2026年6月30日 / 美国东部时间早上7:42 / KFF健康新闻
46岁的本杰明·平克尼从刚过20岁生日起就梦想成为一名医师助理。
他曾在佛罗里达州杰克逊维尔市遭遇飞车枪击，身中两枪住院治疗。他表示，在为期一周的住院期间，一名医师助理每天都到他的病床前探望，警告他黑人男性中弹后往往会瘫痪——甚至更糟，正是这名医师助理改变了他的人生轨迹。
“我以前在街头混，你知道的，走了歪路，”平克尼说，“他让我发誓再也不要以那种方式进入他的急诊室。那是我们的最后一次谈话，就在我出院前。”
从那以后，他的目标就是成为一名医师助理。平克尼职业生涯的大部分时间都在纽约市环卫部门工作，还曾担任陆军预备役军医。最近，他朝着实现目标迈出了一步。今年5月，他以优异的成绩从雷曼学院毕业，获得理学学士学位。
从纽约搬到马里兰州乔治王子县后，他原本计划今年申请医师助理学校。但现在，他担心自己的梦想可能会被新的学生贷款规定击碎。
本杰明·平克尼想要读研究生成为一名医师助理。但他担心新的联邦学生贷款限额可能会迫使他以更高的利率从私人银行借款。埃丽卡·S·李 为KFF健康新闻拍摄
从7月1日起，研究生可从联邦政府贷款的金额将被设置上限。新的学生贷款限额是共和党人称《宏大美好法案》的税收与支出法案的一部分，该法案已于去年由唐纳德·特朗普总统签署生效。
特朗普政府表示，设置这些限额旨在抑制高等教育成本和学生贷款债务的增长。
但批评人士普遍认为，新的限额过低，尤其是对于那些根据该法案颇具争议的“专业学位”定义，每年只能借款20500美元的学生。6月24日，一名联邦法官暂时阻止了教育部执行这一定义。尽管如此，对于许多学生来说，新的限额无法覆盖学费、住宿和生活费的总开支。
这可能导致每年数十万攻读研究生贷款的学生不得不依赖利率更高、还款选择更少的私人放贷机构。
一些专家和学生还担心，这些限额会阻碍少数族裔和低收入家庭学生申请研究生项目，从而威胁到医疗保健劳动力的多元化。他们认为，入学学生的减少可能会加剧现有的农村和初级护理人员短缺问题。
许多政客和贷款专家都承认，高等教育成本问题亟待解决。但美国医师助理协会主席托德·皮卡德表示，新的联邦贷款限额“根本无法实现这一目标”。该协会是就这些规定起诉教育部的多个组织之一。
“这就好比你长了倒刺，我却直接砍掉你的整条胳膊，而不是处理你的倒刺，”皮卡德说，“这种治疗方式与问题根本不匹配。”
“进退两难”
根据该法案的定义，攻读“专业学位”的学生——包括受训医生、牙医、药剂师和脊椎按摩师——的总贷款限额最高为20万美元，每年最高不超过5万美元。
而美国医学院协会的数据显示，公立医学院四年制教育的中位成本接近30万美元，私立医学院的中位教育成本则超过40万美元。
对于攻读其他“研究生学位”的学生，限额设置得更低：整个学位项目的联邦贷款借款限额仅为10万美元，每年限额仅为20500美元。物理治疗、医师助理和护理专业的学生最初被归入这一类。但据美联社报道，根据教育部周一发布的新指导意见，其中部分学生至少暂时可以适用更高的贷款限额。
因新规定被临床医生行业协会和大约24个州起诉的教育部，未回应本文的置评请求。
根据该法案的规定，一名在平均2至3年内完成学业的医师助理学生，原本没有资格借满10万美元。而医师助理职业生涯初期的平均债务为11.2万美元，这意味着部分学生可能不得不依靠高利率的私人贷款来支付教育费用。
“我感觉自己进退两难，”24岁的奥利维亚·特鲁尔说，她将于今年夏天开始在华盛顿州柯克兰的西北大学攻读医师助理项目。她说，这个为期28个月的项目总成本为13.7万美元，仅第一年的学费和杂费估计就有6.2万美元，还不包括生活费。
在法院禁令生效前，特鲁尔表示，她符合新规定下第一年最高20500美元的联邦贷款额度。剩余费用将需要通过私人贷款解决。
她预计需要高达10万美元的私人贷款来支付研究生学费，毕业后每月还款额将超过3000美元。
“我得坐下来好好想想，”特鲁尔说，考虑“我是否愿意在未来10年里都被债务缠身”。她说，有一家私人银行给她的贷款利率接近14%。
平克尼表示，他的本科学位贷款约为1万美元，而他一些已经申请私人学生贷款的朋友收到的利率高达13%。与此同时，联邦研究生贷款的利率每年都会调整，目前约为8%至9%。而且联邦贷款通常比私人贷款提供更灵活的还款选择。
