stages of their educational journeys, from those just beginning prerequisite coursework to those nearing completion of doctoral programs. We represent multiple types of nursing programs including traditional BSN programs, accelerated second-degree programs, RN-to-BSN completion programs, direct-entry master's programs, post-master's certificate programs, and Doctor of Nursing Practice programs. We attend public universities, private nonprofit institutions, and for-profit colleges. We come from diverse backgrounds including career changers who left other professions to pursue nursing, military veterans transitioning to civilian healthcare careers, parents returning to school after raising children, and traditional students who knew from an early age that nursing was their calling. What unites us is our commitment to the nursing profession and our deep concern that the proposed regulations will erect insurmountable financial barriers that will prevent future students from following the paths we have chosen.

The Department's proposed definition of "professional student" at § 685.102(b) explicitly excludes nursing degrees, including the Master of Science in Nursing (MSN) and Doctor of Nursing Practice (DNP), from eligibility for the higher annual loan limit of $50,000 and aggregate loan limit of $200,000 that will be available to students pursuing degrees the Department has deemed "professional." Instead, graduate nursing students will be limited to the standard graduate student limits of $20,500 annually and $100,000 in aggregate limits that are wholly inadequate to cover the actual costs of advanced nursing education and that will force prospective nursing students to either abandon their educational goals, assume crushing private loan debt at unfavorable terms, or cobble together insufficient funding in ways that compromise their ability to focus on their demanding educational programs.

This comment will demonstrate that the Department's exclusion of nursing degrees from professional status lacks legal foundation in the statutory text and regulatory definition the Department purports to apply; contradicts the factual reality of advanced nursing practice, licensure, and professional independence; applies inconsistent standards when compared to other degrees the Department has included on the professional list; ignores the catastrophic healthcare workforce implications of restricting nursing education access; fails to adequately consider the costs that will be imposed on the healthcare system and on patients; disproportionately harms already underrepresented populations in nursing; and suffers from procedural deficiencies including apparent noncompliance with the Higher Education Act's master calendar requirement that calls into question whether the proposed July 1, 2026 effective date is legally attainable. We will further propose specific regulatory amendments that would remedy these deficiencies while remaining consistent with the Department's statutory obligations under the OBBB.

== PART II: PRELIMINARY PROCEDURAL CONCERN — INACCESSIBLE DOCKET ==
Before addressing the substance of the proposed regulations, we must raise significant procedural concerns that have impeded public access to this rulemaking and that call into question the viability of the proposed July 1, 2026 effective date.

=== Section A: Inaccessible Docket on Regulations.gov ===
[[File:Regulations.gov Error 30 January 2026.png|thumb|Regulations.gov Error 30 January 2026|296x296px]]
The Federal Register notice at 91 FR 4254 directs interested parties to submit comments through the Federal eRulemaking Portal at www.regulations.gov, referencing Docket ID ED-2025-OPE-0944. However, as of January 30, 2026—the date of publication, the direct link to this docket<ref>https://www.regulations.gov/document/ED-2025-OPE-0944</ref> (Saved here: https://web.archive.org/web/20260130155658/https://www.regulations.gov/document/ED-2025-OPE-0944) returns an error page rather than the docket materials. The error message states: "We're sorry, an error has occurred. A general error occurred while processing your request." The page suggests that "the link may be outdated or incorrect" or that "the document or docket you are looking for was not found."

This technical failure represents more than mere inconvenience. The Administrative Procedure Act requires agencies to provide meaningful opportunity for public participation in rulemaking. When the primary portal for accessing rulemaking materials and submitting comments is non-functional on the day of publication, the public's ability to participate is materially impaired. Stakeholders attempting to access the docket to review supporting materials, examine the Regulatory Impact Analysis, or begin the comment submission process are unable to do so through the designated channel.

We request that the Department take immediate action to resolve this technical issue and, if the problem persists for any significant duration, extend the comment deadline accordingly. The current 30-day comment period ending March 2, 2026, is already compressed given the complexity and significance of these regulations. Any period during which the Regulations.gov docket is inaccessible should not count against the time available for public comment.

We further request that the Department confirm, in the final rule preamble, the total duration of any accessibility issues with the Regulations.gov docket and explain what steps were taken to ensure that all timely-submitted comments were received and considered despite these technical difficulties.

=== Section B: Apparent Violation of the Higher Education Act Master Calendar Requirement ===
Of even greater significance, the timing of this proposed rulemaking raises serious questions about compliance with the statutory master calendar provisions of the Higher Education Act.

Section 482(c) of the Higher Education Act (20 U.S.C. § 1089(c)) establishes a master calendar requirement for regulations affecting Title IV student aid programs. This provision requires that regulations affecting programs under Title IV of the HEA be published in final form by November 1 prior to the start of the award year (July 1) to which they apply. If student aid regulations are not published in final form by November 1 of a given year, Section 482(c) provides that the regulations do not take effect until July 1 of the second year after that year—meaning regulations that miss the November 1 deadline face a delay of up to nearly 20 months before they can take effect.

The purpose of this master calendar requirement is clear: to provide institutions of higher education, students, and families with sufficient advance notice of the rules that will apply to student aid calculations and eligibility for the upcoming award year. The requirement recognizes that educational planning decisions are made months or years in advance, and that sudden regulatory changes can disrupt institutional operations and student financial planning in ways that cause substantial harm.

The proposed rule before us was published in the Federal Register on January 30, 2026. This is nearly three months after the November 1, 2025 deadline that would have been required for a final rule to take effect on July 1, 2026. Yet the proposed rule states that the regulations will be effective on July 1, 2026 (91 FR 4254). This timeline is facially inconsistent with Section 482(c) unless the Department intends to invoke an exception to the master calendar requirement.

The Department has not explained how it intends to reconcile this proposed rulemaking timeline with the master calendar requirement. The notice of proposed rulemaking does not invoke any statutory exception to Section 482(c). Congress has, in various statutes, provided that Section 482(c) "shall not apply" to specific regulatory changes—but such exemptions must be enacted by statute and do not arise automatically.

If the master calendar requirement applies to these regulations—and loan limits directly affect "the calculation of grant, loan, or work assistance to students" as described in Section 482(c)—then the Department's proposed July 1, 2026 effective date may be legally unattainable. A final rule published after November 1, 2025 would, under the plain terms of Section 482(c), not take effect until July 1, 2027 at the earliest.

We request that the Department clarify in any final rule:

# Whether Section 482(c) applies to the loan limit provisions of this rulemaking;
# If so, what statutory authority exempts these provisions from the master calendar requirement;
# If no exemption applies, whether the Department intends to revise the effective date to July 1, 2027 in compliance with Section 482(c); and
# How the Department will address the hardship to students and institutions if regulations affecting loan limits take effect with less than the notice period contemplated by the master calendar requirement.

The master calendar requirement exists precisely to prevent the kind of disruption that would occur if loan limits changed with minimal advance notice. Students currently enrolled in nursing programs, like Dr. Moates and the other signatories to this comment, made enrollment decisions based on reasonable expectations about federal loan availability. Institutions made admissions decisions, hired faculty, and planned clinical placements based on anticipated student enrollment. Suddenly reducing loan availability without adequate notice would upend these carefully laid plans and cause immediate harm to students, institutions, and ultimately to the healthcare workforce.

If the Department believes that the OBBB's statutory directive to implement these changes compels a July 1, 2026 effective date notwithstanding Section 482(c), we request that the Department explain this reasoning in the final rule and address whether the statutory conflict should be resolved in favor of the procedural protection that the master calendar provides to students and institutions.

=== Section C: Compressed Comment Period and Inadequate Notice ===
The procedural deficiencies identified above are compounded by the compressed timeline the Department has established for this rulemaking. The notice of proposed rulemaking provides only a 30-day comment period, ending March 2, 2026. For regulations of this complexity and consequence, spanning 77 pages in the Federal Register, affecting millions of students, restructuring the entire federal student loan program, and requiring analysis of detailed statutory text, regulatory definitions, and economic impact assessments, a 30-day comment period is manifestly inadequate.

Executive Order 12866 and longstanding agency practice recognize that complex rulemakings warrant extended comment periods to permit meaningful public participation. The Department's own regulations at 34 CFR 300.165 acknowledge that 60 days is the standard minimum for significant regulatory actions. The compressed 30-day period here is particularly problematic given that:

The proposed regulations were published on the same day the Regulations.gov docket was inaccessible, meaning stakeholders lost at least one day—and potentially more—of effective comment time due to the Department's technical failures.

The regulations require analysis not only of the Department's proposed text but also of the incorporated statutory definitions, the negotiated rulemaking history, the Regulatory Impact Analysis, and the supporting documentation, materials that stakeholders could not access through the designated portal on the day of publication.

