Medical debt and your credit report in 2026
Unpaid medical bills can still appear on a credit report, but there is no federal ban: a court vacated the CFPB's 2025 rule on July 11, 2025. What limits reporting now is the seven-year federal clock, the credit bureaus' own 2023 policies, state laws whose enforceability is now contested, and special rules for nonprofit hospitals. You can check your report free every week and dispute errors.
The rules about medical bills and credit reports changed several times in three years, and most of the online explanations are older than the latest change. In early 2025 the Consumer Financial Protection Bureau finalized a rule that would have removed medical debt from credit reports. Months later a federal court vacated it. In between, the credit bureaus had already changed what they report, and a number of states had written their own limits. This guide sets out which of these rules is in force today, what each one covers, and what you can actually do about a medical item on your own report.
Everything here is checked against primary sources on October 22, 2026: the CFPB's rule page, the Fair Credit Reporting Act as it appears in the U.S. Code, the Treasury regulation for nonprofit hospitals, the CFPB's debt collection regulation, a bureau press release, and one state bill page. This is general information, not legal advice. If a report error is costing you a loan, a lawyer or a legal aid office can look at the specifics. This site covers billing and prices only, so there is nothing here about credit scoring models, which this guide does not describe.
Where things stand: a dated status table
Four layers of rules apply to a medical item on a credit report. They are separate, they do different things, and a medical item can be affected by more than one.
| Layer | What it says | Status as checked October 22, 2026 |
|---|---|---|
| Federal CFPB rule (Regulation V medical information rule, finalized January 2025) | Would have barred creditors from furnishing, and consumer reporting agencies from considering, coded medical debt information | Vacated July 11, 2025 by the U.S. District Court for the Eastern District of Texas in Cornerstone Credit Union League v. CFPB. The CFPB page says the court found it exceeded the Bureau's authority and conflicted with the FCRA, and calls its rule materials reference only |
| Fair Credit Reporting Act, 15 U.S.C. 1681c | A collection account may be reported for seven years, counted from 180 days after the delinquency that preceded the collection | In force |
| Credit bureau policies (Equifax, Experian, TransUnion) | Announced April 11, 2023: paid medical collections not included (as of July 1, 2022), a one-year wait before unpaid medical collections appear, and removal of medical collections under $500 | Voluntary policies announced in a press release. Not re-verified on each bureau's site for this guide |
| State laws | Vary: some bar bureaus from including medical debt, some bar providers and collectors from reporting it, some limit use of medical information in reports | Contested. The CFPB's October 28, 2025 interpretive rule (no force of law) says the FCRA generally preempts them; a Texas law was held preempted on August 10, 2026; Colorado's HB23-1126 is under a pending preemption challenge. The Consumer Federation of America counted 14 states as of July 11, 2025 |
| Nonprofit hospital rules, 26 CFR 1.501(r)-6 | Reporting adverse information to credit bureaus is an extraordinary collection action that cannot start until the hospital has made reasonable efforts to determine financial assistance eligibility | In force for nonprofit hospital facilities |
Sources: CFPB rule page; 15 U.S.C. 1681c; TransUnion newsroom copy of the joint bureau release dated April 11, 2023; Consumer Federation of America, July 11, 2025; Colorado General Assembly bill page for HB23-1126; eCFR 26 CFR 1.501(r)-6. All checked October 22, 2026.
The seven-year clock, with a worked timeline
The federal rule on how long a medical collection can stay on a report is the same as for any other collection account. The Fair Credit Reporting Act bars a consumer reporting agency from reporting accounts placed for collection or charged to profit and loss that "antedate the report by more than seven years," and a separate subsection says the seven years start when the 180-day period beginning on the date the delinquency began has expired. Two points follow. The clock does not restart when a collector buys or takes over the account, because it is tied to the original delinquency. And it does not start on the date of service or on the date of the bill.
The dates below are hypothetical, to show how the pieces line up. Nothing in the table is advice about any particular account.
| Hypothetical event | Date | Rule it illustrates |
|---|---|---|
| Care received; hospital sends first post-discharge bill | February 1, 2026 | The nonprofit hospital's 120-day waiting period before any extraordinary collection action runs from this statement |
| Account becomes delinquent (first missed due date) | March 1, 2026 | This is the "commencement of the delinquency" for the federal clock |
| Earliest date the hospital could start an extraordinary collection action, if it also gave the required written notice at least 30 days earlier | June 1, 2026 | 26 CFR 1.501(r)-6(c)(3)(i) and (c)(4)(i): 120 days from the first post-discharge statement, 30-day written notice |
| 180 days after the delinquency began | August 28, 2026 | 15 U.S.C. 1681c(c)(1): the seven-year period starts at the expiration of this 180-day period |
| Seven years later: the collection item must be gone from reports | August 28, 2033 | 15 U.S.C. 1681c(a)(4) |
This is the outer limit set by federal law. A bureau policy or a state law can make the item disappear sooner, or keep it from appearing at all. Under the bureaus' 2023 announcement, for instance, an unpaid medical collection would not have appeared until a one-year wait had passed, and a paid-in-full item would not appear at all. This guide keeps that phrased as the announcement's wording, because the policy comes from a press release and the bureaus' current pages are the better place to confirm it.
