Refund requests are an unavoidable part of running a chiropractic practice. Whether a patient is unhappy with their care, believes an adjustment caused harm, or simply changes their mind, these situations must be handled carefully to avoid escalation. While chiropractors are not legally obligated to issue refunds in most cases, there are times when doing so is the best business decision to protect the practice.
Senate Reconciliation Bill: Mixed Progress for Healthcare Education
Editor's Note: The following article was submitted by Anne Marie Munson, executive director of the Association of Chiropractic Colleges (ACC), with the National Association of Independent Colleges and Universities (NAICU) as a source.
The Senate Committee on Health, Education, Labor, and Pensions (HELP) released its budget reconciliation proposal for federal higher education policy, marking a critical juncture for chiropractic colleges, healthcare programs, and higher education nationwide. While the Senate version makes meaningful improvements over the House bill, significant concerns remain that could alter access to graduate healthcare education.
Notable Improvements from House Version
The Senate proposal deserves recognition for addressing problematic elements from the House legislation. Most significantly, senators excluded the House's institutional risk-sharing framework, which would have placed financial responsibility on colleges for student loan defaults. The Senate also rejected proposals to limit full-time Pell Grant eligibility to 30 credit hours, terminate subsidized loans for undergraduates, and cap federal student aid at median national costs by program.
Additional positive changes include fixing FAFSA's need-analysis formula for family farms and small businesses, and providing resources to address the Pell Grant funding shortfall. Significant advocacy efforts have been underway across healthcare profession associations, with coordinated engagement from chiropractic, medical, nursing, and health sciences communities working to protect educational access. These improvements demonstrate that advocacy efforts are making a meaningful impact.
Persistent Concerns for Healthcare Education
Despite these improvements, the Senate proposal still contains provisions that pose serious threats to higher education, including health professions education. The elimination of Grad PLUS loans would remove a critical financing tool for graduate students, particularly those pursuing public service careers in healthcare. Rather than eliminating this program entirely, implementing reasonable loan limits would better balance fiscal responsibility with educational access.
Also concerning for chiropractic and other healthcare professions is the proposal to cap graduate student borrowing at $100,000 lifetime for non-professional degrees. This reduction from the current $138,500 limit could create significant barriers for students pursuing advanced healthcare degrees. The borrowing limits would push students toward the private loan market, where many graduate students, including those studying healthcare professions, may not qualify for adequate financing. These changes risk contributing to healthcare workforce shortages while impacting students from underserved communities who rely on federal aid programs.
Unclear Pell Grant Changes
The Senate proposal includes language regarding Pell Grant eligibility that could unintentionally eliminate grants for more students than intended. While likely aimed at college athletes receiving full scholarships, the current wording suggests that students whose full financial need is met through non-federal aid could lose Pell eligibility retroactively.
Scope Limitations
The current proposal covers only the Senate HELP Committee's jurisdiction and does not include changes to the federal endowment tax or higher education tax benefits affecting students and families, such as the American Opportunity Tax Credit or the treatment of student loan forgiveness. These issues fall under the Senate Finance Committee's purview and may be addressed in separate legislative language.
Critical Timing and Action Needed
With the Administration pushing for reconciliation completion by July 4th, the window for advocacy is short. The improvements already seen in the Senate version prove that sustained pressure is effective. Higher education and healthcare profession associations have mobilized extensively, creating a unified voice that spans medical, nursing, chiropractic, and other health sciences disciplines. This coordinated advocacy effort has demonstrated collective concern about potential impacts on healthcare workforce development. Healthcare education stakeholders must continue intensive engagement with senators to address remaining concerns.
Looking Forward
While the Senate's reconciliation proposal makes progress over the House version, significant work remains to protect access to healthcare education. The stakes are high for chiropractic and other health sciences programs that serve communities nationwide. Continued advocacy during this narrow window is essential to ensure that federal policy supports rather than undermines the training of tomorrow's healthcare professionals.
The improvements already achieved demonstrate that voices from the healthcare education community are being heard. To facilitate continued engagement, the Association of Chiropractic Colleges (ACC) has established an Action Center on its website that makes it easy for individuals to contact their representatives and senators. Visit www.chirocolleges.org/advocacy/ to learn more.
Sustained engagement with senators over the coming weeks will be crucial in shaping the final legislation to better serve students, institutions, and the patients they will ultimately care for.