She was admitted into 11 nursing programs. She cannot afford any of them.
Colleges use sophisticated pricing models to recruit wealthier students with merit awards while leaving those with the least financial margin to absorb the largest gaps, writes Jennifer Obel.
When Maryam Ahmadi was 13, she arrived in the United States from Afghanistan without her parents, speaking no English. She was separated from them during the bombing at Abbey Gate when the United States evacuated Kabul in 2021. She has not seen them since.
As a girl in Afghanistan, she was denied a formal education and taught herself to read and write at home. Today, she has completed 64 college credits while in high school, works nights and weekends to support herself and her siblings, and was admitted to 11 nursing programs. She cannot afford to attend a single one.
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This is not simply an affordability problem. It is a distribution problem. Colleges have the money, and they decide who receives it. As Stephen Burd, a senior writer at New America, puts it: “These institutions open the door to low-income students, then leave them saddled with debt they may never repay.”
A recent report by New America, a Washington-based think tank focused on education and economic opportunity, found that universities use institutional aid to compete for students who can already pay. As a result, billions of dollars flow to students without financial need, while low-income families are pushed toward debt.
Maryam told me that navigating financial aid, in some ways, felt as disorienting as her journey to the United States.
As her surrogate parents, my husband and I spent months helping Maryam navigate financial aid appeals, writing letters, calling admissions offices, and trying to understand how a student like her could do everything right and still come up short.
Her first-choice school, Loyola University Chicago, offered her a $30,000 annual merit scholarship, the same award the daughter of a friend of mine received despite that applicant coming from a family earning roughly $350,000.
We appealed, believing that once the university understood who Maryam was and how little margin she had, it would find a way. The response was polite and unequivocal: She was already receiving the maximum aid available. We were directed to payment plans, outside scholarships, and private loans.
This pattern is not abstract. It is playing out across Pennsylvania, as well.
At Drexel University, families of Pell Grant recipients take on more than $40,000 in Parent PLUS debt. At Temple University, more than half of Parent PLUS borrowers come from low-income families. Admission becomes contingent on a family’s ability to take on debt, transforming what is presented as opportunity into a financial obligation that shapes a life for decades.
But Maryam has no parents who can borrow on her behalf.
I did not set out to write about higher education finance. I was trying to help one teenager enroll in college. But after months of dead ends, it became impossible not to see what researchers call “predatory inclusion,” a system in which access is offered on terms that undermine the opportunity itself.
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Colleges use sophisticated pricing models to recruit wealthier students with merit awards while leaving those with the least financial margin to absorb the largest gaps.
Philadelphia sits at the center of one of the densest concentrations of higher education in the country, with more than 100 colleges serving half a million students, the fourth-largest university population of any metro area in the United States. Meanwhile, Pennsylvania is projected to be short 20,000 nurses by 2026.
I’ve spent my career in medicine. I know what a nursing shortage looks like.
This spring, Gov. Josh Shapiro stood at Temple University Health System and proposed a $5 million Nurse Shortage Assistance Program that would help cover tuition for nursing students who commit to working in Pennsylvania hospitals after graduation. Pennsylvania says it needs nurses badly enough to invest public dollars in training them, but its universities seem less willing to invest in students like Maryam.
Maryam wants to become one of those nurses. She remembers the care she received in refugee camps and hopes one day to treat patients who arrive frightened, overwhelmed, and unable to navigate a system not built for them.
Maryam wanted to borrow $40,000 to attend the University of Pittsburgh’s nursing program. She was ready to send in her deposit, leave Nebraska, and begin her life in Pennsylvania. My husband and I told her that debt of that magnitude shapes everything that comes after: where she can live, what jobs she can take, and whether she can achieve her dream of working in underserved communities that need nurses most.
Maryam has not made a final decision. She is still waiting on financial aid packages, hoping one institution will find a way to make its offer real. If no affordable option emerges, she may spend the next two years piecing together prerequisites at community college or public university in Nebraska, only to reapply to nursing school all over again. But even then, nothing about the system that failed her will have changed.
Maryam told me that navigating financial aid, in some ways, felt as disorienting as her journey to the United States, which involved surviving a terrorist bombing, crossing borders without her parents, and adapting to a new culture.
Yet the college application process, with its multiple portals, contradictory award letters, and appeals that went nowhere, was the first time I saw her truly discouraged. She had done everything asked of her and discovered that following the rules was not enough.
We say we need more nurses. We had one ready to go, but we sent her the bill.
Maryam will either become the nurse a patient is waiting for, or another qualified student we chose not to invest in.
Jennifer Obel is a retired oncologist.
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