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One of the things you’ll hear reliably from lawmakers talking workforce—and the policies enacted by the current majorities in Washington—is that we need more alternative pathways to jobs than just college. But there are jobs with worker shortages that don’t have an alternative pathway to the workforce other than graduate school, let alone a bachelor’s degree.
The One Big Beautiful Bill Act, the second Trump Administration’s signature legislation, eliminated the Grad PLUS loan program and switched graduate degrees to loans that have annual and lifetime caps. At the start of the year, the Department of Education proposed a rule that had higher caps for degrees in medicine and certain other professional degrees, which have a $50,000 annual cap and a $200,000 lifetime cap.
There are stricter caps for degrees in other healthcare fields. For these other degrees, the proposed rule caps annual lending at $20,500 and installs a $100,000 lifetime cap on all federal lending. One of those degrees? Occupational therapy, home to the people who do things like help stroke victims adapt to life after a serious medical event and aid children with disabilities.
A 2022 paper by the World Federation of Occupational Therapists found that 67 percent of employers surveyed said they had difficulty hiring occupational therapists. Half of these roles remain unfilled for six months or more. Occupational therapy can be key to reducing re-admission within 30 days of discharge for hospital patients treated for things like severe injuries and illnesses. With an aging population and all the little and big ways the human body degrades with age, that’s a big healthcare and workforce risk.
To better understand the impact of the loan changes on occupational therapy, last week I talked to my friend Abe Saffer, who oversees education and workforce policy for the American Occupational Therapy Association, which is opposing the loan limits. Below, we talk about why occupational therapists’ main pathway to the field is through grad school, the anecdotal effects the loan caps already have had on aspiring OTs, and what could be next if the Trump caps go into effect as expected.
Subscribe to read the whole interview below.
The International Union of Painters and Allied Trades (IUPAT) is proud to support JOBS THAT WORK. In a fast-changing and unpredictable economy, our union knows that no matter what is happening with federal funding and the overall jobs landscape, workers and their voices need to be front and center.
Abe Saffer is senior legislative representative for AOTA.
This interview has been edited for length and clarity.
Nick: Some people might say gatekeeping is the reason you have the licensing requirements that require college.
Abe: Not to be glib, but occupational therapists help people [go to the] toilet. I want a little bit of gatekeeping to make sure that the person helping me go to the bathroom knows what they're doing. I want to make sure that the person that I am trusting with my 8-year-old with autism to help them navigate a neurotypical world knows what they're doing.
These are all professions that have evolved over decades of research and studies and innovations and trials to make sure that we know that if OTs try something with a client, that it is going to potentially have the positive effect you're seeking [and] there is not going to be a negative effect. A lot of times when OTs work with a client, you might try three things and one of them works, but at least you know that all three things that you're trying are not going to harm that client. Because if that happens, then they would be liable. You want to make sure that you try to limit that liability as much as possible so that you are saving everyone money.
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