UM-Flint nurse anesthetist leader advocating for affordability reform in wake of new legislation

The future of Michigan's anesthesia workforce faces new questions as federal loan reforms threaten to restrict educational access for certified registered nurse anesthetists. At the forefront of the response is Gena Welch, president of the Michigan Association of Nurse Anesthetists and director of nurse anesthesia education at the University of Michigan-Flint's College of Health Sciences.

Welch, who has spent her career mentoring the next generation of clinical anesthesia providers, believes recent changes to federal financial aid policies could narrow the state's pipeline of qualified CRNAs, at a time when their expertise has never been more critical.

Changing Loan Landscape Puts CRNA Access at Risk

Under the federal One Big Beautiful Bill Act, signed into law in July 2025, graduate students, including those pursuing a career in nurse anesthesia, face new caps on federal student loans. The law eliminates the Graduate PLUS loan program, which has historically allowed CRNA students to borrow up to the full cost of tuition and living expenses. The new annual graduate loan is capped at $20,500 per year, with a lifetime maximum of $100,000.

While students in certain designated "professional degrees" such as medicine, dentistry and law can borrow up to $50,000 annually and $200,000 overall, nurse anesthesia and advanced practice nursing programs were not included in this group, despite their advanced clinical training and vital roles in patient care.

"Together, these changes threaten the pipeline of future CRNAs and undermine ongoing efforts in workforce development, access to care, and health system stability," Welch said. "Michigan needs more anesthesia providers, not fewer. We are putting additional strain on hospitals, clinics, and especially rural facilities that rely heavily on CRNAs to keep essential services available."

CRNAs: Essential Providers Across Michigan

CRNAs are specialized advanced practice nurses responsible for providing anesthesia care before, during and after medical procedures. In many Michigan communities, especially in the northern and rural parts of the state, CRNAs are the sole providers of anesthesia in hospitals, clinics and surgical centers.

"As operating room volumes grow and the population ages, we need more anesthesia providers in every health setting," Welch said. "Limiting educational access doesn't just impact aspiring students; it risks patient safety and the viability of critical services in our communities."

The rising cost of nurse anesthesia education, often exceeding $100,000 for tuition alone, means many students rely on federal loans to complete their training. Welch notes that students who are first-generation, low-income, or from rural backgrounds will be most affected by the new borrowing limits, exacerbating an already pressing shortage.

Advocacy and Solutions for the Next Generation

Welch and other MANA leaders are pushing for nursing and advanced practice nursing to be recognized as professional degree programs for loan purposes, restoring access to the higher borrowing limits afforded to other clinical doctorates. MANA is also supporting efforts to reinstate or replace Grad PLUS-level funding, ensuring students don't have to turn to costly private lenders or forgo training altogether.

"Our students are academically qualified and clinically ready, but affordability is now the barrier," Welch said. "Supporting CRNA education isn't just about fairness—it's about safeguarding the future of our healthcare workforce."

Even as legislative details continue to evolve, Welch remains focused on organizing advocacy at both the state and national levels, collaborating with hospital associations and faculty to highlight the critical role that CRNAs play across Michigan's health care system.

"By excluding nurse anesthesia from professional-degree loan treatment and eliminating Grad PLUS loans, the new rules make it harder for talented, motivated nurses to enter this profession," she said. "Protecting access to graduate and professional funding for CRNA students isn't just about financial security. It's about the future of patient care in Michigan."