Skip to main content

Search form

CRL Report: Financial Distress Dominates Experience of For-Profit Healthcare Support Students

Thursday, June 7, 2018
Robin Howarth
Whitney Barkley-Denney

Numbers Confirm Abysmal Outcomes While Focus Groups Reveal the Human Impact of Bad Federal Education Policy; State Action Crucial

DURHAM, N.C. – A new Center for Responsible Lending (CRL) research report finds that students who enroll in healthcare support programs at for-profit schools end up carrying much more debt relative to their earnings than do their peers in similar public programs. Tuition and fees for these for-profit programs can exceed $17,000 for an 11-month program, an amount that may seem worth it when the marketing materials of for-profit colleges greatly exaggerate the potential of a graduate’s earnings. But focus group participants report a grim reality; those who have taken this path are mired in debt and often unable to find even subsistence-level employment in the field for which they trained.

The U.S. Department of Education, under Betsy DeVos, is rolling back a rule that was designed to protect students from such outcomes. The Gainful Employment (GE) rule requires that career training programs meet certain debt-to-earnings standards for their graduates in order to qualify for federal student-based aid such as Pell grants and Direct loans. For-profit colleges target lower-income nontraditional students because they often qualify for substantial federal aid.

The CRL report, “A Bitter Pill: Gainful Employment and Credentialism in Healthcare Support Fields,” analyzes data from the first public release of information gathered under the GE rule and finds the following:

  • 83% of for-profit healthcare support programs scored poorly in the first release of debt-to-earnings data under the GE rule. In comparison, only 11% of public programs scored poorly.
  • Of all the healthcare support programs that scored poorly across all types of schools, 90% were for-profit programs. An additional 5% were programs at private non-profit colleges that had recently converted from for-profit ownership.

“Our research confirms that many for-profit college programs are failing basic standards for providing an education worth investing in, pinpointing the dismal outcomes in the popular field of healthcare support,” said CRL Senior Researcher Robin Howarth, who co-authored the report. “It also puts a human face on the suffering that this failure exacts on hardworking and ambitious students who hoped only to improve their lot in life and find a way to provide for their families. They are sold a dream and then denied its promise, and end up bearing a burden of debt that may keep their families in financial distress for a lifetime, as well as impact generations to come.”

Participants in focus groups held in Orlando, Florida, most of whom are parents, report that they enrolled in career training programs for fields such as medical assistant, pharmacy technician and medical billing because they were motivated to “get serious” about advancing their careers and providing for their families’ futures. They perceived that their job prospects would be good after graduation, and they were interested in healthcare because of, for example, a love of science and an interest in working with people. But their comments paint a picture of disappointment and disillusionment. Some are now resigned to carrying heavy burdens of debt for their lifetimes.

“You hear the commercial ‘be a medical biller!’ I can see how people get sucked into that – but it’s not what they tell you it’s going to be.”

“I started out making $12 an hour as a medical assistant. The school had told me I’d be making $35 to $40 thousand per year.”

“I can’t buy a house. I can’t buy a car with a decent interest rate. I want to be a homeowner one day; I want to own things to leave to my son one day.”

“This report shows how badly reform is needed to protect vulnerable people, many of whom are first-generation nontraditional students with families, from bitter disappointment and an undeserved fate,” said CRL Senior Policy Counsel Whitney Barkley-Denney, who co-authored the report. “Public and community colleges have proven that college training can be both affordable and high quality, and proper oversight is all that is necessary to make this educational foundation accessible to all families, regardless of their backgrounds. In light of federal failures to reform for-profit college abuses, states should step up and protect their citizens from deceptive and predatory practices and preserve the path to the middle class through education.”

CRL recommends that state policymakers take the following actions:

  • Require that for-profit colleges meet performance standards for debt and employment outcomes;
  • Prohibit use of state tuition dollars at for-profit colleges;
  • Require for-profit colleges to spend more on instruction, which pales in comparison to what they spend on marketing;
  • Protect students from being steered into unaffordable loans, and prohibit other predatory lending abuses;
  • Prohibit for-profit colleges from enrolling students in programs for fields in which they will be ineligible for employment;
  • Repeal laws that revoke the occupational license of student loan defaulters.
  • Require licensing and regulation of student loan servicers;
  • Ensure robust student tuition reimbursement funds.

For more information, or to arrange an interview with a CRL spokesperson, please contact Carol Hammerstein,