The affected stakeholders include students currently enrolled in educational programs who face immediate and irreversible consequences if loan limits change mid-education, yet who have the least capacity to monitor Federal Register publications and prepare detailed regulatory comments while simultaneously managing demanding academic programs.

The January 30, 2026 publication date falls during the spring semester, when nursing students, like Dr. Moates and the other signatories—are engaged in intensive coursework and clinical rotations that leave minimal time for civic participation in regulatory processes.

We request that the Department extend the comment period by at least 30 additional days to provide stakeholders meaningful opportunity to analyze the proposed regulations and prepare substantive comments. Given the inaccessibility of the Regulations.gov docket on publication day and the apparent master calendar compliance issues, an extended comment period would also provide the Department time to address these procedural deficiencies before finalizing regulations that may face legal challenge on procedural grounds.

=== Section D: Cumulative Effect of Procedural Deficiencies ===
Taken together, the procedural deficiencies identified in this Part raise serious questions about whether this rulemaking can proceed on the timeline the Department has proposed. The Department has published a proposed rule after the master calendar deadline, with an inaccessible docket, during a compressed comment period, proposing an effective date that may be legally unattainable—all while seeking to implement changes that will profoundly affect the educational opportunities of hundreds of thousands of students.

We do not suggest that the Department has acted in bad faith. The OBBB imposed substantial implementation burdens on the Department with aggressive statutory timelines. But the solution to statutory pressure is not to sacrifice procedural regularity. If the Department cannot lawfully implement these regulations by July 1, 2026, the appropriate response is to acknowledge that reality and work with Congress to address any statutory conflicts—not to proceed with a rulemaking that may be procedurally defective from inception.

We urge the Department to take the following steps to address these procedural concerns:

# Immediately restore public access to the Regulations.gov docket and confirm the duration of any accessibility failures.
# Extend the comment period by at least 30 days, with the extension measured from the date the docket becomes fully accessible.
# Clarify in the final rule whether Section 482(c) applies to these regulations and, if so, what statutory authority permits a July 1, 2026 effective date.
# If no master calendar exemption applies, revise the effective date to July 1, 2027 and provide institutions and students adequate notice of the impending changes.
# Consider whether the cumulative procedural deficiencies warrant withdrawal and re-proposal of the rule with adequate time for proper notice-and-comment procedures.

The substance of these regulations is important, but so is the process by which they are adopted. Students, institutions, and the public deserve a rulemaking process that complies with statutory requirements and provides meaningful opportunity for participation. The procedural shortcuts evident in this rulemaking undermine public confidence in the regulatory process and expose the final rule to legal vulnerability that could delay implementation far longer than proper procedures would have required.

== PART III: BACKGROUND ON THE PROPOSED REGULATIONS AND NURSING EDUCATION ==

=== Section A: Overview of Relevant Provisions ===
The OBBB, signed into law by President Trump on July 4, 2025, made extensive changes to the federal student loan programs administered by the Department of Education. Among the most significant changes are new annual and aggregate loan limits for graduate and professional students that take effect for periods of enrollment beginning on or after July 1, 2026. The statute creates a distinction between "graduate students" and "professional students" that did not previously exist in the loan programs, with professional students eligible for substantially higher borrowing limits in recognition of the typically higher costs associated with professional degree programs.

Under the proposed regulations implementing these statutory provisions, graduate students who are not professional students will be limited to annual borrowing of $20,500 in Direct Unsubsidized Loans, with an aggregate lifetime limit of $100,000 (91 FR 4268-4269, proposed § 685.203(b)(2)(iv)(A)(1) and (e)(4)(i)). Professional students, by contrast, will be permitted to borrow up to $50,000 annually in Direct Unsubsidized Loans, with an aggregate lifetime limit of $200,000 (91 FR 4269, proposed § 685.203(b)(2)(iv)(A)(2) and (e)(5)). Additionally, the Graduate PLUS Loan program, which previously allowed graduate and professional students to borrow up to the full cost of attendance with no aggregate limit, is being phased out entirely for new borrowers beginning July 1, 2026 (91 FR 4267-4268, proposed § 685.200(b)(2)).

The dramatic difference between the graduate and professional loan limits, professional students can borrow two and a half times as much annually and twice as much in aggregate, makes the definition of "professional student" enormously consequential. Students in programs classified as professional will have access to federal loan funding that may cover most or all of their educational costs, while students in programs classified as merely graduate will face severe funding shortfalls that can only be addressed through private loans (if available and at whatever terms private lenders offer), personal savings, family support, or reduced enrollment and delayed completion.

The OBBB defines a professional student as "a student who is enrolled in a program of study that awards a professional degree (as that term is defined under section 668.2 of title 34, Code of Federal Regulations, and in effect on the date of enactment of July 4, 2025), upon completion of the program" (91 FR 4260-4261). The incorporated regulatory definition at 34 CFR 668.2 states that a professional degree is one that "signifies both completion of the academic requirements for beginning practice in a given profession and a level of professional skill beyond that normally required for a bachelor's degree" and notes that "professional licensure is also generally required" (91 FR 4262). The definition includes an illustrative list of ten fields: Pharmacy (Pharm.D.), Dentistry (D.D.S. or D.M.D.), Veterinary Medicine (D.V.M.), Chiropractic (D.C. or D.C.M.), Law (L.L.B. or J.D.), Medicine (M.D.), Optometry (O.D.), Osteopathic Medicine (D.O.), Podiatry (D.P.M., D.P., or Pod.D.), and Theology (M.Div., or M.H.L.).

The definition also states that these examples "include but are not limited to" the listed degrees, indicating that the list is illustrative rather than exhaustive (91 FR 4263). The Department has therefore engaged in an interpretive exercise to determine which additional degree programs, beyond the ten explicitly listed, meet the operative definition of a professional degree. Through this exercise, the Department has proposed to add Clinical Psychology (Psy.D. or Ph.D.) to the list of professional degrees (91 FR 4260-4261, proposed § 685.102(b)(2)(i)). The Department has also proposed to extend professional status to all programs within the same four-digit Classification of Instructional Programs (CIP) code grouping as the enumerated degrees, provided those programs meet the other criteria in the operative definition (91 FR 4263-4264).

Critically for purposes of this comment, the Department explicitly considered and rejected the inclusion of nursing degrees on the professional degree list. The Department's analysis of nursing degrees appears at 91 FR 4265-4266 of the proposed rule, where the Department concludes that "neither the MSN nor the DNP would satisfy the professional degree definition."

=== Section B: The Reality of Advanced Nursing Education ===
To understand why the Department's exclusion of nursing degrees is so harmful, it is necessary to understand what advanced nursing education actually involves, what it prepares students to do, and how the profession is structured.

Nursing education in the United States exists along a continuum that ranges from certificate programs for nursing assistants through doctoral programs preparing nurse scientists and advanced practice clinicians. The entry point for professional nursing, as distinguished from unlicensed assistive personnel, is licensure as a Registered Nurse (RN), which can be obtained through completion of either an Associate Degree in Nursing (ADN), typically a two-year program offered at community colleges, or a Bachelor of Science in Nursing (BSN), typically a four-year program offered at colleges and universities. Both pathways lead to the same RN licensure examination (the NCLEX-RN), and graduates of both types of programs can practice as registered nurses.

However, RN licensure is not the endpoint of nursing education or practice for a growing proportion of the nursing workforce. Advanced Practice Registered Nurses (APRNs) are nurses who have completed graduate-level education, at minimum a master's degree, and increasingly a doctoral degree—that prepares them for expanded roles in healthcare delivery. The four recognized APRN roles are Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified Nurse Midwife (CNM), and Certified Registered Nurse Anesthetist (CRNA). Each of these roles requires completion of an accredited graduate nursing program, passage of a national certification examination, and state licensure as an APRN in addition to underlying RN licensure.

The Master of Science in Nursing (MSN) is the traditional terminal practice degree for advanced practice nursing. MSN programs typically require two to three years of full-time study for students who already hold a BSN, or three to four years for students in direct-entry programs who enter with bachelor's degrees in fields other than nursing. The curriculum includes advanced coursework in pathophysiology, pharmacology, health assessment, and specialty practice areas, along with hundreds of hours of supervised clinical practice. Upon completion, graduates are eligible to sit for national certification examinations in their specialty area and to apply for state APRN licensure.

The Doctor of Nursing Practice (DNP) is a relatively newer degree that has rapidly become the preferred credential for advanced practice nursing. The American Association of Colleges of Nursing (AACN) has endorsed the DNP as the terminal practice degree for all APRN roles, and an increasing number of employers and states prefer or require doctoral preparation for advanced practice positions. DNP programs build on master's-level preparation with additional coursework in healthcare systems, quality improvement, evidence-based practice, and leadership, along with completion of a scholarly practice improvement project. The degree typically requires an additional one to two years of study beyond the MSN, or three to four years for students in BSN-to-DNP programs.

