The Hippocratic Oath is coming for higher education. Last week, Senate Republicans released a package of higher education reforms that includes a “do no harm” standard for colleges: Degree programs would be ineligible for federal student loans if their former students’ earnings are too low.

If enacted, the proposal would improve on the status quo, as the lowest-quality degree programs could no longer load students up with debt they will likely never repay in full. But the Senate could make further improvements: too many degree and certificate programs violate the principle of “do no harm” but nonetheless maintain access to loans under the proposed framework.

Here’s how the Senate proposal works:

• For undergraduate degree programs: The median earnings of working former students four years after exit must exceed the median earnings of working high school graduates aged 25 to 34 in the same state as the institution.
• For graduate programs of less than three years: The median earnings of working former students six years after entry must exceed the median earnings of working bachelor’s degree holders aged 25 to 34 who are either in the same state as the institution, in the same broad field of study as the program, or in the same state and field of study (the threshold is the lowest of these three options).
• For graduate programs of three years or more: The same as above, except former students’ earnings are measured ten years after entry.
• For undergraduate certificates: No standard.

For institutions where over half of students are out-of-state, earnings benchmarks are calculated based on the national population of comparable high school graduates or bachelor’s degree holders, rather than those in the same state as the institution.

If a program fails the earnings standard for two of three consecutive years, the institution may no longer disburse federal loans to students in that program. (Students may continue to access Pell Grants.) The test is program-level: a school’s gender studies program might lose access to loans while its engineering program continues to receive them.

Under the Senate’s framework, the vast majority of degree and certificate programs would maintain access to federal loans. The “do no harm” standard would hit two-year degrees hardest, along with a smattering of bachelor’s and master’s degree programs at private colleges.

Admittedly, my estimates are rough. The student cohorts in the Senate bill include both completers and non-completers—but existing federal data measure program-level earnings for completers alone. I adjust these figures to account for estimated earnings of non-completers, but such adjustments are imprecise. 

Under the Senate plan, over half of associate degree programs could lose loan access. Among two-year degrees in general studies, the passage rate is just 20%. Vocational associate degrees do somewhat better, but associate degrees overall have among the worst return on investment in higher education and high dropout rates to boot.

The upside is that associate degree programs are less dependent on loans to begin with, so losing access may not be catastrophic. After all, part of the appeal of a two-year degree is earning college credits with less debt.

By contrast, over 90% of bachelor’s and master’s programs pass the Senate’s earnings test. The bachelor’s programs with the lowest pass rates include culinary arts (8%), behavioral sciences (19%) and dance (29%). Among master’s degrees, the lowest pass rates are in alternative medicine (0%), music (19%), and dietetics (25%). This addresses programs with truly abysmal outcomes—median earnings for a master’s degree in alternative medicine are just $27,000.

The Senate proposal’s main shortcoming is its failure to account for debt burdens. Many degree programs deliver earnings slightly above the benchmark but impose outrageous student debt burdens. For example, New York University offers a master’s degree in film where median earnings are $46,000, but graduates owe a median debt burden of $168,000.

New borrowing limits in the Senate bill help this problem; most master’s degree students will face a lifetime borrowing cap of $100,000. But even that allows for excessive borrowing. The Senate’s accountability system would be stronger if it included an incentive for colleges to reduce debt burdens for low-earning programs.

Another issue with the framework is its exclusion of undergraduate certificate programs. Certificates like cosmetology are among the worst offenders in the chthonic pantheon of low-return postsecondary education. That may have been a political decision—senators wanting to avoid crushing the certificate sector entirely—but there should be some earnings benchmark for these programs. A compromise could be 150% of the federal poverty line, the same threshold short-term vocational programs must exceed to qualify for Pell Grants.

Overall, the Senate’s “do no harm” proposal would strengthen the higher education system. But the current political environment presents a once-in-a-generation chance to fix the broken federal role in higher education. Lawmakers shouldn’t miss the opportunity to go further.