Letters to the Editor

A ccess to care in the United States contin- ues to decline, especially in rural communities.¹This problem worsened after COVID-19, as providers left the workforce in large numbers due to burnout.The resulting shortage has increased demand for nurse practitioners (NPs).Yet the proposed federal loan limits remove nursing from the list of "professional" degrees eligible for higher federal loan limits, undermining a workforce already stretched thin. 2 Today, 30 states allow full practice authority for NPs. 3 As an adult-gerontology acute care nurse practitioner (AGACNP) in Arizona, I see approximately 25 patients a day-similar to my physician colleagues.It is difficult to imagine that my patients and physician colleagues would not view my role as "professional."Evidence consistently shows that nurse-led care is as safe and often more patient-centered than physician-led care.4 Despite this well-documented need for providers, the proposed federal loan reforms will cap graduate loan availability in ways that hit nursing students particularly hard, especially by limiting access to GradPLUS loans.For many NP students, these loans are not optionalthey are essential for covering the true cost of graduate education: clinical requirements, technology, textbooks, childcare, transportation, and lost wages.Tuition alone rarely reflects the real burden.Even when it does, tuition for many graduate nursing programs already exceeds the proposed federal cap.For example, the first year of the University of Arizona's AGACNP DNP program costs more than $27 000-well above the proposed $20 500 annual limit.Under this plan, even the most financially prepared students would need additional resources simply to cover tuition.Expecting NP students to work 40 or more hours a week to pay for school and basic living expenses is