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POSITION PAPER
THE AMERICAN ASSOCIATION OF NURSE ATTORNEYS (TAANA)
Comment on Docket ID: ED-2025-OPE-0944
Re: Proposed Rule Redefining 'Professional Degree Programs'
EXECUTIVE SUMMARY
The proposed rule excluding graduate nursing programs from the definition of “professional degree programs” rests on a structural misclassification of Advanced Practice Registered Nurse (APRN) entry education. Graduate education is mandatory for APRN licensure nationwide (National Council of State Boards of Nursing [NCSBN], 2026).
Excluding these programs risks contraction of the rural healthcare workforce, destabilization of behavioral health services, impairment of military medical readiness, and worsening of existing faculty shortages (Health Resources & Services Administration [HRSA], 2023; Washington Center for Nursing, 2025). TAANA urges the Department to revise or withdraw the rule to prevent foreseeable workforce and public health consequences and to avoid potential Administrative Procedure Act vulnerabilities.
I. Structural Overview of APRN Licensure
APRNs—including Nurse Practitioners (NPs), Certified Registered Nurse Anesthetists (CRNAs), Certified Nurse Midwives (CNMs), and Clinical Nurse Specialists (CNSs)—must complete graduate-level education, obtain national certification, and secure state licensure in all 50 states and the District of Columbia (NCSBN, 2026).
In 27 states and the District of Columbia, NPs hold full practice authority (American Association of Nurse Practitioners (AANP), 2026). In all remaining states, graduate education remains a mandatory entry requirement regardless of collaborative structures. APRNs are independently licensed professionals under state statutory frameworks.
II. Federalism Considerations
Professional licensure and entry-to-practice standards are historically matters of state authority. States have enacted detailed APRN regulatory frameworks grounded in graduate education requirements (NCSBN, 2026). A federal reclassification that effectively diminishes recognition of state-licensed professional categories raises significant federalism concerns.
III. Workforce and Public Health Impact
Rural Healthcare Access
APRNs are central to rural healthcare delivery. Workforce projections demonstrate persistent shortages in nursing and advanced practice roles, particularly in rural and underserved regions (HRSA, 2023; Washington Center for Nursing, 2025).
CRNAs are the primary anesthesia providers in many rural hospitals, enabling obstetric services, trauma stabilization, and emergency surgical care.
Constraining graduate financing will predictably reduce APRN and CRNA pipeline capacity, leading to diminished local access to surgical, obstetric, and primary care services.
Behavioral Health Workforce
Psychiatric Mental Health Nurse Practitioners represent one of the fastest-growing segments of the mental health workforce (HRSA, 2023). In many shortage areas, PMHNPs are the only prescribing mental health clinicians available. Any contraction in graduate education access will worsen psychiatric workforce shortages and exacerbate existing behavioral health access gaps.
Military and National Security Implications
CRNAs serve as primary anesthesia providers in deployed military environments and disaster response settings. Military and civilian surgical systems rely heavily on doctoral-prepared nurse anesthetists. Educational costs for CRNA programs frequently exceed
$200,000. These programs are structured as full-time, clinically intensive doctoral programs that significantly limit students’ ability to maintain outside employment during training.
Faculty and Educational Capacity
Nursing schools nationwide face faculty shortages and clinical placement bottlenecks (HRSA, 2023). Graduate programs produce nurse educators and advanced clinical leaders. Restricting professional classification may reduce faculty pipeline development and compound existing shortages.
IV. Administrative Procedure Act Analysis
Under 5 U.S.C. § 706(2)(A), agency action must not be arbitrary or capricious. Agencies must engage in reasoned decision-making and consider relevant factors (Motor Vehicle Mfrs. Ass’n v. State Farm Mut. Auto. Ins. Co. (1983).
Failure to distinguish between RN entry education and APRN professional-entry education, and failure to consider workforce impact and reliance interests, may expose the proposed rule to vulnerability under established APA precedent (Department of Homeland Security v. Regents of the Univ. of California, 2020; Encino Motorcars, LLC v. Navarro, 2016).
V. Reliance Interests
Universities, healthcare systems, and students have structured educational pathways in reliance on longstanding federal loan frameworks. Abrupt reclassification without adequate consideration of these reliance interests conflicts with Supreme Court precedent requiring agencies to address such interests (Department of Homeland Security v. Regents of the Univ. of California, 2020; Encino Motorcars, LLC v. Navarro, 2016).
CONCLUSION
Graduate APRN-entry education is professional education under any licensure-based framework. The proposed exclusion would reduce APRN enrollment, worsen rural healthcare access, deepen behavioral health shortages, impair military readiness, exacerbate faculty shortages, and undermine coordinated federal and state healthcare priorities.
TAANA respectfully requests withdrawal or substantial revision of the proposed rule.
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