今年5月，25个州和哥伦比亚特区就新规定向联邦法院起诉教育部。诉状称该法案对“专业学位”的定义“武断且反复无常”。
在6月提起的另一项联邦诉讼中，美国医师助理协会和PA教育协会声称，新规则剥夺了学生就读医师助理学校所需的贷款额度。他们认为，PA学生应该能够获得与医学院和其他专业学位学生相同的更高贷款限额。（尽管“physician assistant”和“physician associate”通常指同一职位，但美国医师助理协会在2021年采用了“physician associate”这一称谓，原因是“担忧‘assistant’一词无法体现PA在为患者提供高质量医疗服务中所扮演的重要角色”。）
与此同时，特朗普政府官员坚称，整体而言研究生院的成本过高。教育部长琳达·麦克马洪今年5月在众议院委员会就新限额发表讲话时表示：“我们的总体目标是降低大学和教育的成本。”
事实上，一些专家承认新限额可能有助于降低成本。20年前国会设立的联邦Grad PLUS贷款项目并未对研究生的联邦贷款额度设置上限，而该项目在《宏大美好法案》中被取消了。
“有大量证据表明，人们借的钱比他们实际上学所需的要多，”高等教育经济学家、城市研究所高级研究员桑迪·鲍姆说。
鲍姆表示，已经有一些研究生项目降低了学费。例如，加州大学欧文分校今年5月宣布，将降低其MBA项目的学费数万美元，使其低于新的联邦贷款限额。
但鲍姆并不预计会有很多其他学校效仿。
“我不认为我们会看到学费出现大幅下降，”她说，“我认为一些项目可能会因为无法维持运营而关闭。”
“已经掉了不少眼泪”
鲍姆表示，新的贷款限额还会对黑人学生造成不成比例的影响，因为他们历史上的借款金额高于白人和西班牙裔学生。
对于一些已经借款支付本科学费的学生来说，新的限额影响尤其严重。根据新规则，他们的联邦学生贷款终身限额为25.7万美元。
“有些学生将无法入学，”鲍姆说。
26岁的安德烈·罗布是南卡罗来纳医科大学的医学生，领导着查尔斯顿校区的金融兴趣小组。他表示，许多同龄人都担心贷款限额会让学生群体的多样性下降。
他还担心，由于医学院的入学需求已经极高，学校可能会优先录取来自富裕背景的学生，“仍然能招满班级”。
“这不是我们想要的医生队伍，”罗布说，他作为在校生不受新规定的约束，“我们希望医生队伍能代表全国的人口结构。”
26岁的贾丝明·巴斯克斯已被亚特兰大南方学院的医师助理项目录取，她决定将入学时间推迟到2027年，部分原因是希望融资方案有所变化。她担心从私人银行贷款会背负过重的债务。
“已经掉了不少眼泪，”巴斯克斯说，她将于9月分娩，“这完全不是我能控制的。”
学生贷款顾问协会主席贝琪·马约特预计，新规定将迫使一些毕业生在无力偿还私人贷款时申请破产。
但她首先预计，入学人数会下降，一些研究生项目会因无法招到足够学生而关闭。她还预计，随着学生在学位项目中途触及联邦贷款限额，毕业率也会下降。
除此之外，她预测医疗保健专业的毕业生会转向高薪专业，加剧农村和服务不足社区的人员短缺问题。
“他们会去能赚最多钱的地方，”马约特说。
平克尼表示，他“不太确定”未来会怎样。他在读本科时大部分费用都是靠打工支付的，但全职攻读医师助理项目的学生通常无法这样做。
他考虑过转而申请生物医学科学研究生项目，他估计该项目的成本约为3万美元——这个金额“更容易承担”，他说。这将让他有机会在实验室或制药行业工作，他说。这仍然与医学相关，他说，但无法帮助他实现与患者打交道的目标。
“也许这件事会不了了之，”他在谈到新的联邦贷款限额时说。与此同时，他仍抱有希望。
“如果我能影响一个人的人生，那就是我对当年激励我的那位医师助理的回馈，”他说，指的是1999年那位改变他人生的医师助理，“要从这个梦想中转而其他方向，太难了。”
KFF健康新闻是一家制作深度健康问题新闻的全国性新闻编辑部，也是KFF的核心运营项目之一——KFF是独立的卫生政策研究、民意调查和新闻资讯来源。
He dreamed of becoming a physician assistant. New loan rules may thwart him.
