California’s health care workforce crisis is a policy choice | Opinion
California is in the midst of a health care workforce crisis. Patients struggle to get appointments, clinics cut back services and hospitals scrape to staff essential shifts. Too often, we treat these outcomes as inevitable or mysterious, but they aren’t — they are policy choices.
After President Donald Trump’s so-called Big Beautiful Bill passed, it will be “harder for Californians to train for and advance in health care careers just when we need more workers,” according to LeadingAge, a community of nonprofit aging services providers. This bill strips nursing and other health programs, including physical and occupational therapy, of their status as professional degrees.
Why does this matter? Graduate students training in these health fields would be limited to a lower, $100,000 borrowing cap on their federal loans.
Put simply: once this change takes effect, graduate nursing degrees and other essential healthcare programs will no longer receive the same federal financial aid treatment as medical and dental degrees. Yet nurses and allied health professionals deliver critical care every day.
When educational debt rises and loan access tightens, fewer students — especially first-generation, low-income and working adult learners — can afford to pursue the very careers California needs.
In communities across our state, from Central Valley migrant farmworker towns to rural Northern California counties to urban neighborhoods in Los Angeles and San Diego, advanced practice nurses and allied health professionals are the backbone of primary care and chronic disease management. These are the clinicians who keep small clinics open, care for aging patients in home- and community-based settings and fill gaps where physicians are scarce.
Under the current interpretation of the Big Beautiful Bill, the pathway to those roles is getting harder. This, despite California’s rapidly aging population. We need more nurses, behavior health specialists and health practitioners — not less. But we are facing a persistent shortage of these workers.
The solution is not to abandon responsible fiscal policy, but to align it with the long-term needs of patients and workers. California policymakers, healthcare employers, educators and community leaders should come together to urge federal decision-makers to reverse the punitive loan classification and expand support for health care training. We should also redouble our own state investments in health care workforce pathways and financial support for students pursuing critical fields.
Workforce shortages are not an accident. They are the result of choices about how we classify professions, how we invest in training and whose opportunity we prioritize. California deserves a health care workforce built on access, stability and opportunity for all those who are called to serve.
Van Ton-Quinlivan is the CEO of Futuro Health, a Sacramento-based non-profit serving nine states and Washington, D.C., providing tuition-free health care training and scholarships for more than 10,000 individuals since it was founded in 2020.