Direct-entry nursing programs deserve special mention because they represent a crucial pathway for diversifying the nursing workforce and attracting talented individuals from other fields, and because they fundamentally undermine the Department's rationale that nursing students are "already licensed nurses" when they begin their graduate programs.

Direct-entry Master of Science in Nursing (MSN-DE) programs, such as the program in which Dr. Moates is currently enrolled at Herzing University, admit students who hold bachelor's degrees in fields entirely unrelated to nursing. These students may have undergraduate degrees in psychology, biology, sociology, business administration, English literature, engineering, or any other discipline. They have never taken a nursing course. They have never held any nursing license. They have never worked a single shift as a nurse at any level. When they enroll in their direct-entry MSN programs, they are entering nursing for the first time—not advancing within a profession they have already joined, but beginning their nursing education from the very first principles of the discipline.

The structure of direct-entry MSN programs reflects this reality. Students in these programs complete foundational nursing coursework covering anatomy and physiology, health assessment, fundamentals of nursing practice, pharmacology, pathophysiology, and nursing theory. They learn to perform basic nursing skills, medication administration, vital sign assessment, wound care, patient positioning, and dozens of other fundamental competencies, in skills laboratories before ever touching a patient. They complete clinical rotations in medical-surgical units, pediatrics, obstetrics, mental health, and community health settings, gaining the same breadth of clinical exposure as students in traditional undergraduate nursing programs. Only after mastering this foundational content do they progress to the advanced practice curriculum that prepares them for their APRN specialty.

The timeline for direct-entry MSN programs reflects the compression of what would otherwise be years of sequential education. A traditional pathway to nurse practitioner practice might involve four years of undergraduate BSN education, followed by clinical practice as an RN to gain experience, followed by two to three years of MSN education, a total of eight to ten years or more from high school graduation to APRN licensure. Direct-entry MSN programs compress this timeline to approximately three years of continuous intensive study, enabling career changers to enter advanced practice nursing without first spending years working as entry-level RNs. This acceleration is educationally sound, the programs are designed to integrate foundational and advanced content in pedagogically appropriate ways, but it requires full-time commitment that precludes substantial outside employment.

Direct-entry Doctor of Nursing Practice (DNP-DE) programs follow a similar model but extend to the doctoral level. These programs admit students with non-nursing bachelor's degrees and prepare them for APRN practice through curricula that include foundational nursing content, advanced practice preparation, and the additional doctoral-level coursework in healthcare systems, evidence-based practice, quality improvement, and leadership that characterizes DNP education. Students complete scholarly practice improvement projects demonstrating their ability to translate evidence into clinical practice. The programs typically require three to four years of full-time study, producing graduates who enter practice with doctoral credentials and are prepared for leadership roles in healthcare delivery.

Both direct-entry MSN and direct-entry DNP programs exist because the nursing profession recognized that individuals with undergraduate education in other fields could become excellent advanced practice nurses. These programs open pathways into nursing for people who did not discover their calling until after completing other educational or career pursuits. They attract mature students with life experience, professional skills, and diverse perspectives that enrich the nursing profession and improve patient care. Military veterans who provided combat medical support and recognized their aptitude for healthcare. Teachers who observed the health challenges facing their students and wanted to make a greater impact. Scientists who realized they preferred direct patient care to laboratory research. Social workers who saw the limits of their ability to help clients without clinical training. Business professionals who experienced personal healthcare encounters that inspired them to pursue nursing. Parents who spent years caregiving for children or aging relatives and discovered a passion for healing work.

These students, who have never held nursing licenses, who have never worked as nurses, who are entering the nursing profession for the first time through their graduate programs, are precisely the students the Department's analysis ignores. The Department's assertion that graduate nursing students are "already licensed nurses when they begin the degree program" is simply, factually, demonstrably false for every single student enrolled in a direct-entry MSN or direct-entry DNP program. These students are not advancing within nursing; they are entering nursing. Their graduate degrees do not supplement existing nursing credentials; their graduate degrees provide their first and only pathway into nursing practice.

The number of students in direct-entry programs is substantial and growing. Hundreds of institutions across the United States offer direct-entry pathways to advanced nursing practice, enrolling thousands of students annually. These programs have expanded in recent years as the nursing profession has sought to address workforce shortages by opening additional pathways into practice. The American Association of Colleges of Nursing tracks enrollment in these programs and has documented steady growth as institutions respond to student demand and workforce needs.

The costs of direct-entry programs are among the highest in nursing education. Because students must complete both foundational and advanced nursing preparation, program lengths extend to three or four years of full-time study. Tuition over this extended period, combined with the living expenses that students must cover while precluded from significant employment, generates total educational costs that routinely exceed $100,000 and approach $200,000 at many institutions. The proposed annual loan limit of $20,500 would cover barely one-third of a single year's expenses for many direct-entry students. The proposed aggregate limit of $100,000 would be exhausted before students complete their programs, leaving them to find alternative financing for their final years of study or to abandon their educational goals entirely.

The Department's failure to account for direct-entry programs represents a fundamental analytical error that pervades the proposed rule's treatment of nursing. By assuming that all graduate nursing students hold prior nursing licenses, the Department has constructed a rationale for excluding nursing from professional status that does not apply to a significant portion of the affected student population. This error alone would be sufficient grounds to reconsider the Department's determination. When combined with the other legal and factual errors described in this comment, it demonstrates that the Department's exclusion of nursing is not the product of careful analysis but of unfamiliarity with the actual structure of nursing education and practice.

The costs of advanced nursing education are substantial and largely unavoidable. Nursing programs face high fixed costs including clinical placement fees paid to healthcare facilities that host students, liability insurance premiums, simulation laboratory equipment and maintenance, standardized patient programs, certification examination preparation resources, and the salaries of faculty members who must hold advanced degrees and maintain clinical expertise. Unlike some graduate programs where students can progress largely through independent study, nursing education requires intensive hands-on supervision, both in skills laboratories where students learn clinical techniques and in healthcare settings where students provide care to real patients under the watchful eyes of preceptors. These pedagogical requirements drive costs that cannot easily be reduced without compromising educational quality or accreditation standards.

The financial returns to advanced nursing education are strong, which is one reason students are willing to invest in these programs. Nurse practitioners earn median annual salaries of approximately $120,000-$130,000, with significant variation by specialty and geographic location. Certified registered nurse anesthetists earn median salaries exceeding $200,000. These earnings compare favorably to many other professional fields and represent substantial returns on educational investment. However, these returns materialize only after students successfully complete their programs and enter practice, and the proposed loan limits threaten to prevent many students from ever reaching that point.

== PART IV: THE DEPARTMENT'S RATIONALE FOR EXCLUDING NURSING IS LEGALLY AND FACTUALLY FLAWED ==

=== Section A: The Department's Stated Reasons for Excluding Nursing ===
The Department offers two primary justifications for its determination that nursing degrees do not qualify as professional degrees. These justifications appear at 91 FR 4265-4266 of the proposed rule, and we quote them at length to ensure accurate representation of the Department's reasoning:

First, the Department states that "neither the MSN nor the DNP would satisfy the professional degree definition because, for example, the degrees are not necessary for entrance into the nursing profession. While holders of an MSN or a DNP may obtain licensure as a nurse practitioner, students entering degree programs which lead to an MSN, or a DNP, are already licensed nurses when they begin the degree program. Therefore, Department does not believe that the MSN or the DNP satisfy a core aspect of the definition of professional degree."

Second, the Department states that "while the Department acknowledges that nurse practitioners engage in different forms of work than other nurses, the Department is hesitant to treat them as being distinct for the purpose of this regulation, primarily due to the fact that their practice authority (and therefore, their scope of work) differs substantially from state to state." The Department elaborates that "full practice authority states permit all nurse practitioners to evaluate patients; diagnose, order, and interpret diagnostic tests; and initiate and manage treatments, including prescribing medications and controlled substances, under the exclusive licensure authority of the state board of nursing, while restricted practice authority states require career-long supervision, delegation, or team management by another health provider in order for the nurse practitioners to provide patient care." Based on this variation, the Department concludes that "nurse practitioners cannot be said to be part of a distinct profession, meaning that the MSN and DNP are not requirements for entrance into a profession."

The Department adds a third rationale that applies to nursing and several other excluded fields: "the Department does not believe that the statute permits the classification of degrees as 'professional' when the degree leads to employment where the employee must be supervised by another professional who has, as required by their license and degree, more education, training, and qualifications than the person being supervised" (91 FR 4265-4266).

Each of these rationales is fundamentally flawed, as we demonstrate in the sections that follow.

=== Section B: The "Already Licensed" Rationale Conflates Distinct Professions ===
The Department's first rationale, that nursing degrees cannot be professional degrees because students are "already licensed nurses when they begin the degree program," reflects a fundamental misunderstanding of the structure of nursing practice and the relationship between entry-level nursing and advanced practice nursing.