June 30, 2026 / 7:42 AM EDT / KFF Health News
Benjamin Pinckney, 46, has dreamed of becoming a physician assistant since just after his 20th birthday.
He had been targeted by a drive-by shooter in Jacksonville, Florida, and hospitalized with two gunshot wounds. During his weeklong hospitalization, he said, a physician assistant changed the course of his life by visiting his hospital bed each day and warning him that Black men with gunshot wounds often end up paralyzed — or worse.
“I used to run the streets, you know, on the wrong sides of the track,” Pinckney said. “He made me promise that I would never come into his ER that way again. That was the last conversation we had, right before I was discharged.”
His goal since then has been to become a physician assistant. Pinckney, who spent most of his career working for New York City’s Department of Sanitation and as an Army Reserve medic, recently took a step toward achieving it. In May, he graduated with departmental honors from Lehman College with a Bachelor of Science degree.
After moving from New York to Prince George’s County, Maryland, he’d planned on applying for physician assistant school this year. But now, he’s worried his dream may be thwarted by new student loan rules.
Benjamin Pinckney wants to go to graduate school to become a physician assistant. But he worries new federal student loan limits may force him to borrow money from a private bank at a higher interest rate. Erica S. Lee for KFF Health News
Starting July 1, the amount of money graduate students will be allowed to borrow from the federal government will be capped. The new student loan limits are part of the GOP’s tax-and-spending legislation known as the One Big Beautiful Bill Act, which President Donald Trump signed into law last year.
The caps are intended to curb the cost of higher education and student loan debt, according to the Trump administration.
But critics widely agree the new limits are too low, especially for students allowed to borrow only $20,500 a year in federal loans due to the law’s controversial definition of a “professional degree.” On June 24, a federal judge temporarily blocked the Department of Education from enforcing that definition. Still, for many students, the new caps won’t cover the combined cost of tuition, housing, and living expenses.
This could leave hundreds of thousands of students who borrow money for graduate school each year at the mercy of private lenders with higher interest rates and fewer repayment options.
Some experts and students also worry that the limits will threaten efforts to diversify the healthcare workforce by deterring minorities and people from low-income households from applying to graduate programs. A drop in incoming students could worsen existing rural and primary care shortages, they argue.
Many politicians and loan experts have acknowledged that the cost of higher education needs to be addressed. But the new federal loan limits are “just not going to achieve that goal,” said Todd Pickard, president of the American Academy of Physician Associates, one of several organizations that have sued the Department of Education over the rules.
“It’d be like if you had a hangnail and I cut your whole arm off instead of just taking care of your hangnail,” Pickard said. “The treatment doesn’t match the problem.”
“A rock and a hard place”
Students working toward what the law describes as “professional degrees” — including trainee doctors, dentists, pharmacists, and chiropractors — will be allowed to borrow up to $200,000 total, and no more than $50,000 a year.
Meanwhile, the median cost of attending a public medical school is nearly $300,000 over four years, while the median cost of a private medical school education exceeds $400,000, according to the Association of American Medical Colleges.
The caps were set even lower for those pursuing other “graduate” degrees, who face a $100,000 borrowing limit for federal loans over the course of their degree programs. The annual limit for this category of students is only $20,500. Students pursuing physical therapy, physician assistant, and nursing degrees were originally included in this group. But according to new guidance issued by the Department of Education on Monday, some of these students will at least temporarily be able to borrow up to the higher limit, according to The Associated Press.
The Department of Education, which has been sued by clinician trade groups and about two dozen states over the new rules, did not respond to questions for this article.
As the law was written, a physician assistant student who completed their degree within the average two to three years would not have been eligible to borrow the full $100,000. Meanwhile, physician assistants typically start their careers with an average debt of $112,000, meaning some could be forced to finance their education with higher-interest private loans.
“I feel like I’m between a rock and a hard place,” said Olivia Trull, 24, who is scheduled to begin the physician assistant program at Northwest University in Kirkland, Washington, this summer. The 28-month program costs $137,000, with about $62,000 in tuition and fees estimated for the first year, she said. That doesn’t include living expenses.
Before the court order, Trull said she qualified for the maximum annual allotment under the new rules of $20,500 in federal loans during her first year of graduate school. The balance would need to be financed through a private lender.
She anticipated she would need up to $100,000 in private loans to finance her graduate degree and would face loan payments of more than $3,000 a month when she was done.
