The Impact of the Reconciliation Bill on Medical Education
With Minnesota and the nation facing a growing shortage of physicians in the next decade, it’s crucial to remove barriers rather than create new ones. Students like Eva Skipwith, who have the potential to contribute significantly to the medical field, should be encouraged, not discouraged. However, recent legislative changes may be doing just that.
Skipwith is a junior majoring in biology at Augsburg University in Minneapolis and works as a lab tech for the Children’s Minnesota health care system. She is also the eldest child of immigrant parents and spent two years in Somalia as a teenager. Her experiences abroad sparked an interest in both medicine and public service. “I wanted to go into the field to give back to people,” she said during an interview, aspiring to family medicine, heart health, or trauma surgery.
Unfortunately, the recently passed reconciliation bill, known as the Big Beautiful Bill, has derailed her dreams of becoming a doctor. One of the bill’s measures eliminates the Graduate PLUS loan program and limits the amount of federal loans students can take out to cover medical school costs. According to a letter from U.S. Sen. Amy Klobuchar, this change could deter students from pursuing careers in medicine.
Skipwith now plans to become a physician assistant, which requires 27 months of additional education after her undergraduate degree. While this path offers a shorter timeframe and less debt, she is wary of private loans due to higher interest rates. She is currently attending classes on a scholarship, but it doesn’t cover all her costs. Becoming a physician assistant means a faster start to paying off any debt she accumulates.
Skipwith emphasizes that she isn’t settling for being a physician assistant. She acknowledges that this educational path is still a privilege, especially when so many people don’t have the opportunity to attend college. However, she would have liked to have more options, including the possibility of medical school.
The Minnesota Medical Association and other professional organizations are sounding the alarm about these changes. They note that getting a medical degree is the most expensive post-secondary education in the United States. The University of Minnesota’s budget for the 2025-26 academic year highlights the high costs involved. First-year tuition alone is $49,282, not including books, housing, food, transportation, and loan fees. Adding these expenses brings the total first-year cost to $83,963.
The reconciliation bill’s changes are problematic because they eliminate the Graduate PLUS program for new borrowers starting next year. Existing borrowers who received a Grad PLUS loan before June 30, 2026, can continue borrowing under current terms through the 2028-29 academic year. However, the bill also creates new challenges by capping annual and total amounts students can borrow. The new limits are $50,000 a year with a $200,000 lifetime limit.
While proponents of the bill have valid concerns about the cost of medical education, limiting what students can borrow without offering alternative assistance is not a viable solution. This approach is more wishful thinking than smart policy, and there’s too much at stake to rely on it.
Students like Skipwith may choose to pursue other fields, which is discouraging. The Association of American Medical Colleges estimates that the U.S. will face a physician shortage of up to 86,000 by 2036. In Minnesota, rural areas already face severe shortages of primary care physicians, according to a 2024 report. Many rural physicians plan to leave the workforce within the next five years, leading to longer wait times for appointments and increased travel for patients.
The University of Minnesota notes that the new loan limits could also deter other students from entering the state’s future health care workforce, such as dentists, veterinarians, and pharmacists. About 70% of the state’s physicians and other health workers receive training at the University, and nearly 1,000 current graduate health professionals use the Grad PLUS Loan program.
Incentives, not deterrents, are critical to strengthening the pipeline of future medical professionals. The architects of the Big Beautiful Bill diagnosed the student debt problem accurately but made a serious error in prescribing a cure.
