Closing the Door on the Healthcare Workforce: ADPA CEO Response to Federal Student Loan Regulations and the RISE Rulemaking

Peter Yen, DMSc, MSHA, PA-C, LSSGB

CEO, Academy of Doctoral PAs

I want to be clear about what’s at stake.

These new federal student loan regulations, outlined in the Department of Education’s Reimagining and Improving Student Education (RISE) final rule, are not just financial policy. They are workforce policy. And from where I sit, they move us in the wrong direction.

Let’s ground this in the actual rule.

The Department of Education, through its final regulations under the Federal Student Loan Program, establishes new borrowing limits for graduate and professional students and phases out the Graduate PLUS loan program.

It also eliminates multiple existing income driven repayment plans and replaces them with a narrower set of options, fundamentally changing how borrowers manage repayment.

And during the rulemaking process itself, stakeholders raised concern that these changes could discourage individuals from pursuing higher education due to borrowing limits and financial risk.

That’s not speculation. That’s documented in the Department’s own record.

Now let’s connect that to healthcare.

Professional healthcare education is not optional training. It is the gateway into the workforce. It is expensive, time intensive, and heavily dependent on federal financing. When you restrict access to that financing, you restrict access to the profession.

There’s no workaround. No shortcut.

You either fund the pipeline or you shrink it.

This rule shrinks it.

The assumption behind these changes is that limiting borrowing will control costs and promote responsible decision making. That sounds reasonable until you look at how education markets actually behave. Tuition does not rapidly fall because borrowing is capped. Instead, access becomes selective. Those with financial means continue forward. Those without are forced to reconsider or walk away.

That has consequences.

Fewer students entering training programs means fewer clinicians entering the workforce. And healthcare is not a sector where reduced supply quietly balances itself. Demand continues to rise. Patients still show up. Needs still grow. The pressure simply shifts onto the system and the people already in it.

The repayment changes compound the issue.

By phasing out existing income driven repayment plans, the rule reduces flexibility for early career professionals who are navigating high debt with relatively lower starting income. That flexibility has historically allowed clinicians to pursue work in underserved areas or mission driven roles without immediate financial collapse.

Take that away, or narrow it significantly, and you change behavior. Not in theory. In reality.

People make safer financial choices. They avoid risk. They move away from lower paying but high need environments.

Again, the system absorbs the impact.

Let’s be honest about what this is.

This is a policy aimed at correcting financial inefficiencies in the student loan system. That’s a fair goal. But it does so by tightening access to professional education rather than addressing the underlying drivers of cost.

And in doing so, it places healthcare directly in the line of fire.

From the standpoint of ADPA, and from my position leading an organization committed to advancing the physician associate profession, this approach is short sighted.

You don’t stabilize a system by restricting its input.

You don’t solve workforce shortages by making entry harder.

And you don’t improve healthcare outcomes by limiting who can afford to become a clinician.

If we want a stronger healthcare system, we need more trained professionals, not fewer. We need broader access to education, not narrower pathways.

Right now, this policy moves us in the opposite direction!

To overturn the Department of Education's April 2026 final rule eliminating Grad PLUS loans and capping graduate debt, stakeholders can: lobby Congress to pass legislation reversing the cuts, submit public comments, initiate legal challenges, and mobilize professional organizations to pressure the Department to expand the "professional" degree classification.