“I have to actually sit down and have a conversation with myself,” Trull said, to consider “if I want to be drowning in debt for the next 10 years of my life.” One private bank offered her a loan with an interest rate of nearly 14%, she said.
Pinckney, who said he finished his undergraduate degree with about $10,000 in federal student loan debt, said some of his friends who have already applied for private student loans have been quoted interest rates as high as 13%. Meanwhile, interest rates for federal loans for graduate students, which are set annually, are currently about 8-9%. Federal loans also offer more flexible repayment options than private loans typically do.
In May, 25 states and the District of Columbia filed a federal lawsuit against the Department of Education over the new rules. The complaint described the law’s “professional degree” definition as “arbitrary and capricious.”
In a separate federal lawsuit filed in June, the American Academy of Physician Associates and the PA Education Association alleged that the new rules deny students the loan amounts needed to attend physician assistant schools. They argue that PA students should be able to access the higher loan limits available to students in medical school and other professional degree programs. (While “physician assistant” and “physician associate” typically refer to the same role, the AAPA adopted the title “physician associate” in 2021 because of “concern that ‘assistant’ does not reflect the important role of PAs in delivering high-quality healthcare to patients.”)
Meanwhile, Trump administration officials have contended the cost of graduate school is too high across the board. Education Secretary Linda McMahon, speaking before a House committee in May about the new limits, said, “It is our overall goal to bring down the cost of college and education.”
Indeed, some experts acknowledge that the new limits may be helpful in bringing down costs. The federal Grad PLUS loan program, established by Congress 20 years ago, did not cap the amount graduate students could borrow in federal loans. That program was eliminated in the One Big Beautiful Bill Act.
“There is considerable evidence that people borrowed more than they really needed to go to school,” said Sandy Baum, a higher education economist and a senior fellow at the Urban Institute.
Already, some graduate programs have lowered tuition prices, Baum said. In May, for example, the University of California-Irvine announced it would lower the cost of its MBA programs by tens of thousands of dollars to fall below the new federal lending thresholds.
And yet Baum doesn’t anticipate many other schools will follow suit.
“I don’t think we’re going to see some dramatic decline in prices,” she said. “I think some programs could close down because they can’t manage.”
“Tears have been shed”
The new lending limits will also disproportionately affect Black students, Baum said, because they have historically borrowed more than white and Hispanic students.
For some students who borrowed money to finance their undergraduate degrees, the new limits will hit especially hard. Under the new rules, they will be subject to a lifetime limit of $257,000 in federal student loans.
“There will be students who can’t enroll,” Baum said.
Andrei Robu, 26, a medical student at the Medical University of South Carolina, leads the Financial Literacy Interest Group on the Charleston campus. He said many of his peers are worried that the lending limits will make the student body less diverse.
He is also concerned that, because the demand for acceptance into medical school is already so high, schools could prioritize entrance for students from wealthy backgrounds and “still fill up their classes.”
“That’s just not what we want in our physician workforce,” said Robu, who isn’t subject to the new rules as a current student. “We want to represent the population of the country at large.”
Jasmine Vasquez, 26, who has been accepted into the physician assistant program at South College in Atlanta, decided to defer her enrollment until 2027, partly to see if her financing options change. She is worried about taking on too much debt from a private bank.
“Tears have been shed multiple times,” said Vasquez, who is due to give birth in September. “It’s nothing that’s within my control.”
Betsy Mayotte, president of the Institute for Student Loan Advisors, expects the new rules will force some graduates into bankruptcy when they can’t afford to repay private loans.
First, though, she expects enrollment numbers to drop and some graduate programs to close because they can’t recruit enough students. Completion rates will also drop, she expects, as students run into federal loan limits partway through their degree programs.
Beyond that, she predicts healthcare graduates will seek jobs in high-paying specialties, exacerbating shortages in rural and underserved communities.
“They’re going to go where they can make the most money,” Mayotte said.
Pinckney said he is “not really sure” what the future holds. He paid for most of his undergraduate education by working while he was in school, but that’s typically not possible for full-time physician assistant students.
He has considered applying to a biomedical science graduate program instead, which he estimated would cost about $30,000 — an amount that’s “a lot more doable,” he said. It would allow him to potentially work in a lab or in pharmaceuticals, he said. It’s still aligned with medicine, he said, but it wouldn’t help him realize his goal of working with patients.
“Maybe this thing will blow over,” he said of the new federal loan limits. In the meantime, he’s holding out hope.
“If I can influence one person’s life, that would be my way of paying him forward for what he did,” he said, referring to the physician assistant who inspired him back in 1999. “It’s very hard to pivot from that dream.”
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.