Guide. A federal rule would have removed medical debt from credit reports. A court struck it down in 2025. Here is what still protects you. Updated September 6, 2026.
In January 2025 the Consumer Financial Protection Bureau finalized a rule barring credit reporting companies from putting medical debt on consumer reports. On July 11, 2025 the U.S. District Court for the Eastern District of Texas vacated it, holding that the Fair Credit Reporting Act permits reporting medical debt that is coded to protect medical privacy. So medical bills can appear on your report again, and lenders can consider them.
That is the headline. The part that matters more for most people never depended on the rule: the three bureaus made their own changes in 2022 and 2023, and those still stand.
What the bureaus removed on their own
- Paid medical collections are off. Once the balance is zero, the entry should not appear at Equifax, Experian or TransUnion.
- Medical collections under $500 are off. That threshold took effect on April 11, 2023.
- New medical collections wait a year. The bureaus hold a medical collection for one year from the date of service before it can appear, instead of the 60 to 120 days that applied before. That year is your window to sort out the bill, the insurer and the itemization.
The CFPB estimated these changes took medical debt off the reports of about half the people who had it. They are voluntary industry policy, not law, which is why they can change and why checking your own report still matters.
What the models do with what remains
Not all scores treat a medical collection like a credit card collection. FICO 9, FICO 10 and VantageScore 3.0 and 4.0 weigh medical collections less than other collections, and all four ignore a collection once it is paid. FICO 8, still common at card issuers, does not make the distinction. Mortgage underwriting often uses older FICO versions, which is where a medical collection does the most damage.
The order that gets medical debt off your file
- Ask for an itemized bill. Not a summary, the line-by-line. Duplicate charges, services never received and wrong dates are common, and a bill you dispute with the provider is a bill the collector cannot verify.
- Check the insurer's explanation of benefits against it. If the claim was denied for a paperwork reason, appeal it. A resubmitted claim can erase the whole balance.
- Ask about financial assistance. Nonprofit hospitals must have a written financial assistance policy to keep their tax status, and many people who qualify never apply. Ask for the policy by name.
- If it is already in collections, demand validation in writing within 30 days of the first notice. Under the Fair Debt Collection Practices Act and Regulation F, collection stops until they prove the debt, and medical debts that changed hands often fail this step.
- Check the amount and the age. Under $500 or paid means it should not be on the report at all. Dispute it with the bureau and cite the policy.
- Never pay from a phone call. Get the settlement or the deletion agreement on the collector's letterhead before money moves.
What changed for state laws
Several states passed their own bans on reporting medical debt. The same July 2025 decision held that the Fair Credit Reporting Act preempts state laws in this area, which puts those bans in question. State rules on billing, financial assistance and collection practices are a separate matter and still apply. Check your state's attorney general page before assuming either way.
Three things not to do
- Do not put a medical bill on a credit card to make it disappear. A hospital balance at 0% beats a card balance at 22%, and the card version cannot be negotiated.
- Do not ignore the first letter. The 30-day validation window is the strongest tool you get, and it closes.
- Do not assume the collector has the paperwork. Ask for the itemized bill, the assignment and the provider's own record.
Find it before a lender does. A Banrox three-bureau monitor alerts you the day a collection lands on Experian, Equifax or TransUnion, while the validation window is still open. The Documents Lab has the validation request and the CFPB dispute letter, free.
Sources
- CFPB: Paid medical debt and amounts under $500 should no longer be on your report
- CFPB: Regulation F, debt collection
- FTC: Debt collection FAQs
Educational content, not legal advice. The CFPB medical debt rule was vacated on July 11, 2025 by the U.S. District Court for the Eastern District of Texas; bureau policies described here are voluntary and can change.