The premise that MSN and DNP students are "already licensed nurses" is factually incorrect for a substantial portion of the student population affected by this rule. Direct-entry MSN programs, like the program Dr. Moates is attending, specifically admit students who are NOT licensed nurses. These students hold bachelor's degrees in fields other than nursing, biology, psychology, sociology, business, or any number of other disciplines, and enter nursing education with no prior nursing licensure. They complete their entire nursing education, from foundational concepts through advanced practice preparation, within the graduate nursing program. When they graduate, they have never worked as licensed nurses at any level; their first professional nursing role is as advanced practice registered nurses.

The Department's analysis simply ignores this entire category of nursing education. Direct-entry programs represent a significant and growing pathway into advanced practice nursing, enrolling thousands of students annually across hundreds of programs nationwide. These programs exist precisely because the nursing profession and nursing educators recognized that talented individuals from other fields could make excellent advanced practice nurses if provided appropriate educational opportunities. By assuming that all graduate nursing students are "already licensed nurses," the Department has written regulations based on factual premises that do not apply to a substantial portion of affected students.

Even for students who do hold RN licensure before entering graduate programs, the Department's reasoning reflects a categorical error. The Department treats "nursing" as a single, undifferentiated profession such that anyone licensed as a nurse at any level is already "in" the nursing profession and therefore cannot be entering a profession by obtaining additional education. This reasoning fundamentally misunderstands how healthcare professions are structured and how professional boundaries are defined.

Consider an analogy from the legal profession, which the Department has unquestionably included on the professional degree list. Many law students worked as paralegals or legal assistants before entering law school. Some states permit paralegals to perform certain legal tasks under attorney supervision, including limited court appearances in some jurisdictions. By the Department's reasoning, these individuals were "already in the legal profession" before law school, and therefore the J.D. degree should not be considered a professional degree because it is not "necessary for entrance into" the legal field. Obviously, this reasoning is absurd—paralegal work and attorney practice are understood as distinct, even though they exist within the same general field of law. The J.D. is required for entrance into the profession of attorney, regardless of what other legal-adjacent work the student may have done previously.

The same analysis applies to nursing. Entry-level registered nursing and advanced practice nursing are distinct professions with different educational requirements, different scopes of practice, different licensure, different certification, different professional responsibilities, and different roles within the healthcare system. An RN cannot perform the work of a nurse practitioner any more than a paralegal can argue cases in court. The fact that both exist within the broader field of nursing (or law) does not make them the same profession.

This understanding is reflected in how state licensing boards structure their regulatory frameworks. State boards of nursing issue separate licenses for RNs and APRNs, with separate application processes, separate examinations, separate renewal requirements, and separate practice standards. An individual who is licensed as an RN cannot legally function as a nurse practitioner; they must obtain separate APRN licensure, which requires graduation from an accredited graduate program and passage of a national certification examination. This is the hallmark of distinct professional status: separate licensure requirements based on separate educational preparation.

The Department's reasoning would, if applied consistently, exclude many degrees from professional status. Physical therapy doctoral students often have undergraduate degrees in exercise science or related fields that may have included some clinical exposure. Clinical psychology doctoral students may have worked as psychological technicians or behavioral health aides before entering doctoral programs. Pharmacy students may have worked as pharmacy technicians. Medical students may have worked as medical assistants or emergency medical technicians. In each case, one could argue that the students were "already in" the healthcare field before pursuing their professional degrees. The Department has not applied this reasoning to any of these fields, and it should not apply it to nursing.

=== Section C: The "Variable Practice Authority" Rationale Is Internally Inconsistent ===
The Department's second rationale, that nurse practitioners cannot constitute a distinct profession because their practice authority "differs substantially from state to state", applies a standard that the Department does not apply to any other field on the professional degree list and that is not found anywhere in the statutory text or regulatory definition.

The operative definition of professional degree requires that professional licensure be "generally required" to begin practice (91 FR 4262). The definition does not require uniform practice authority across all jurisdictions, uniform scope of practice, or absence of interstate variation in regulatory frameworks. Every profession on the Department's list exhibits significant variation in practice authority and scope of practice across state lines.

Attorneys provide the clearest example. The practice of law varies dramatically across jurisdictions: some states permit non-lawyers to provide certain legal services that other states reserve to licensed attorneys; bar admission requirements differ substantially among states; unauthorized practice of law statutes vary in scope and enforcement; and recent years have seen significant state-level experimentation with alternative legal service providers. No one would seriously argue that law is not a profession, or that the J.D. is not a professional degree, because of this interstate variation.

Physicians face their own patchwork of state regulations. Scope of practice rules differ among states regarding which procedures physicians may perform without specialist training, whether physicians may dispense medications from their offices, how physician supervision of other healthcare providers must be structured, and numerous other practice parameters. Medical licensing requirements, including examination passage standards and continuing education obligations, vary among states. Yet medicine remains unquestionably on the professional degree list.

Chiropractors operate under widely varying regulatory frameworks. Some states permit chiropractors to perform procedures that other states prohibit; some states allow chiropractors to order and interpret diagnostic imaging while others do not; scope of practice ranges from narrow spinal manipulation-only models to broad "portal of entry" models that encompass extensive diagnostic and treatment authority. The Department has not suggested that these variations disqualify chiropractic from professional status.

The Department's treatment of nurse practitioners as uniquely disqualified by practice variation reflects either unfamiliarity with how other professions are regulated or application of a double standard that demands uniformity from nursing while tolerating variation from favored fields.

Moreover, the factual premise underlying the Department's rationale is rapidly becoming outdated. The trend in state regulation of nurse practitioners has moved strongly and consistently toward full practice authority over the past two decades. Currently, 27 states plus the District of Columbia grant full practice authority to nurse practitioners, meaning that in a majority of U.S. jurisdictions, nurse practitioners can evaluate patients, diagnose conditions, order and interpret diagnostic tests, and initiate and manage treatments including prescribing medications, all "under the exclusive licensure authority of the state board of nursing" (91 FR 4265-4266). The trajectory of regulatory change points clearly toward continued expansion of full practice authority, not its contraction. The Department is basing its regulatory classification on a snapshot of state practice authority that is already obsolete and will become more so with each passing year.

The Department acknowledges that nurse practitioners in full practice authority states exercise independent professional judgment in precisely the same manner as physicians, dentists, optometrists, and other recognized professionals. The Department does not explain why the existence of some states with more restrictive frameworks should negate the professional status of nurse practitioners in the majority of states—and nationwide for federal regulatory purposes—any more than the existence of states with restrictive legal services rules negates the professional status of attorneys.

=== Section D: The "Supervision" Rationale Is Invented, Unsupported, and Inconsistently Applied ===
The Department's third rationale, that degrees cannot be "professional" if they lead to employment requiring supervision by another professional "who has, by virtue of their licensure, more education, training, and qualifications," is perhaps the most troubling because it reflects a standard that appears nowhere in the statute, nowhere in the incorporated regulatory definition, and nowhere in the Department's prior interpretive history.

The operative definition of professional degree, as set forth at 34 CFR 668.2 and incorporated by reference into the OBBB, contains four elements: (1) the degree signifies completion of academic requirements for beginning practice in a profession; (2) the degree signifies a level of professional skill beyond that normally required for a bachelor's degree; (3) professional licensure is generally required; and (4) the degree falls within certain specified fields or is comparable to degrees in those fields. Supervision, whether required, optional, or prohibited, is not mentioned. Practice independence is not mentioned. Collaborative practice arrangements are not mentioned. The Department has invented a fifth criterion that Congress did not enact and that the prior regulatory definition did not include.

The Department cannot lawfully add substantive requirements to a statutory definition through the rulemaking process. The OBBB specifically incorporated the regulatory definition "as in effect on the date of enactment," which was July 4, 2025 (91 FR 4260-4261). That definition did not include any supervision-related criterion. By adding such a criterion now, the Department is not interpreting the statute; it is amending it, which exceeds the Department's rulemaking authority.

Even if the Department could lawfully add new criteria to the professional degree definition, the supervision rationale would fail because it is applied inconsistently and inaccurately.

Consider medical education. Physicians holding the M.D. degree, which is unquestionably on the professional degree list, are not permitted to practice independently upon graduation from medical school. They must complete residency training lasting three to seven years depending on specialty, during which they practice under the supervision of attending physicians who have "more education, training, and qualifications" by virtue of having completed residency themselves. Residents cannot independently admit patients to hospitals, cannot perform procedures without attending oversight, cannot prescribe certain medications without attending co-signature, and must have their clinical decision-making reviewed and approved by supervisors. In many states, physicians remain under supervision requirements, such as chart review and consultation mandates, for years after completing residency, particularly in surgical specialties. Yet no one would argue that the M.D. is not a professional degree because new physicians practice under supervision.

