Education Department adds nursing, other healthcare-related fields to list of professional degrees

The One Big Beautiful Bill Act, which was signed into law last July, includes several cuts to educational funding. The law caps undergraduate loans and eliminates the GRAD PLUS loan program for graduate and professional students. It also created a "new and simplified" Repayment Assistance Plan (RAP) that allows graduate students to borrow a maximum of $100,000 and professional students to borrow a maximum of $200,000.

However, the Education Department only categorized certain programs, such as medicine, pharmacy, dentistry, and law, as being professional. This meant that several healthcare-related professions, including nursing, physical therapy, and physician assistants, were excluded, leading to pushback from states and healthcare organizations.

In May, a coalition of 25 states and the District of Columbia sued Education Secretary Linda McMahon, arguing that she exceeded her authority and bypassed guardrails set by Congress by creating an arbitrary definition of "professional degree." Eight trade organizations, including the American Association of Nurse Practitioners and the PA Education Association, also filed their own lawsuit over the new federal loan limits.

Late last month, U.S. District Judge Beryl Howard issued a preliminary injunction in the trade organizations' lawsuit, saying that "Congress did not direct the Department to evaluate and update the regulatory definition" of professional degrees.

To follow the court's order, the Education Department issued a revised rule expanding the number of programs classified as professional degrees from 11 to 29. Nursing, physical therapy, athletic training, speech-language pathology, physician associates, and anesthesiologist assistants were among the fields added to the list.

However, agency officials said the change was temporary as the lawsuit continues to play out in court. "We will continue to make the case that the [previous] definition is both lawful and appropriate," said Education Department Undersecretary Nicholas Kent.

Ali Knight, a research director at Advisory Board, said that "the reinstatement of 18 disciplines, including nursing, to the professional degrees list is a positive step. However, given its temporary status, organizations should balance cautious optimism with sustained focus on strategies that safeguard long-term workforce sustainability."

To help organizations safeguard their workforce sustainability, nursing experts, including Knight and Advisory Board's Monica Westhead, outline five priorities:

• Impact analysis: Understand how loan caps affect pipelines for nursing, PA, and allied health roles.
• Workforce planning: Build strategies for recruitment, retention, and succession to prevent shortages. Providing nurses with career growth opportunities beyond advanced degrees can also help promote retention and offer nurses new ways to develop their skills.
• Operational efficiency: Reduce cognitive strain through workflow redesign and technology integration.
• Staff well-being: Reinforce with your teams that this change in definition does not diminish their roles as nurses, physical therapists, PAs, and other healthcare professionals. Embed mental health resources and resilience programs to combat burnout and other causes of discontent within the healthcare workforce.
• Innovation: Expand telehealth, team-based care, and predictive workforce models to meet demand.

(Douglas-Gabriel, Washington Post, 6/25; Douglas-Gabriel, Washington Post, 7/7; Binkley, Associated Press, 6/29)

HHS drops proposed rule banning Medicaid and Medicare funding for gender-affirming care

In December, HHS proposed a rule that would bar hospitals from providing gender-affirming care to children under the age of 18 or performing surgical interventions on transgender children as a condition of participating in Medicaid and Medicare, effectively blocking all Medicaid and Medicare funding for any services at hospitals providing pediatric gender-affirming care.

In response to the proposed rule, several major U.S. medical groups, including the American Medical Association and the Children's Hospital Association, expressed concerns about the potential impact on patients and urged HHS to rescind or withdraw the proposed rule.

Recently, NPR reported that HHS will no longer be finalizing the rule to block funding for hospitals providing pediatric gender-affirming care. The information was found in an official document obtained by NPR. So far, neither HHS nor CMS have commented on the matter.

According to Sam Bagenstos, a professor at Michigan Law who served as general counsel at HHS under the Biden administration, the Trump administration backing down from the proposed rule is "a victory for people who are defending the rights and interests of trans people."

However, Bagenstos added that this decision likely does not suggest "a more general retreat from the aggressive posture of the Trump administration."

(Simmons-Duffin, NPR, 7/13)

CMS launches Medicare GLP-1 Bridge program

Earlier this month, CMS launched the Medicare GLP-1 Bridge program, which aims to lower the cost of expensive weight-loss drugs for eligible Medicare and Medicare Advantage beneficiaries.

Under the program, which will run until the end of 2027, patients will be able to access GLP-1 medications from Novo Nordisk and Eli Lilly for $50 a month, regardless of dosage. To be eligible for the program, people need to be enrolled in Medicare Part D and have a body mass index (BMI) of at least 35, or a BMI of at least 27 with another health condition, such as prediabetes or a past heart attack.

However, patients who have health conditions that can be treated by GLP-1s and are already covered by Medicare, such as type 2 diabetes, are not eligible to participate in the program.

According to a KFF analysis, roughly 3.8 million people meet the eligibility criteria for the GLP-1 Bridge program and could access the drugs at significantly lower costs.

"For many older Americans living with obesity, this is a moment they and their families have been waiting for," said Jamey Millar, EVP for U.S. operations at Novo Nordisk. "We are committed to helping patients, caregivers, and healthcare professionals navigate this program with confidence."

Currently, longer-term coverage of GLP-1 drugs for weight loss is uncertain, but CMS Administrator Mehmet Oz said the agency plans to "carefully track participation and outcomes" to see whether an extension of the GLP-1 Bridge program or another solution would be the best option in the future.

"We can't decide what's going to happen long term with Bridge until we see some of the data," Oz said, adding that negotiations to lower costs with drug companies are ongoing.

(Swenson, Associated Press/The Hill, 7/1; Minemyer, Fierce Healthcare, 7/1; Olsen, Healthcare Dive, 7/1)