NASN's Board of Directors and several former Board Members joined together to meet with their U.S. Senators and Representatives to educate and advocate for NASN's legislative priorities, as well as to strengthen awareness of the critical role school nurses play in supporting student health. School nurses are frontline healthcare professionals who address both physical and mental health, ensuring that students are healthy, safe, and ready to learn.

NASN’s legislative “Asks” were 

1. the NURSE Act (Nurses for Under-Resourced Schools Everywhere);
2. Protect the Individuals with Disabilities Education Act (IDEA); and
3. Reauthorize the Title VIII Nursing Workforce Development Programs. 

Please see more information on NASN’s Legislative Priorities and use NASN’s Action Center to let your elected officials know of your support for these important priorities. Their continued leadership and advocacy help ensure every student has access to the care they need to thrive. 

The Urban Institute issued a report on Medicaid and the cuts mandated by the One Big Beautiful Act (OBBA) and how that will impact Medicaid in schools: 

“In addition to providing health insurance to millions of Americans, Medicaid supports health care in public school districts nationwide. Students enrolled in Medicaid can receive certain health services through their school, such as early vision screening, diagnostic treatments, and services mandated in a student’s individualized education plan. 

But cuts to Medicaid spending and greater restrictions on enrollment enacted under the One Big Beautiful Bill Act (OBBBA) last summer could jeopardize school funding, potentially hurting students’ long-term educational attainment and development. 

Why This Matters 

The Congressional Budget Office projects OBBBA will reduce Medicaid enrollment by 7.5 million people and federal Medicaid spending by more than $900 billion over the next 10 years. Those cuts and their ripple effects will affect low-income individuals, including students, most directly, but the cuts will also have implications for other systems, including K–12 education. OBBBA reductions could affect schools’ revenues in three key ways: 

1. Schools could receive fewer Medicaid dollars while still being required to provide services mandated by law. 
2. Declines in Medicaid enrollment among students could lead to fewer students receiving free or reduced-price lunches through direct certification and to fewer students being counted as low-income for the purposes of state K–12 funding. 
3. States could reduce spending in other areas to make up for less Medicaid funding, with K–12 funding being an appealing option given its share of the budget in most states. 

At a time when state budgets are tightening, any reduction in funding could force state and school leaders to make difficult decisions about how to support K–12 education. Read the full report.

Nursing Degrees Still Not Considered Professional Degree by Trump Administration

The Department of Education has finalized sweeping changes to federal student loan rules that will significantly limit how much graduate students can borrow—prompting concern from healthcare and education leaders about the long-term impact on workforce supply. 

At the center of the overhaul is a stricter definition of which programs qualify as “professional degrees,” a designation that determines access to higher federal loan limits. Under the new rules, only a narrow group of fields—such as law, medicine, dentistry, and a handful of other doctorate-level programs—will be eligible for up to $50,000 per year and $200,000 total in federal loans. All other graduate programs will be capped at $20,500 annually and $100,000 overall. 

Notably excluded from the “professional” category are several high-demand fields, including nursing, architecture, accounting, and education. That decision, which remained unchanged in the final rule despite widespread opposition, has drawn sharp criticism from industry groups and policymakers who argue it could discourage students from pursuing advanced degrees in critical sectors. 

Nursing advocates have been especially vocal. The American Nurses Association warned that the lower borrowing caps will make it harder for nurses to advance into specialized and leadership roles—such as nurse practitioners, nurse anesthesiologists, and educators—at a time when many communities already face provider shortages. These concerns are particularly acute in rural areas, where advanced practice nurses often serve as primary care providers. 

Critics across multiple sectors argue that the department’s narrow interpretation of “professional” contradicts congressional intent and risks reducing enrollment in essential, high-cost graduate programs. They contend that many excluded fields—especially in healthcare—require advanced training, offer strong earning potential, and have historically low loan default rates, making them suitable candidates for higher borrowing limits. 