The same pattern applies to Clinical Psychology, which the Department has added to the professional degree list in this very rulemaking. The Department notes that clinical psychology programs are "included with other professional degree programs requiring postgraduate training to obtain licensure" (91 FR 4263). In most states, clinical psychologists must complete one to two years of supervised postdoctoral experience before obtaining independent licensure. During this period, they practice under the supervision of licensed psychologists who have more experience and credentials. The Department does not consider this supervision requirement to disqualify clinical psychology from professional status.

Dentists, after completing their D.D.S. or D.M.D. degrees, often enter residency programs in oral surgery, periodontics, or other specialties, where they practice under the supervision of more experienced dentists. Optometrists in some states face limitations on their ability to prescribe certain medications or perform certain procedures and must collaborate with ophthalmologists for complex cases. Newly licensed attorneys typically have their work reviewed by senior partners and may face restrictions on court appearances or client contact. In each case, the existence of supervision or collaborative practice arrangements does not negate the professional status of the degree.

The Department's focus on supervision is particularly ironic given that the nursing profession has led the way in documenting the safety and effectiveness of independent APRN practice. Decades of research have established that nurse practitioners provide care that is at least equivalent in quality to physician care for conditions within the NP scope of practice, with high levels of patient satisfaction and no increased risk of adverse outcomes. This evidence base has driven the state-level policy movement toward full practice authority. The Department is punishing nursing for a regulatory framework that is already changing and that has no evidentiary basis in patient safety concerns.

=== Section E: The Department's Analysis Ignores the Structure of the Illustrative List ===
The Department's interpretive methodology claims to rely on the illustrative list of professional degrees at 34 CFR 668.2 to provide "additional contextual clues" about what Congress meant by a professional degree (91 FR 4262). If this methodology were applied consistently, it would support rather than undermine the inclusion of nursing.

The illustrative list includes theology, specifically the M.Div. (Master of Divinity) and M.H.L. (Master of Hebrew Letters). The Department's own footnote acknowledges that "states do not license, supervise, or regulate the practice of religion, including the licensure of clergy who may earn degrees in theology" (91 FR 4266 n.15). Theology degrees therefore fail the criterion that professional licensure is "generally required" to begin practice—not just in some states, but in all states. No state in the United States licenses clergy; no state requires any credential whatsoever to practice as a minister, rabbi, priest, imam, or other religious leader. Yet theology remains on the professional degree list without question.

If theology degrees qualify as professional degrees despite the complete absence of any licensure requirement, it is difficult to understand how nursing degrees can be excluded when they involve mandatory licensure at both the RN and APRN levels, national certification examinations, state regulatory oversight, and scope of practice limitations enforced through the legal system. Nursing is more regulated than theology by any conceivable measure.

The Department attempts to explain the theology anomaly by suggesting that the listed theology degrees meet other criteria even if licensure is not required (91 FR 4262 n.5). But this reasoning undermines the Department's own analysis of nursing. If degrees can qualify as professional even without meeting the licensure criterion, then the Department's concerns about nursing practice authority variation become irrelevant—nursing degrees clearly meet the other criteria (academic requirements for practice, skill beyond bachelor's level, doctoral-level education), and the licensure criterion is satisfied even more fully than for theology.

The illustrative list also includes optometry, chiropractic, and podiatry, fields that, like nursing, involve significant interstate variation in scope of practice and that, like nursing, sometimes involve collaborative or consultative relationships with physicians. The Department does not explain why variation in optometric scope of practice is acceptable while variation in nurse practitioner scope of practice is disqualifying.

== PART V: THE PROPOSED REGULATIONS WILL CAUSE SEVERE AND IRREVERSIBLE HARM ==

=== Section A: The Financial Reality Facing Nursing Students ===
The Department's proposed loan limits of $20,500 annually and $100,000 in aggregate are catastrophically inadequate for advanced nursing education. To understand the magnitude of this shortfall, it is necessary to examine the actual costs that nursing students face.

Tuition and fees for graduate nursing programs vary widely based on institution type, program length, and geographic location, but are substantial across the board. Public university MSN programs typically charge in-state students $15,000-$40,000 annually, with out-of-state students facing tuition that may be two to three times higher. Private nonprofit nursing schools often charge $40,000-$70,000 annually. For-profit institutions, which serve a disproportionate share of working adult students and students from underrepresented backgrounds, may charge comparable amounts. DNP programs add additional years of tuition expense beyond the master's level.

Direct-entry MSN programs, which compress foundational and advanced nursing education into intensive curricula lasting two to four years, involve total tuition costs that commonly range from $80,000 to $200,000. The Herzing University program that Dr. Moates attends, like many direct-entry programs, requires continuous full-time enrollment over multiple years, generating tuition obligations that quickly exhaust the proposed aggregate limit.

Beyond tuition, nursing students face substantial additional costs that students in other graduate fields may not encounter. Clinical placement fees can total thousands of dollars per semester as programs pay healthcare facilities to host students. Background checks, drug screens, and health compliance requirements (including vaccinations, titers, and annual TB testing) involve recurring costs. Students must purchase scrubs, stethoscopes, and other clinical equipment. Many programs require students to purchase expensive software packages for electronic health record training, standardized testing preparation, and clinical simulation. Certification examination fees, which must be paid upon graduation before the student can begin practice, add several hundred dollars more.

Living expenses during graduate nursing education are particularly burdensome because of the intensive nature of the programs. Unlike some graduate programs that allow students to work full-time while taking evening or weekend classes, nursing programs, especially those with substantial clinical components, require time commitments that make full-time employment impossible. Clinical rotations often begin early in the morning and run late into the evening; classroom and laboratory sessions are scheduled throughout the week; and the volume of studying required to master complex pharmacological, pathophysiological, and clinical content leaves little time for paid work. Students in accelerated direct-entry programs, who must master nursing fundamentals while simultaneously completing graduate-level coursework, face particularly crushing time demands.

The result is that many nursing students must finance not only their tuition and fees but also their living expenses through educational borrowing. A student whose annual educational costs total $60,000, comprising $40,000 in tuition and fees plus $20,000 in living expenses, would exhaust the proposed $20,500 annual limit before covering even half of their costs. Over a three-year direct-entry program, this student would need $180,000 to complete their education, but would be limited to $100,000 in federal loans, leaving an $80,000 gap that must somehow be filled.

=== Section B: The Inadequacy of Alternative Financing Options ===
The Department's Regulatory Impact Analysis acknowledges that reduced federal loan availability will force students to seek alternative financing, but dismisses this concern by noting that students may "pursue employment while enrolled or tak[e] out private loans" (91 FR 4296-4297). This analysis fundamentally misunderstands both the nature of nursing education and the realities of private credit markets.

Employment during nursing school is not a viable option for most students in accelerated and advanced practice programs. Clinical rotations are scheduled by healthcare facilities, not by students, and frequently conflict with work schedules. The cognitive demands of mastering complex clinical content while simultaneously providing safe patient care leave students exhausted; adding work hours would compromise both academic performance and patient safety. Nursing programs know this and often explicitly discourage or prohibit significant outside employment, particularly during clinical semesters. The Department cannot assume that students can simply work more hours to make up for inadequate loan access.

Private student loans are not a universal solution and may not be available at all to students who most need them. Private lenders conduct credit underwriting that considers the borrower's credit history, income, and debt-to-income ratio. Students who have limited credit histories, existing debt from undergraduate education, or gaps in employment during their educational careers may not qualify for private loans at any interest rate. Students who have experienced financial hardships, the very circumstances that often motivate career changes into stable healthcare fields, may have credit impairments that preclude private borrowing.

Even when private loans are available, they typically carry interest rates substantially higher than federal student loans, do not offer the income-driven repayment options that make federal loans manageable for borrowers with variable incomes, and do not provide the public service loan forgiveness pathways that appropriately incentivize employment in underserved areas and public health settings. A student who finances their nursing education with high-interest private debt will face larger monthly payments upon graduation, less flexibility during periods of financial stress, and reduced incentives to serve in high-need practice settings.

The Department's analysis also assumes that families can step in to fill financing gaps, noting that students may need to use "personal savings" or "family support" (91 FR 4296-4297). This assumption reflects a profound disconnect from the demographics of the nursing student population. Many nursing students are first-generation college graduates whose families lack the financial resources to contribute to graduate education. Many are working adults who have depleted savings to support themselves through the early stages of their programs. Many come from communities where intergenerational wealth transfer is limited by historical discrimination and structural inequality. The assumption that family wealth can substitute for adequate federal loan access perpetuates and exacerbates existing inequities.

=== Section C: The Nursing Workforce Crisis ===
The United States faces a nursing shortage of historic severity that threatens the stability of the healthcare system and the health of the American people. The proposed regulations will worsen this shortage by restricting educational access at precisely the moment when the nation most needs to expand its nursing workforce.

