New Biden administration rule would ban medical debt from credit reports

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Vice President Kamala Harris on Tuesday announced a new effort to ban medical debt from credit reports, something that would ease a burden that falls most heavily on women and Black people.

“Medical debt makes it more difficult for millions of Americans to be approved for a car loan, a home loan or a small business loan, all of which in turn makes it more difficult to just get by, much less get ahead, and that is simply not fair. Especially when we know that people with medical debt are no less likely to repay a loan than those without medical debt,” Harris said. “No one should be denied access to economic opportunity simply because they experienced a medical emergency.”

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Federal efforts to remove medical debt from credit reports began last fall after Harris announced that the Consumer Financial Protection Bureau (CFPB) would take the first steps to create rules that would take medical bills off credit reports, prohibit creditors from using medical bills to make underwriting decisions and ban collectors from using medical debt to pressure consumers to make payments. These proposals would narrow the 2005 exemption in the Fair Credit Reporting Act, which allowed creditors to use medical debts in underwriting credit decisions. Creditors would still have the ability to access medical debts and bill information in certain instances, such as to evaluate loan applications for medical services.

Other federal efforts to curb medical debt include the No Surprises Act, which took effect in July 2022 and requires private health insurers to cover most emergency services, emergency care and non-emergency in-network services and prohibits medical providers from billing patients more than in-network cost sharing.

The rule change could lead to more people being able to borrow money, as CFPB Director Rohit Chopra said it would give lenders more accurate and predictive information about borrowers.

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“The 15 million Americans who would benefit from this credit reporting change would see their scores rise by an average of 20 points. … For mortgages alone, we estimate that this could lead to approximately 22,000 additional home loans each year,” he said. “Our action today is an important step toward reducing some of the unnecessary costs of getting sick in America.”

According to a senior administration official, this rule would include historical medical bill information and dental debt.

Other federal efforts to curb medical debt include the No Surprises Act, which took effect in July 2022 and prohibits surprise billing for most emergency services and non-emergency services done out-of-network.

The nationwide credit reporting agencies, which are Equifax, Experian and TransUnion, removed medical debt under $500 from consumer credit reports as of April 2023. However, this April, the CFPB released research that found 15 million Americans still have medical debt on their credit reports — particularly those in the American South and low-income communities. A March 2022 report from the CFPB found that Americans were harboring $88 billion in medical debt.

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A KFF Health Policy Research analysis published this year based on the 2021 national Survey of Income and Program Participation found that 20 million people owed a collective $220 billion in medical debt. The analysis found that 13 percent of people with disabilities reported having medical debt, compared with 6 percent of those without a disability. It also found that non-Hispanic Black people carry more medical debt than other racial and ethnic groups, and women carry more than men. A separate analysis found that 14 percent of people who gave birth within the last year and a half reported having medical debt, compared with 7 percent of those who did not.

“Since we know that Black adults and women are more at risk of having medical debt, then I would expect this policy would benefit those groups,” said Cynthia Cox, KFF vice president and director of the foundation’s Program on the Affordable Care Act, which examines health care coverage costs, affordability and accessibility.

Undue Medical Debt, the nonprofit formerly known as RIP Medical Debt that contacts hospitals and health care systems requesting that they sell or donate portions of patients’ debt, and Perry Undem, a nonpartisan public opinion research firm, surveyed over 2,600 adults in August 2023, 229 of whom were Black women. Among Black women, 27 percent said they have delayed or said no to health services out of concerns over acquiring medical debt. A study from the American Cancer Society published in March suggested that “medical debt is associated with worse health status, more premature deaths, and higher mortality rates at the county level in the US.”

In 2022, YouGov, a research data and analytics technology group, reported that 66 percent of Americans supported government relief for medical debt. Eva Stahl, the vice president of public policy and program management at Undue Medical Debt, attributes this support to the fact that it can impact anyone.

“It’s not a debt of choice, it’s a debt of necessity. Because there’s a general consensus about that, it’s not really a partisan issue,” she said.

Stahl said they have gotten interest from legislators across the nation, even in the South, with some jurisdictions in Texas and Kentucky showing interest in erasing residents’ medical debt. Some state-level efforts to erase medical debt for state residents have either passed or been proposed — some in partnership with Undue Medical Burden.

In June 2023, Colorado became the first state to prohibit medical debt from being included on residents’ credit reports. Similar legislation was passed this year in Connecticut and proposed in New Jersey.

Last year, Connecticut’s state legislature approved a budget that would allocate $6.5 million in American Rescue Plan (ARP) funding toward erasing medical debt for residents whose medical debt is 5 percent of their income or whose household income is up to 400 percent of the federal poverty line. Earlier this year, Arizona Gov. Katie Hobbs, a Democrat, announced efforts to use $30 million of ARP funding to cancel medical debt for up to 1 million Arizonans, using similar criteria as Connecticut. Both states partnered with Undue Medical Debt.

To Stahl, removing medical debt from credit reports has limitations.

“It's an action that is helpful, but it's not getting it's not at the it's not at the root,” which is “that people don’t have access to affordable high quality health care,” Stahl said. “Even if you banned medical debt from credit reports, which is an important and worthy exercise, people still have unpaid medical bills. … Patients will still feel the stress of having debt collectors call them several times a day, asking them when they're going to pay their medical bills, or they may get into payment plans that they can't really afford.”

A senior administration official said public comments are being accepted through August 12. They expect the rule to be finalized early next year.

The 19th is an independent, nonprofit newsroom reporting on gender, politics and policy.