By Thoai D NgoShareNewsweek is a Trust Project memberDuring the early days of the COVID-19 pandemic, Americans shouted from balconies, clapped from windows and banged pots in nightly appreciation for nurses, public‑health staff and other essential workers. Five years later, those same workers are facing something unthinkable: a federal move to strip their degrees of “professional” status—to dramatically reduce the financial support for these degrees and diminish the legitimacy of those professions.
The Department of Education claims its recent proposal to redefine what counts as a “professional degree” is about costs. But in truth, it poses one of the sharpest threats in decades to our nation’s health‑workforce pipeline and Americans’ access to care. It will impact whether a child in a rural county, a senior in care, or a parent or child in an underserved community will get the care and services they need.
What This Policy Change Really Does
By recategorizing degrees such as nursing, public health, social work, physician assistant studies, audiology and physical therapy as “non‑professional,” the Department of Education is signaling that these fields are second-tier.
...In practice, these changes will reduce access to federal graduate‑loan programs, including Grad PLUS—a federal loan lifeline many graduate students rely on to enter fields like nursing and public health. They will also create major financial deterrents for students wishing to pursue careers in these fields, resulting in workforce shortages. And they will further devalue professions already facing burnout, shortages and recruitment challenges.
The consequences will not be evenly distributed. These fields disproportionately attract women and people of color—more than 80 percent of public‑health majors are women, and 55 percent are individuals of color. Reducing access to federal loans to cover the costs of these careers will shut out the very communities whose members most often return home to serve them—in rural towns, low‑income neighborhoods, tribal nations and immigrant communities.
Why This Matters for American Health
Public health and the broader health care ecosystem depend on a diverse constellation of professionals beyond doctors: nurses, nurse practitioners, social workers, behavioral scientists, physical therapists, public‑health professionals and more. According to the Bureau of Labor Statistics, the U.S. health care and social assistance sector faces over 2 million job openings every year.
Redefining these degrees would threaten an already fragile and strained pipeline. The U.S. is projected to face a 10 percent shortage of registered nurses (RNs) by 2027—roughly 208,000 full‑time RNs. More than 190,000 additional RN openings are expected annually through 2034. At the same time, local and state public‑health departments employ about 239,000 people nationwide, yet years of underinvestment, burnout and long-standing vacancies already leave many health departments unable to maintain basic services—from maternal-health home visiting to outbreak investigation. Reclassifying these degrees would further weaken that infrastructure and leave even more communities without essential protections.
Reducing access to federal loans will likely put graduate degrees beyond the reach of many students—particularly those from under‑represented or economically marginalized communities. The results will be devastating: fewer of these essential workers, which will result in reduced or eliminated services and entire communities being left behind.
If this proposal goes into effect, here’s what Americans will feel: a mother in rural Mississippi waiting weeks for her child’s asthma care because the only pediatric nurse practitioner has left; a Detroit home-health aide forced to abandon her dream of becoming a physical therapist when federal loans disappear; a first-generation student in Texas giving up a public-health career altogether.
What Policymakers Must Do Now
Congress, governors, state legislatures, education leaders, accreditation bodies and public‑health institutions must act urgently. First, they should reinstate and protect federal loan eligibility for all advanced degrees in essential health professions. They must also update the “professional degree”—unchanged since the 1990s—so that it reflects licensure, advanced training and the realities of today’s public‑health workforce rather than outdated prestige categories. In addition, the country must expand faculty capacity and training pipelines; nursing alone faces nearly 2,000 faculty vacancies. Lastly, leaders must strengthen recruitment from under‑represented communities to build a diverse, culturally competent workforce capable of meeting the nation’s health needs.
A Nation That Cannot Staff Its Health System Is Not Protecting Its People
Since nurses, nurse practitioners, public‑health workers, social workers and allied‑health professionals are essential to making America healthy again, this Trump administration proposal represents a direct threat to that goal. Today’s downgrade becomes tomorrow’s unstaffed clinic, tomorrow’s delayed vaccination campaign, tomorrow’s preventable crisis.
We are at a pivotal moment. In public health, our motto is simple: prevention first, equitable access always. But prevention depends on people; access depends on the workforce. When we devalue the degrees that underpin that workforce, we are not trimming bureaucracy—we are crippling the nation’s ability to care for itself.
Every American deserves to live in a community where health workers are trained, accessible and valued. Downgrading these degrees is not streamlining government or making degrees in these fields more affordable. It is dismantling America’s ability to care for its people—one nurse, one social worker, one public-health professional at a time.
Thoai D. Ngo, PhD, MHS, is the chair and professor of the Heilbrunn Department of Population and Family Health at Columbia University Mailman School of Public Health.
The views expressed in this article are the writer's own.
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