What changed when the CFPB rule was vacated
The CFPB's rule page records the sequence. The Bureau finalized a Regulation V rule, "Prohibition on Creditors and Consumer Reporting Agencies Concerning Medical Information," in January 2025. The page explains that the Fair Credit Reporting Act already allows creditors to furnish and bureaus to consider medical information as long as it does not identify or allow someone to infer the specific provider or the nature of the services, products or devices. The rule would have changed that. On July 11, 2025, the Eastern District of Texas vacated it, with the Bureau and the plaintiffs jointly requesting that outcome, in Cornerstone Credit Union League v. CFPB. The court concluded the rule exceeded the Bureau's authority and conflicted with the Act, and that the Bureau lacked authority to limit the contents of consumer reports based on state and other law. The CFPB page now describes the rule materials as for reference only.
Practically, for a person with an old medical collection, two things followed. First, a nationwide ban never took effect. Second, the bureaus' voluntary changes and state laws became the main protections, so the answer to "will this show up" depends on the date, the amount, the bureau and the state.
Whether the Fair Credit Reporting Act overrides state laws that limit medical debt reporting is now being decided in court, and three dated developments bear on it. First, on October 28, 2025 the CFPB issued an interpretive rule, "Fair Credit Reporting Act; Preemption of State Laws" (90 Federal Register 48710), replacing a 2022 rule it had withdrawn. It says the FCRA generally preempts state laws that touch broad areas of credit reporting, and argues that the 2022 rule wrongly concluded that states can regulate the presence of categories of information such as medical debt on a consumer report. The rule says on its face that it is guidance with no legally binding effect, so it states the Bureau's view and does not decide the question. Second, on August 10, 2026 the U.S. District Court for the Western District of Texas, in Consumer Data Industry Association v. State of Texas (No. 1:19-CV-876-RP), granted summary judgment in part, held that Texas Business and Commerce Code section 20.05(a)(5), which barred certain out-of-network medical collection accounts from consumer reports, is expressly preempted by 15 U.S.C. 1681t(b)(1)(E), and permanently enjoined its enforcement. The order is the source here; this guide has not checked whether the State appealed. Third, a federal lawsuit in Colorado, ACA International and Fresno Credit Bureau v. Fulford (No. 1:25-cv-03530-RBJ, D. Colo.), challenges HB23-1126 as preempted by the FCRA and as a restriction on speech. Its amended complaint was filed January 9, 2026, and no ruling was found as of October 22, 2026. This guide takes no position on the merits. The practical point is that a state law limiting medical debt reporting may not protect you in the way its text suggests, and a state attorney general's office or a legal aid organization is the right place to ask how a particular law is being applied today.
What the bureaus said in 2023, and how to read it
On April 11, 2023, Equifax, Experian and TransUnion jointly announced that they had removed medical collection debt with an initial reported balance under $500 from U.S. consumer credit reports, following commitments made the year before. The same release restated two earlier changes: that, as of July 1, 2022, medical collection debt paid in full is no longer included on credit reports, and that the time before an unpaid medical collection appears on a report had been increased from six months to one year. The release was read on TransUnion's newsroom page on October 22, 2026.
Three cautions about using that announcement. It is a press release, not a statute or a regulation, so the policies can change without notice. No current policy page on each bureau's site was reviewed for this check, so the statements above are written as what was announced in 2023, not as a guarantee about today. And the thresholds are defined by the reported initial balance, so a $480 bill that grows with a late fee in collection is judged by its initial reported balance, as the release describes it. If a medical item appears on your report that seems to fall within one of these categories, say so in your dispute and name the announcement.
Nonprofit hospitals face an extra limit before they can report
Many hospitals are tax-exempt, and for them the Treasury regulation 26 CFR 1.501(r)-6 lists "reporting adverse information about the individual to consumer credit reporting agencies or credit bureaus" as an extraordinary collection action that cannot begin until the hospital has made reasonable efforts to decide whether you qualify for its financial assistance policy. The waiting periods and notice steps are set out once, in the guide on hospital financial assistance and charity care. In a dispute, ask the hospital when it sent its first bill, whether it gave the required written notice before the item was reported, and whether an assistance application was pending.
Three limits apply. The rule covers nonprofit hospital facilities, not physician groups, ambulance companies or labs that bill separately, and not for-profit hospitals. It protects eligibility for assistance, which turns on the hospital's own policy. And it governs when an action may begin, not whether a valid debt can ever be reported.
State laws: what to look for without a map
The Consumer Federation of America's July 11, 2025 summary says that 14 states had passed laws since 2023 aimed at removing many medical bills from residents' credit reports, in three forms: barring consumer reporting agencies from including medical bills in credit reports, barring certain health care providers and debt collectors from sending medical bills to consumer reporting agencies, and prohibiting the use of medical information that appears on consumer reports. It referred to an interactive map, which was not available for review. Given the developments above, treat that count as the number of laws enacted, not the number currently enforceable, and this guide did not verify the laws of individual states beyond one.
