The District of Columbia, where Black residents make up 45% of the population, now faces a direct threat to its health care workforce after the Trump administration stripped nursing of its professional degree status.
The change hits hardest on the very people who keep the District’s health system functioning. Black women represent 86% of licensed practical nurses providing clinical care in D.C. Many depend on advanced degrees to move into higher-paying, leadership and primary care roles.
A senior D.C. nursing official described the danger clearly.
“You put patient care at risk when you take away the ability of nurses to pursue the education their work requires,” the official said.
Under the One Big Beautiful Bill Act, nursing is no longer considered a professional degree. Students in graduate nursing programs can borrow only $20,500 per year with a total cap of $100,000. Students in protected fields can borrow up to $50,000 per year and $200,000 total. Tuition for advanced nursing programs in the District routinely exceeds those limits by tens of thousands of dollars.
According to the D.C. Board of Nursing, 966 licensed practical nurses provide clinical care in the city. More than 60% are aged 50 or older. Nearly 30% are over 60. With many nearing retirement, the District depends heavily on new graduates to fill roles critical to the stability of hospitals, clinics, nursing homes, and community health centers. Those pathways narrow under the federal downgrade.
Research shows that Black nurses and Black nurse practitioners play a central role in improving care for underserved populations in D.C. Studies document how Black nurses navigate racism, inequity, and a lack of organizational support while providing culturally informed care in neighborhoods that have faced long standing health disparities.
Local schools warn that the federal change will reduce enrollment and push students out of nursing programs that the District desperately needs. Without sustained access to graduate education, the District risks losing the workforce responsible for much of its primary and community-based care.
Kim Brundidge, who continues to practice while pursuing her doctorate, described the consequences for Washington patients.
“If students are not able to afford these programs,” she said, “the quality and number of nurses entering the workforce will decline.”
Health leaders across the city describe one shared concern. Advanced practice nurses are essential to D.C.’s care system. Reducing their ability to train will deepen the city’s existing disparities and reduce access to care in communities already facing shortages.
“In many communities across the country, advanced practice registered nurses ensure access to essential and high-quality care that would otherwise be unavailable,” Jennifer Mensik Kennedy of the American Nurses Association said. “Limiting nurses’ access to graduate education threatens the very foundation of patient care.”