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When the administration’s One Big Beautiful Bill became law in July 2025, it included provisions for overhauling the nation’s federal student loan system. In the months since, the Department of Education convened a Reimagining and Improving Student Education (RISE) Committee, with the goal of placing “commonsense limits and guardrails on future student loan borrowing and [simplifying] the federal student loan repayment system.”
RISE Committee has proposed that designated nonprofessional graduate programs, which include physician associate (PA) programs, have federal student loan caps of $20,500 per academic year — with a lifetime limit of $100,000. The proposed rule immediately raised alarm bells for PA advocates across the country. With looming healthcare provider shortages, it was unclear how such caps might influence the future PA graduate pipeline.
The American Association of Physician Associates (AAPA) quickly fielded a survey to more than 4500 PAs, PA students, and prospective PA students to understand the potential fallout.
“We really wanted to know the thoughts of [PAs, students, and prospective students] and hear their stories,” said Todd Pickard, DMSc, PA-C, president and chair of the Board of Directors at AAPA. “And 84% of the people who did the survey said they felt these caps would decrease the number of people who would ultimately apply to PA school.”
About Medscape Insights
Medscape continually surveys physicians and other medical professionals about key practice challenges and current issues, creating high-impact analyses. For example, Feeling the Impact of the Physician Shortage Medscape Report 2025 found that:
- 34% of doctors surveyed said the number of qualified nurse and PA applicants stayed about the same over the past 3 years.
- 52% of physicians said there is a shortage of qualified nurse and PA applicants in their local area.
- 16% of doctors surveyed said that new patients have been turned away due to healthcare professional shortages.
A Numbers Mismatch
Lisa Walker, PA-C, founding director of the PA program at Endicott College in Beverly, Massachusetts, said the results from the AAPA survey did not surprise her — it comes down to simple math. With an annual cap of $20,500 and a lifetime cap of $100,000, many students would struggle to cover tuition and living expenses while in school.
“It’s important to keep in mind that most PA programs are 2 years long. That means students can only get a total of $41,000 in federal student loans under this rule,” she explained. “The typical tuition for programs is around $100,000 plus fees. Most people can’t work while in PA school, so they also need money to live on. And the reality is, if you have to come up with an extra $30-40,000 each year from your own pocket or from higher-interest private loans, PA school is going to be out of reach for a lot of people.”
Kris Pyles-Sweet, DMSc, PA-C, a board member of the AAPA PA Foundation, the philanthropic arm of the AAPA, agreed and added that she’s been hearing concerns about how to fund PA education from many current and prospective students. And she understands those concerns personally.
“Federal student loans were essential for me to become a PA. As a single mother at the time, there is simply no way I could have completed PA education without access to those loans,” she said. “Many students, those who will be most affected by this change, have shared feelings of frustration after working so hard to get into school and become a PA, that their dream may be cut short.”
Estelle Yamoah, who is currently completing her master’s degree in public health and planned to apply to PA school, is one of those students. She said she sees this as another barrier to achieving her dream of providing family medicine care to patients in medically underserved areas. She, like more than three quarters of the AAPA survey participants, believes that these federal school loan caps will reduce the number of PAs practicing in the rural and medically underserved communities that need them most.
“People who were once really excited to be PAs are saying they might not continue on,” she said. “I really want to be in this field. I’ve spent a lot of time and a lot of money on my education so far. I’m keeping my fingers crossed that everything will go well and I will be able to get the money for my PA degree. But I do have to think about what happens if I can’t. Do I decide to take a different career path even though I really want to pursue this one?”
Understanding the Reasoning
On a Department of Education frequently asked questions page, the agency said it wants to implement these loan caps to help protect students by “[driving] down the cost of graduate programs and [reducing] the debt students have to take out.” To the first point, Walker said she is unsure how limiting loans, and by extension, the number of PA students, will help to reduce tuition costs in the long run.
“We already can’t hire experienced, clinically savvy faculty because we offer salaries much lower than what PAs can make in clinical practice,” she said. “Ultimately, I believe these caps won’t do anything but decrease our student numbers and lead to programs closing down. Once that happens, the number of graduates will dwindle, and we’ll have just another hole in the dike that is the healthcare provider shortage.”
As for protecting students from overwhelming student loan debt, Pickard said many students will have to take out private loans with “super high interest rates” to pay for school. This would ultimately leave them in even more dire financial straits.
“There’s a legitimate conversation to be had about why tuition is so expensive,” he added. “But even if you do reduce tuition, you cannot reduce those other important costs of attendance like housing, electricity, food, gas, and insurance…so what these caps ultimately do is make it so only those who have the personal means to go into these programs will have the ability to do so. It de-incentivizes the people who would be best positioned to go back and practice in rural and socially disadvantaged areas.”
Looking for a Change in Course
With these survey results in hand — as well as compelling stories from PAs, students, and prospective students — Pickard hopes that the Department of Education will start to understand the impact of these federal student loan caps and reconsider them.
“We are facing a healthcare provider shortage,” he said. “We know that a significant part of the workforce providing healthcare in the future will be PAs. So why wouldn’t the federal government be looking for ways to invest in these important providers and grow the pipeline instead of slowing it down and turning away the people that we need?”
Sydney Kasner, a recent PA school graduate, said she would have been one of the people taken “out of the PA applicant pool before I even had the chance to try” had such a rule been in place just a few years ago. She, too, hopes that the Department of Education, as well as other organizations, will find a way forward to better support future PA cohorts to “fill wonderful and well-needed areas of medicine.”
“The PA progression has, historically, addressed healthcare shortages all over the United States, filling in gaps in rural communities or other areas where there are primary care provider shortages,” she added. “We should be looking for more resources to cover the cost of PA programs so we can train more people, including people from rural communities and minority communities, so PAs can continue to help provide the kind of quality care that so many people across the country need.”
Kayt Sukel is a healthcare and science writer based outside Houston.