The Bureau of Labor Statistics projects the need for approximately 194,500 new registered nurses annually through 2032 to fill newly created positions and replace nurses who retire or leave the profession. This figure understates the challenge because it does not account for accumulated vacancies that already exist throughout the healthcare system. Hospital vacancy rates for registered nurses have risen sharply in recent years, with many facilities reporting that 10-20% of their nursing positions are unfilled. Long-term care facilities, which employ large numbers of nurses to care for aging populations, face even higher vacancy rates.

The shortage of advanced practice registered nurses is particularly acute. The Health Resources and Services Administration projects shortfalls of 40,000-50,000 nurse practitioners by 2030, with even larger shortages in certain specialties and geographic areas. Mental health, the specialty Dr. Moates is pursuing, faces critical workforce shortages that the proposed regulations will make worse. Psychiatric-Mental Health Nurse Practitioners (PMHNPs) provide essential services in a mental healthcare system already stretched beyond its capacity; reducing the pipeline of PMHNP graduates will leave more patients without access to care.

The nursing shortage has real consequences for patient care and health outcomes. Research consistently demonstrates that inadequate nurse staffing increases mortality rates, infection rates, and medication errors while reducing patient satisfaction and increasing lengths of hospital stay. When nurses are overworked because facilities cannot fill vacancies, quality suffers. When patients cannot access primary care because there are not enough nurse practitioners in their communities, chronic conditions go unmanaged until they become acute crises. When mental health patients cannot find PMHNP providers, they end up in emergency rooms or jails instead of treatment settings.

The proposed regulations will reduce the nursing education pipeline by erecting financial barriers that prevent qualified, motivated students from entering or completing advanced nursing programs. Students who would have become nurse practitioners, clinical nurse specialists, nurse midwives, or nurse anesthetists will be forced to abandon their educational goals or never begin them in the first place. The nursing shortage will deepen, patient care will suffer, and the healthcare system will be pushed closer to collapse.

=== Section D: Disproportionate Impact on Underrepresented Populations ===
The nursing profession has made significant progress in diversifying its workforce, but substantial disparities persist. Men represent only approximately 9.4% of registered nurses; Black or African American nurses represent approximately 7.2% of the workforce; Hispanic or Latino nurses represent approximately 5.6%. These underrepresentation rates are problematic because research demonstrates that workforce diversity improves patient care, enhances communication and trust between providers and patients, and reduces health disparities.

Career-changer programs, including direct-entry MSN programs like the one Dr. Moates attends, represent a crucial pathway for diversifying nursing. These programs attract individuals from underrepresented backgrounds who completed undergraduate education in other fields before discovering their calling to nursing. They attract military veterans who developed interest in healthcare during their service. They attract men who may not have considered nursing as a first career but who recognize its value after working in other fields. They attract individuals from lower-income backgrounds who worked after completing their bachelor's degrees and are now seeking to advance into professional careers.

These are precisely the populations least able to supplement inadequate federal loans with family wealth or favorable private credit terms. First-generation graduate students cannot call upon parents or grandparents who navigated graduate education financing. Students from lower-income backgrounds have not accumulated savings sufficient to bridge multi-year financing gaps. Students who took time between undergraduate and graduate education to work may have accumulated consumer debt that impairs their credit profiles for private borrowing. Military veterans transitioning from service may have limited civilian employment history that complicates credit evaluation.

The proposed regulations will disproportionately harm these populations by making advanced nursing education financially accessible only to students who can draw upon personal or family resources that underrepresented groups are less likely to possess. The result will be a nursing workforce that is more homogeneous, less representative of the patient population, and less capable of providing culturally competent care to diverse communities.

=== Section E: Impact on Rural and Underserved Communities ===
The nursing workforce distribution challenge extends beyond aggregate numbers to geographic distribution. Rural and medically underserved areas face nursing shortages far more severe than national averages, with vacancy rates that may exceed 25-30% in some regions. These communities often struggle to attract and retain healthcare providers of all types, but nurse practitioners are particularly critical because they may serve as the sole primary care providers in areas that cannot support or attract physicians.

Students from rural areas who pursue advanced nursing education often intend to return to their home communities to practice. These students bring knowledge of local culture, relationships with community members, and commitment to serving populations that often lack alternative healthcare options. They are exactly the providers rural communities need most.

However, students from rural areas also tend to come from lower-income backgrounds, to attend less selective undergraduate institutions, to have less family wealth available to support graduate education, and to face more limited private borrowing options. The proposed loan limits will fall most heavily on exactly the students most likely to serve in high-need settings upon graduation.

The Department's Regulatory Impact Analysis entirely fails to consider these geographic distribution effects. While the analysis discusses aggregate changes in loan volume and institutional revenue, it does not examine how the regulations will affect workforce distribution across practice settings. A complete analysis would recognize that restricting nursing education access will have magnified effects in communities that are already underserved.

== PART VI: THE DEPARTMENT'S REGULATORY IMPACT ANALYSIS IS INCOMPLETE AND MISLEADING ==

=== Section A: Healthcare System Costs Are Ignored ===
The Regulatory Impact Analysis accompanying the proposed rule examines costs and benefits primarily from the perspective of the federal student loan programs. The analysis considers changes in loan volume, projected savings from reduced loan forgiveness, administrative costs of implementing new systems, and transfers between the federal government and borrowers. What the analysis entirely fails to consider are the costs that will be imposed on the healthcare system and on patients as a result of a diminished nursing workforce.

These costs are substantial and will far exceed any savings the Department projects from reduced loan forgiveness. Consider the following categories of healthcare system costs that the Department's analysis ignores:

Increased temporary staffing costs: When healthcare facilities cannot fill nursing positions with permanent employees, they turn to temporary staffing agencies that supply travel nurses at premium rates. Travel nurse contracts typically cost facilities two to three times the cost of permanent staff, representing enormous additional expenditures that are ultimately passed on to patients and payers. The nursing shortage has already driven healthcare staffing costs to unprecedented levels; restricting the nursing education pipeline will extend and deepen this crisis.

Reduced healthcare access: When APRN supply cannot meet demand, patients face longer wait times for appointments, reduced availability of services, and in some areas complete absence of providers. The economic costs of delayed or forgone care include lost productivity from untreated conditions, increased emergency department utilization when chronic conditions become acute, and premature mortality from conditions that would be manageable with adequate primary care.

Poorer health outcomes: Research consistently demonstrates that nursing staffing levels correlate with patient outcomes including mortality rates, hospital-acquired infection rates, pressure ulcer development, medication error rates, falls, and readmissions. Facilities struggling to maintain adequate staffing due to workforce shortages will experience more adverse events, generating costs in terms of additional treatment, legal liability, and human suffering.

Physician burnout and system strain: Nurse practitioners and other APRNs provide essential capacity that extends the reach of physician providers. When APRN supply is insufficient, physicians face unsustainable patient volumes that contribute to burnout, already at crisis levels throughout the healthcare system. Physician burnout leads to reduced clinical hours, early retirement, and career changes that further diminish healthcare capacity.

A complete regulatory impact analysis would monetize these effects and weigh them against the projected savings from reduced loan forgiveness. Such an analysis would almost certainly conclude that the costs imposed on the healthcare system vastly exceed the benefits to the federal student loan programs.

=== Section B: Behavioral Responses Are Inadequately Modeled ===
The Department's analysis assumes that institutions will respond to reduced loan availability by lowering prices, based on research finding correlation between loan availability and tuition levels. This assumption may have some validity for graduate programs in fields where institutional costs are flexible and where market competition can drive price reductions. It has little validity for nursing education, where costs are largely fixed and where demand far exceeds supply.

Nursing programs face cost structures that cannot be substantially reduced without compromising educational quality or accreditation standing. Clinical placement costs are determined by healthcare facilities that have no incentive to reduce fees when demand for placement sites exceeds supply. Faculty salaries must be competitive with clinical practice compensation to attract qualified instructors, and faculty shortages already constrain nursing program capacity. Simulation equipment, skills laboratories, and other specialized facilities require capital investment and ongoing maintenance that cannot be avoided. Accreditation standards mandate specific faculty-student ratios, clinical hours, and educational resources that set minimum cost floors.

Unlike law schools or MBA programs, which might reduce costs by increasing class sizes, shifting to online instruction, or reducing specialized offerings, nursing programs have limited ability to become more efficient. The discipline simply requires hands-on supervision that is labor-intensive and therefore expensive.

The more likely institutional response to reduced student financing capacity is not price reduction but program contraction. Nursing programs may reduce enrollment—accepting fewer students into programs that already turn away qualified applicants due to capacity constraints. Some programs may close entirely, particularly at institutions serving lower-income student populations that cannot substitute private financing for federal loans. Remaining programs may shift focus toward students from wealthier backgrounds who can afford reduced federal loan access, abandoning the diversity and access missions that have characterized nursing education.

