Potential Barriers to Accessing Medical Care Under Trump's Presidency
In the realm of education, California's professional school students, including those pursuing law, medicine, dentistry, or pharmacy, are bracing for changes under the Trump administration's One Big Beautiful Bill (OBBB) Act. This legislation, set to take effect from July 1, 2026, brings significant alterations to federal student loan programs.
One of the key changes is the consolidation of repayment options into just two plans: the Repayment Assistance Plan (RAP) and the Standard Repayment Plan (SRP). RAP, a newly designed income-driven repayment plan, requires a minimum monthly payment of $10, even for borrowers with no income, a stark contrast to previous plans that could allow zero payments in such cases.
The OBBB Act also eliminates economic hardship and unemployment deferments for new loans, meaning borrowers facing job loss or economic hardship will no longer qualify to defer payments. This significantly affects borrowers' flexibility in repayment.
Moreover, the Act caps aggregate graduate borrowing at $100,000, and for professional students specifically, borrowing is capped at $200,000 total, including undergraduate debt limits. This replaces the previous Grad PLUS loan program, which had no such aggregate caps. This means professional students in California may face borrowing limits that restrict how much federal loan debt they can accumulate for their education.
The OBBB Act also introduces a measure that programs with "low-earning outcomes" relative to statewide median incomes will lose access to federal student loans. For graduate programs, such as many in professional schools, at least half of former students must meet earnings benchmarks compared to Bachelor's degree holders in the state. Programs failing this test could be excluded from the federal loan system, potentially limiting options for students seeking loans to attend these programs.
Furthermore, the Trump administration has restarted interest accrual for borrowers in previously implemented income-driven plans like the Biden-era SAVE plan, which had paused interest and allowed zero percent interest status. This could lead to increased interest charges and monthly payment obligations for affected borrowers.
These reforms represent a significant tightening of borrowing limits and repayment terms compared to pre-OBBB policies and could increase financial pressure on professional school students in California relying on federal loans.
In response, California is considering creating an additional student loan program to counteract the effects of the OBBB Act. The new California student loan program, if created, would be managed under the auspices of the California Student Aid Commission. The state could bolster federal student loans with state loans to support students in law school, particularly those aspiring to public interest and public service jobs.
The "justice gap" exists, leaving many without legal aid lawyers, particularly in areas such as eviction, employment, public benefits, and domestic violence. By supporting law students pursuing public interest and public service careers, California could help address this gap and ensure access to legal representation for those who need it most.
Similarly, California is facing a shortage of health professionals, with an estimated shortage of 36,000 nurses. The state could reinvigorate and expand its loan repayment program for those practicing in underserved areas, such as primary care, to help address this shortage.
Marsha Cohen, emerita professor of law at UC Law San Francisco, suggests that California should intervene to build up the talent pool for the decades ahead. By providing additional financial support for professional school students, California can help ensure a steady supply of doctors, lawyers, and other professionals ready to serve the state's needs.
In conclusion, the OBBB Act brings significant changes to federal student loan programs, potentially increasing financial pressure on professional school students in California. However, by creating a new student loan program, California can help mitigate these effects and support the next generation of professionals ready to serve the state.
- Under the Trump administration's One Big Beautiful Bill (OBBB) Act, changes in federal student loan programs are anticipated for education sectors like law, medicine, dentistry, or pharmacy in California starting from July 1, 2026.
- The OBBB Act consolidates repayment options into only two plans: the Repayment Assistance Plan (RAP) and the Standard Repayment Plan (SRP), requiring a minimum monthly payment of $10 even for borrowers with no income.
- Economic hardship and unemployment deferments for new loans will be eliminated, affecting borrowers' flexibility in repayment.
- The Act caps aggregate graduate borrowing at $100,000, and professional students specifically, at $200,000 total, restricting how much federal loan debt they can accumulate.
- Programs with low earning outcomes could lose access to federal student loans under the OBBB Act, potentially limiting options for students seeking loans for professional school.
- The Trump administration has restored interest accrual for borrowers in income-driven repayment plans like the SAVE plan, leading to increased interest charges and monthly payment obligations.
- California is contemplating creating an additional student loan program to counteract the effects of the OBBB Act, managed by the California Student Aid Commission.
- The new California student loan program, if established, could provide support to law students pursuing public interest and public service jobs, helping to address the "justice gap" in legal representation.
- California, facing a shortage of health professionals, could rejuvenate and expand its loan repayment program for those practicing in underserved areas to help resolve the nursing shortage, while also supporting professional school students to ensure a supply of doctors and other professionals ready to serve state's needs, according to Marsha Cohen, an emerita professor of law at UC Law San Francisco.