Education officials, however, defended the approach, saying the clearer, more uniform definition avoids ambiguity and prevents institutions from exploiting broader classifications to raise tuition. The loan caps themselves were established by Congress in last year’s legislation, and the finalized rule represents the administration’s implementation of those statutory limits. 

The changes are part of a broader effort to curb student debt, discourage overborrowing, and stabilize the federal lending system. Still, with the new limits set to take effect July 1, 2026, some students in affected programs may increasingly turn to private loans to bridge funding gaps—potentially shifting financial risk away from the federal government and onto borrowers. 

In order to redress this, Congress must weigh in with a legislative fix. Fortunately, many Congressional champions have been outspoken about their opposition to this proposal prior to the publication of the rule. Let your Member of Congress know how you feel through Voter Voice.

Senator Jeff Merkley (D-OR) and Representative Jen Kiggans (R-VA) have introduced the Nursing is a Professional Degree Act to explicitly classify post-baccalaureate nursing programs as "professional degrees" under the Higher Education Act, making it easier for nurses to pursue these degrees, which NASN has endorsed. Additionally, please see the press releases by our champions: Rep. Kiggans press release and Rep. Suzanne Bonamici's press release.

Report Examines Decline in OCR Enforcement Activity

U.S. Senate HELP Committee minority staff released a report on April 28 stating that the Department of Education’s Office for Civil Rights (OCR) reached a 12-year low in enforceable relief for students facing discrimination, with resolutions falling from 507 in 2024 to 112 in 2025. This indicates a sharp decline in OCR’s ability to resolve cases and protect students' civil rights. Read the complete report. 

Nebraska Implements Medicaid Work Requirements 

On Friday, May 1, Nebraska became the first U.S. state to implement Medicaid work requirements, moving months ahead of the 2027 federal deadline established under Republicans’ “One Big Beautiful Bill Act,” signed into law in 2025. The law requires most adults enrolled through Medicaid expansion to work, volunteer, attend school, or participate in job training for at least 80 hours per month to maintain coverage. 

The policy applies to expansion enrollees ages 19 to 64, with exemptions for certain groups including pregnant women, medically frail individuals, people with disabilities, caregivers, and those in substance use treatment programs. Nebraska opted to roll out the changes early through a state plan amendment, after announcing in late 2025 that enforcement would begin May 1, 2026. 

State leaders, including Republican Gov. Jim Pillen, argue the requirement will encourage long-term independence, while House Speaker Mike Johnson has framed the broader policy as a way to reduce “fraud, waste and abuse” in Medicaid. But health policy experts and advocates warn the changes could lead to significant coverage losses—often not because people fail to meet the requirements, but due to administrative hurdles such as paperwork issues or difficulty proving eligibility for exemptions. 

About 70,000 Nebraskans are enrolled in Medicaid through expansion, out of roughly 346,000 total Medicaid recipients in the state. Estimates suggest that between 16,000 and 30,000 people could lose coverage in the coming years, with some projections indicating up to 25,000 individuals—around 36% of those subject to the rules—may be affected. Nationally, analysts at the Urban Institute project that millions could lose Medicaid coverage as similar requirements are implemented across states. 

Despite these concerns, data suggest that many of those affected are already working or in school. As of 2025, roughly 65% of Medicaid expansion adults in Nebraska without dependent children were meeting the 80-hour monthly threshold. Others who do not meet the requirement may still qualify for exemptions. 

Even so, experts caution that implementing the policy is complex. States must overhaul eligibility and enrollment systems, conduct outreach and education, train staff, and coordinate with insurers and providers. Questions also remain about how to define key exemption categories, such as “medically frail,” with federal guidance still pending in some areas. 

Nebraska’s early rollout is being closely watched by policymakers and researchers as a test case for the rest of the country. At least two other states, Iowa and Montana, are planning to implement Medicaid work requirements later in 2026. The policy will ultimately apply in 42 states and the District of Columbia that have expanded Medicaid eligibility. Analysts estimate that nationwide enrollment could decline by several million people once the requirements are fully in place. 

State Legislation News

Florida Special Session

States Expand Access to Epinephrine 

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