These behavioral responses will reduce nursing education capacity at exactly the wrong moment, generating healthcare workforce costs that the Department's analysis fails to consider.

=== Section C: Distributional Effects Receive Inadequate Attention ===
The Regulatory Impact Analysis acknowledges that the proposed regulations will affect different student populations differently, but does not adequately examine these distributional effects or weigh them in the overall cost-benefit assessment.

The analysis notes that private loans may be unavailable to borrowers "because non-Federal lenders deem the programs and institutions the students attend to be financially risky, or because the borrowers do not have adequate credit histories or cannot obtain a co-signer" (91 FR 4296-4297). This observation acknowledges that the regulations will have differential effects based on students' financial backgrounds, but the analysis does not follow through to examine what these differential effects mean for educational equity.

Students who can supplement federal loans with family resources will continue to access nursing education. Students who cannot, who are disproportionately first-generation students, students from lower-income backgrounds, students of color, and students from rural areas—will be excluded. The regulations will make nursing education less accessible to exactly the populations whose increased representation in the nursing workforce would most benefit patients and communities.

A complete analysis would examine these equity implications and either justify them based on countervailing considerations or modify the regulations to mitigate distributional harms. The Department has done neither.

== PART VII: THE DEPARTMENT'S INTERPRETATION CONTRADICTS PRIOR REGULATORY TREATMENT OF NURSING ==
The Department has, in other contexts and for other purposes, treated advanced nursing degrees as professional credentials. This inconsistent treatment creates administrative confusion, undermines regulatory coherence, and suggests that the exclusion of nursing from professional status in this rulemaking reflects considerations other than principled application of the operative definition.

For purposes of institutional accreditation, program approval, and eligibility for Title IV funding, the Department has long treated graduate nursing programs as professional programs subject to specialized accreditation requirements. The Commission on Collegiate Nursing Education and the Accreditation Commission for Education in Nursing evaluate nursing programs using standards developed specifically for professional healthcare education, not general graduate education standards.

For purposes of data collection and reporting through the Integrated Postsecondary Education Data System (IPEDS), the Department has classified certain advanced nursing programs as professional degrees. The National Center for Education Statistics, which operates IPEDS, uses classification schemes that recognize the professional character of advanced nursing credentials.

For purposes of graduate medical education funding and healthcare workforce planning, federal agencies including the Health Resources and Services Administration have treated nurse practitioners and other APRNs as distinct professional categories requiring specialized educational preparation.

The Department cannot coherently treat nursing degrees as professional for purposes of accreditation oversight, data classification, and workforce planning while simultaneously treating them as merely graduate for purposes of loan limits. Either nursing degrees are professional degrees with the characteristics that justify specialized regulatory treatment, or they are ordinary graduate degrees that require no special attention. The Department has historically treated them as professional; its sudden reversal in this rulemaking demands explanation that the Department has not provided.

== PART VIII: REQUESTED REGULATORY MODIFICATIONS ==
In light of the foregoing analysis, we request that the Department modify the proposed regulations in one or more of the following ways:

=== Option A: Add Nursing to the Professional Degree List ===
The most appropriate remedy would be to add nursing degrees to the list of professional degrees at proposed § 685.102(b)(2)(i). Specifically, we request that the Department add the following language:

"Nursing (MSN, DNP, or equivalent degrees from accredited nursing programs when such degrees lead to eligibility for licensure as an Advanced Practice Registered Nurse, including Nurse Practitioner, Clinical Nurse Specialist, Certified Nurse Midwife, and Certified Registered Nurse Anesthetist)"

This modification would recognize that advanced nursing practice constitutes a distinct profession with separate licensure requirements, scope of practice, and professional responsibilities from entry-level nursing. It would align with the operative definition by recognizing that MSN and DNP degrees signify completion of academic requirements for beginning practice in advanced nursing, represent skill levels beyond bachelor's preparation, and lead to mandatory professional licensure. It would support critical healthcare workforce needs by maintaining educational access for prospective nurse practitioners and other APRNs. And it would treat nursing consistently with other healthcare professions including medicine, dentistry, pharmacy, and optometry that involve similar educational structures, licensure requirements, and practice frameworks.

=== Option B: Apply the 4-Digit CIP Code Methodology to Nursing ===
The Department has proposed to extend professional status to programs within the same four-digit CIP code groupings as the enumerated professional degrees, reasoning that programs in the same intermediate classification share "comparable content and objectives" with the listed degrees (91 FR 4264). We request that the Department apply this same methodology to nursing.

The Classification of Instructional Programs includes CIP code 51.38, which covers Registered Nursing, Nursing Administration, Nursing Research and Clinical Nursing. Graduate nursing programs within this classification prepare students for advanced clinical practice, nursing leadership, and specialized nursing roles. These programs share common characteristics: intensive clinical training, preparation for advanced licensure, development of specialized skills beyond bachelor's-level nursing, and pathways to distinct professional practice.

Applying the 4-digit CIP methodology to nursing would provide administrative clarity by using classification systems that institutions already employ for IPEDS reporting and other regulatory purposes. It would treat nursing consistently with the methodology the Department has applied to other fields. And it would recognize the professional character of advanced nursing education without requiring the Department to create a separate category specifically for nursing.

=== Option C: Modify the Operative Definition to Capture Nursing Accurately ===
The Department's exclusion of nursing relies heavily on the reasoning that nursing degrees do not provide "entrance into a profession" because students may already hold RN licensure. We request that the Department modify the operative definition to clarify that professional degrees include those providing entrance into specialized professional practice within a field, not only those providing initial entry to any practice within the field.

Specifically, we request that the Department amend proposed § 685.102(b)(1)(i) to read:

"Signifies both completion of the academic requirements for beginning practice in a given profession or for beginning specialized or advanced practice within a profession that requires separate licensure or certification, and a level of professional skill beyond that normally required for a bachelor's degree;"

This modification would accurately capture the structure of advanced nursing education, and of advanced practice in many other fields, while remaining consistent with the statutory framework. It would recognize that professions may include multiple tiers of practice requiring distinct educational preparation and credentials, and that degrees qualifying individuals for higher tiers are professional degrees even when entry-level practice is possible with lesser credentials.

=== Option D: Create a Healthcare Workforce Exception ===
If the Department declines to classify nursing as a professional degree through any of the above mechanisms, we request that the Department use its authority under the institutionally-determined loan limit provision at proposed § 685.203(m)(2) to create flexibility for healthcare workforce programs.

The proposed regulations permit institutions to "limit the total amount of Direct Loans that a student, or a parent on behalf of such student, may borrow for a specific program of study" (91 FR 4271). We request that the Department interpret this provision, or add a parallel provision, to permit institutions to certify eligibility for higher loan limits for students in healthcare programs addressing documented workforce shortages.

Under this approach, institutions offering graduate nursing programs could certify that their programs prepare students for healthcare professions facing critical workforce shortages, and students in those programs would be eligible for the professional student loan limits of $50,000 annually and $200,000 in aggregate. This certification would be subject to Department verification and would be available only for programs demonstrating workforce need through objective measures such as Health Resources and Services Administration shortage designations or Bureau of Labor Statistics projections.

=== Option E: Remove the Invented Supervision Criterion ===
At minimum, we request that the Department remove all references to supervision arrangements as factors in determining professional degree status. The supervision criterion appears nowhere in the statutory text or incorporated regulatory definition, is applied inconsistently to other fields, and reflects factual misunderstandings about how healthcare professions are structured.

The Department should clarify that the professional degree analysis considers only the four factors in the operative definition: (1) completion of academic requirements for beginning practice; (2) skill level beyond bachelor's degree; (3) general requirement of professional licensure; and (4) comparability to enumerated degrees. Supervision arrangements, collaborative practice requirements, and interstate variation in scope of practice are not relevant to this analysis and should not be considered.

== PART IX: SPECIFIC COMMENTS ON REGULATORY TEXT ==
Beyond our primary objection to the exclusion of nursing from professional status, we offer the following specific comments on provisions of the proposed regulations that will affect nursing students:

=== Section A: Definition of "Expected Time to Credential" (§ 685.102(b)) ===
The proposed definition of "expected time to credential" provides important protection for students who are enrolled in programs as of June 30, 2026, by grandfathering them into the prior loan limits for their expected completion period. We support this provision but note that the three-academic-year limit on expected time to credential may be inadequate for some nursing programs.

Direct-entry MSN programs, which admit students without prior nursing education, often require more than three years to complete because students must master both foundational nursing content and advanced practice preparation. A three-year expected time to credential may force some currently enrolled students into the new lower loan limits before they complete their programs, creating unexpected financial hardship mid-education.

We request that the Department either extend the expected time to credential limit for healthcare professional programs, or clarify that the three-year limit applies to anticipated program length at the time of enrollment rather than elapsed time from the effective date of the regulations.

