**Claim (2026, horizon 2045):** Program mix (licensed vs. unlicensed share of credit hours) is the dominant predictor of institutional direction, but region governs whether the winning program mix is *reachable*. SEC/Sunbelt publics hold both advantages — growing 18-year-old cohorts through 2045, and existing nursing/engineering complexes they can scale — and grow seats 10–25% through 2040 as legislatures fund them as economic development. Northeast and Rust Belt institutions face a structural squeeze: their 18-year-old cohorts contract 10–15%, and pivoting into licensed programs takes 7–10 years (clinical placements, faculty, facilities, state approval) — longer than their enrollment runway, so decline locks in. Projection: majority-licensed Sunbelt publics grow; Northeast small privates without a licensed core shrink 30–50% by 2040 regardless of governance quality; surviving Northeast exceptions are licensed-core institutions with hospital-system or land-grant ties. Formulation: program mix picks the winners, but regional demography picks which losers can still switch.