Darreonna Davis, The 19th

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.

Why threats against members of Congress are driving more security spending

Originally published by The 19th

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The rules around campaign funds — and the levels of threat faced by elected women of color — are in the spotlight as the Justice Department investigates spending by Rep. Cori Bush.

Threats targeting members of Congress — especially women of color — have grown over the past few years, and so has some members’ spending on security. This spending, and the rules surrounding it, are in the spotlight in the wake of news that the Justice Department is investigating spending by Rep. Cori Bush, a Missouri Democrat.

Bush said she used campaign funds to pay for security services provided by her husband but that she did so in compliance with regulations and in response to “relentless” threats. She has denied wrongdoing.

The House Committee on Ethics and the Federal Election Commission (FEC) are also reviewing Bush’s campaign spending. The Office of Congressional Ethics also conducted an investigation and found no wrongdoing, according to Bush.

Here’s what we know about Congress, campaigns and security spending.

What rules are there around campaign spending on security?

The FEC prohibits campaign spending on personal use — that is, anything that an officeholder would have even if they weren’t in office. These things include rent or mortgage payments, food, household supplies, clothing and tuition.

Any expense that an officeholder incurs as a result of their position — such as security following excessive threats — does not count as personal use. Candidates can pay family members to work on their campaign if they are providing a service to the campaign — such as security — but their family members are not allowed to work in their congressional offices. Additionally, the cost for the campaign services they provide must be within fair market value.

What security services are provided by Congress?

The Capitol complex, where members work in Washington, D.C., has security staffing. But not all members are guaranteed security when they’re outside of the complex.

Rank-and-file members, or those who do not have leadership positions, such as Bush, don’t get extra security. Only leaders, such as the speaker of the House and the Senate and House majority and minority leaders and whips are eligible for full-time protective services from the U.S. Capitol Police.

How much are Congress members spending for security?

An analysis from CQ Roll Call found that congressional campaign spending on security recently jumped, increasing from $385,000 in the entire 2019-2020 campaign cycle to nearly $3 million in 2021 alone. Bush, along with fellow Squad member New York Rep. Alexandria Ocasio-Cortez, and former Wyoming Republican Rep. Liz Cheney, were the only women among the top 10 security spenders in 2021. Bush, the top spender among women, spent $170,000 that year; Ocasio-Cortez $73,000; and Cheney $59,000.

Once in office, candidates can hire security personnel to accompany them during member-hosted events, events and to be stationed in district offices during business hours, according to the Committee on House Administration.

U.S. Capitol Police are seen on Capitol Hill in Washington, D.C. (STEFANI REYNOLDS/AFP/GETTY IMAGES)

How often have women in politics experienced threats in recent years?

The Capitol Police said they investigated 8,008 threats last year. They do not provide details about who received the most threats, but other studies show that elected officials who are women or people of color are more likely to face threats and acts of violence than men and White politicians.

In a poll of former Congress members by the University of Massachusetts Amherst last year, women, African-American and Latinx officials were more likely to say they and their families received threats often.

The same trends hold in other offices. A recent report on intimidation of state and local officeholders from the Brennan Center for Justice, a nonpartisan law and policy institute, found that women officials experience gender-targeted abuse three to four times more than their men counterparts, and officials of color were more likely to experience race-based abuse than White officials. Over 40 percent of state legislators faced threats or attacks over the past three years.

The year started with a spate of threats of violence against elected officials, many of them women. A number of those have come in the form of swatting, or when false reports are filed that result in police dispatching to someone’s home, and happened to officials including Republican presidential candidate Nikki Haley; Georgia Republican Rep. Marjorie Taylor Greene; Boston Mayor Michelle Wu; and Judge Tanya Chutkan, the federal judge who is overseeing former President Donald Trump’s election case. In the Brennan Center’s report, more Republican local and state officeholders said they experienced abuse than Democrats.

“The big takeaway is there’s no level of government, and there’s no type of candidate that’s immune from this problem, so really everybody should care about it,” said Gowri Ramachandran, the deputy director of elections and government at the Brennan Center’s Democracy program and author of the report on abuse.

What is the impact of these threats?

Threats discourage people, especially women of color, from pursuing political offices. Forty-four percent of the former Congress members surveyed by the University of Massachusetts Amherst said they are very concerned about election-related violence this year. In the Brennan Center’s report, half of the local officeholders who were women were less likely to run for reelection or a higher office due to abuse.

“It has been very difficult to recruit candidates for this upcoming election cycle. I’ve noticed it more this year than any other year that I’ve been involved in trying to get women and people of color to run for office,” Oklahoma state House Minority Leader Cydni Munson, the first Asian- American woman elected to the Oklahoma legislature, told the Brennan Center.

Beyond even their potential reelection, some expressed hesitancy to speak out on issues such as reproductive rights and gun safety for fear of threats.

“That’s really unfortunate because we need more women in the legislature. We need more mothers in the legislature. Those are real-life stories she could be bringing to the state Capitol,” Munson told the Brennan Center.