=== Section B: Aggregate Limit Structure (§ 685.203(e)(4)) ===
The proposed aggregate limit structure creates a distinction between graduate students "who are not and have never been a professional student" (limited to $100,000) and graduate students "who are or have been a professional student" (limited to $200,000 minus amounts borrowed as a professional student) (91 FR 4269). This structure is intended to prevent students from first exhausting professional limits and then accessing additional graduate limits.

However, the structure creates an anomaly for students who begin professional programs, leave without completing, and later enter graduate programs. Such students would be subject to the $200,000 limit minus their prior professional borrowing, rather than the $100,000 graduate limit. This may result in lower available borrowing for some students than if they had never entered professional programs.

We request clarification of how the aggregate limit applies to students who borrow as professional students but do not complete professional degrees. Such students should not be disadvantaged relative to students who never entered professional programs.

=== Section C: Less Than Full-Time Enrollment Provisions (§ 685.203(m)(1)) ===
The proposed regulations implement the OBBB requirement that students enrolled less than full-time receive prorated loan amounts. We understand this provision is statutory and the Department has limited discretion. However, we note that nursing students may have their enrollment status reduced involuntarily due to factors beyond their control, such as clinical placement availability or course scheduling conflicts.

We request that the Department clarify that the less-than-full-time proration applies based on enrolled credits at the time of disbursement, as the proposed regulations state (91 FR 4270-4271), and that institutions may certify enrollment status changes that occur after disbursement without requiring immediate repayment or adjustment.

=== Section D: Repayment Assistance Plan Provisions (§ 685.209) ===
The proposed Repayment Assistance Plan offers improvements over current income-driven repayment options in some respects, including the interest subsidy and principal matching provisions that prevent negative amortization. We support these features and believe they will benefit borrowers including nursing graduates.

However, we note that the 30-year repayment period before forgiveness under the Repayment Assistance Plan is substantially longer than the 20-25 year periods under current plans. For nursing graduates who pursue Public Service Loan Forgiveness (available after 10 years of qualifying payments), this change may be less significant. For graduates who do not pursue PSLF-qualifying employment, the extended repayment period represents a substantial reduction in forgiveness benefits.

We request that the Department consider whether healthcare professionals, who provide essential public services regardless of employer type, should receive enhanced forgiveness timeline benefits comparable to those available through PSLF.

== PART X: CLOSING ==
The Department's proposed exclusion of nursing degrees from professional status reflects legal error, factual misunderstanding, procedural deficiency, and policy failure.

The exclusion is legally erroneous because it applies criteria that appear nowhere in the statute or incorporated definition, applies those criteria inconsistently compared to other fields, and contradicts the Department's prior regulatory treatment of nursing education.

The exclusion reflects factual misunderstanding because it conflates entry-level nursing with advanced practice nursing, mischaracterizes the structure of nursing licensure and practice authority, relies on an outdated snapshot of state regulatory frameworks that have moved strongly toward full practice authority, and entirely ignores the existence of direct-entry MSN and DNP programs that admit students who have never held any nursing license and are entering the nursing profession for the first time through their graduate education.

The rulemaking process itself suffers from procedural deficiencies that undermine its validity. The Regulations.gov docket was inaccessible on the day of publication, impeding public participation in violation of Administrative Procedure Act principles. More fundamentally, the Department's proposed July 1, 2026 effective date appears to violate the Higher Education Act's master calendar requirement at Section 482(c), which mandates that final rules affecting Title IV programs be published by November 1 of the preceding year. The proposed rule was published on January 30, 2026, nearly three months after the November 1, 2025 deadline. Under the plain terms of Section 482(c), regulations published after November 1 cannot take effect until July 1 of the second following year, which would be July 1, 2027. The Department has not explained what statutory authority, if any, exempts this rulemaking from the master calendar requirement. If no exemption applies, the proposed effective date is legally unattainable, and students and institutions are being asked to comment on regulations that cannot lawfully take effect when the Department proposes.

The exclusion represents policy failure because it will restrict nursing education access at a time of critical workforce shortage, impose costs on the healthcare system that vastly exceed any savings to the loan programs, and disproportionately harm underrepresented populations whose increased presence in nursing would benefit patients and communities.

We urge the Department in the strongest possible terms to reconsider the proposed exclusion of nursing degrees and to adopt one of the alternative approaches we have described. The nursing profession, nursing students, healthcare institutions, and most importantly the patients who depend on adequate nursing workforce supply deserve regulatory treatment that reflects the professional reality of advanced nursing practice.

If the Department proceeds with the proposed exclusion despite the evidence and arguments we have presented, it will bear responsibility for the consequences: nursing programs that close or contract; students who abandon their educational goals or assume crushing private debt; workforce shortages that deepen and spread; patients who cannot access care; and a healthcare system that fails the American people when they need it most.

The Department has an opportunity to make a different choice. We hope it will do so.

== Signatories ==
{| class="wikitable"
|+
!Names
|-
|Michael Moates, Ed.D., QBA, LBA, CEAP
Advocacy Leader, Graduate Nursing Student Academy, American Association of Colleges of Nursing

MSN-DE Candidate, Herzing University

St. Thomas University, Psychiatric-Mental Health Nurse Practitioner Track

Fellow, Institute for Social Innovation, Fielding Graduate University
|-
|Jasmine Bond
MSN-DE Candidate, Herzing University
|-
|Ayla Rose
MSN-DE Candidate, Herzing University
|-
|Stormie West
MSN-DE Candidate, Herzing University
|-
|Alicia Mendiola, MSN, RN
Assistant Dean, Galen College of Nursing

Doctor of Nursing Practice Candidate
|-
|Ofure Aibuedefe, BScN, RN
Doctor of Nursing Practice Candidate, University at Buffalo-SUNY
|}

== APPENDIX A: SUMMARY OF REQUESTED MODIFICATIONS ==

* Primary Request: Add nursing degrees (MSN, DNP) to the professional degree list at § 685.102(b)(2)(i) when such degrees lead to Advanced Practice Registered Nurse licensure.
*# Alternative Request A: Apply the 4-digit CIP code methodology to CIP 51.38 (Registered Nursing, Nursing Administration, Nursing Research and Clinical Nursing) to extend professional status to graduate nursing programs.
*# Alternative Request B: Modify § 685.102(b)(1)(i) to clarify that professional degrees include those providing entry to specialized or advanced practice within a profession requiring separate licensure.
*# Alternative Request C: Create institutional certification authority for healthcare workforce programs addressing documented shortages to access professional student loan limits.

* Minimum Request: Remove all references to supervision arrangements as factors in professional degree determination, as this criterion appears nowhere in statute or regulation and is applied inconsistently.
* Procedural Request A: Extend the comment deadline to account for any period during which the Regulations.gov docket (ED-2025-OPE-0944) was inaccessible, and confirm in the final rule preamble the duration of any accessibility issues and steps taken to ensure all comments were received.
* Procedural Request B: Clarify how the proposed July 1, 2026 effective date complies with the Higher Education Act master calendar requirement at Section 482(c), which requires final rules to be published by November 1 of the preceding year. If no statutory exemption applies, revise the effective date to July 1, 2027 or explain the legal basis for proceeding with the earlier date.

== APPENDIX B: DOCUMENTATION OF REGULATIONS.GOV ACCESS FAILURE ==
On January 30, 2026—the date of publication of the Notice of Proposed Rulemaking in the Federal Register, the undersigned attempted to access the regulatory docket through the direct link provided in the Federal Register notice. The URL <nowiki>https://www.regulations.gov/document/ED-2025-OPE-0944</nowiki> returned an error page with the following message:

'''''"We're sorry, an error has occurred A general error occurred while processing your request. What could have caused this? The link may be outdated or incorrect. The document or docket you are looking for was not found."'''''

This error prevented access to the docket materials, supporting documents, and comment submission portal on the first day of the comment period. We have preserved a screenshot of this error for the record and request that the Department investigate the cause and duration of this accessibility failure.

== References ==
<references />2. 34 CFR § 668.2. Definitions (as in effect July 4, 2025).
3. 34 CFR § 685.102 (proposed). Definitions.

4. 34 CFR § 685.203 (proposed). Loan Limits.

5. 34 CFR § 685.209 (proposed). Income-Driven Repayment Plans.

6. One Big Beautiful Bill Act, Pub. L. 119-21 (2025).

7. 20 U.S.C. § 1087e (Higher Education Act, as amended).

8. American Association of Colleges of Nursing. Nursing Shortage Fact Sheet (2024).

9. American Association of Nurse Practitioners. State Practice Environment (2025).

10. Bureau of Labor Statistics. Occupational Outlook Handbook: Registered Nurses (2024).

11. Health Resources and Services Administration. National Center for Health Workforce Analysis: Nursing Workforce Projections (2024).

12. National Center for Education Statistics. Classification of Instructional Programs (CIP) (2020).