That one is Colorado. The legislature's bill page for HB23-1126 says that consumer reporting agencies may not include adverse information in a consumer report if they know or should know it concerns medical debt, and that debt collectors may not falsely or misleadingly claim that medical debt will appear on a consumer report or affect a credit score, with an exception for credit transactions above the national conforming loan limit. The governor signed the bill on June 5, 2023, and it took effect August 7, 2023. It is the subject of the pending federal lawsuit described above, in which the plaintiffs ask the court to let bureaus resume reporting medical debt; no ruling was found. Until a court decides, a Colorado reader should check the current status before relying on the law.
To find out what your state does, search the legislature's site for the state's medical debt credit reporting law, or ask the state attorney general's consumer protection office. Ask four questions: does the law bar the bureaus, the furnishers or both; does it apply only above or below a dollar amount; when did it take effect; and has a court limited it. A law that took effect last year does not remove an item that was already on your report unless it says so.
Step by step: find it, check it, dispute it
1. See what is actually on your reports
The Federal Trade Commission's consumer site says the three nationwide credit bureaus have permanently extended a program that lets you check your report from each of them once a week for free through AnnualCreditReport.com, and that federal law also entitles you to a free report from each bureau every 12 months. The FTC says AnnualCreditReport.com is the only authorized source for those reports and warns against going to the bureaus individually for them. Pull all three, because different bureaus can hold different items. Look for the collector's name, the original creditor, the amount, the date opened, the date of first delinquency and the status.
2. Compare each item with your own paper
Match each medical item against the bill, the explanation of benefits and any payment record. The usual problems fall into a short list.
| What you see | Why it may be wrong or removable | What to gather |
|---|---|---|
| A collection for a bill your insurance should have paid | The claim may never have been processed, or was denied and is under appeal | Explanation of benefits, claim number, appeal letters |
| An item you paid in full | Under the bureaus' 2023 announcement, paid medical collections are no longer included | Receipt, bank record, a paid letter from the collector |
| An initial balance under $500 | The 2023 announcement says these were removed | The original bill amount and the date |
| An item reported less than a year after it went to collection | The 2023 announcement describes a one-year wait before unpaid medical collections appear | The date the item was first reported |
| A hospital bill reported while you had a financial assistance application pending | A nonprofit hospital must make reasonable efforts to determine eligibility before reporting | Application, dates, the hospital's notice letter or lack of one |
| A collector reported it before ever contacting you | Regulation F bars a debt collector from furnishing information to a bureau until it has spoken with you, or sent a letter and waited a reasonable time for a notice that it was undeliverable | Your records of when the first contact arrived |
| The wrong amount, a duplicate or an account that is not yours | Basic accuracy; the same debt can be listed by two collectors | Itemized bill, identity documents, both account numbers |
| A state with a reporting law on the books | The law may bar the item altogether | The statute and the effective date |
The regulation behind the sixth row is 12 CFR 1006.30(a), in the CFPB's debt collection rule. It also applies to third-party collectors, not to a hospital collecting its own bill in its own name, a distinction covered in the guide on what to do when a medical bill goes to collections.
3. Dispute in writing, with both the bureau and the furnisher
The FTC page says you should contact both the credit bureaus and the business that supplied the information to fix a mistake. Under the Fair Credit Reporting Act, once a bureau receives a dispute it generally must reinvestigate and either record the item's current status or delete it within 30 days. That period can be extended by up to 15 more days if you send relevant information during the first 30. The bureau must notify the business that supplied the item within five business days, including the information you gave it. It must send you written results within five business days after finishing. If an item is found inaccurate or incomplete, or cannot be verified, the bureau must promptly delete or modify it. If the dispute is not resolved, you may add a brief statement of your side to your file, which the bureau can limit to 100 words.
Your dispute letter should identify the item by account number and creditor, say what is wrong, say why with the specific rule if one applies, attach copies, and ask for deletion. Keep it short, send it by a method that gives you proof of delivery, and keep the date. Do not send originals.
4. If the item is correct and unpaid
If the debt is yours and the amount is right, the question becomes whether to pay, negotiate or apply for assistance first. The 2023 announcement says paid-in-full items are not included, which matters for choosing between paying and settling. A settlement for less than the full balance may leave the item reported as something other than paid in full, so ask the collector in writing, before you pay, how it will report the account. The guide on negotiating a hospital bill covers payment plans and settlements in the order that protects you.
What about the medical bill that is still with the hospital?
Most of the damage from medical bills comes when a bill leaves the provider. While it is still with the billing office, the provider has not reported anything, and you can use that time. Check that the claim was processed (see how to read an explanation of benefits), ask for the itemized bill, ask about financial assistance, and ask in writing for a hold on the account while a dispute or an application is pending. A hold request is a request, not a rule, but it creates a record that the hospital was on notice. For nonprofit hospitals, the 120-day and 30-day periods described above are the minimums, and the application period for financial assistance is set by the hospital's policy.
Mistakes that make the report worse
- Ignoring a debt validation notice. The collector's notice sets a window, discussed in the collections guide, in which a written dispute stops collection until the debt is verified.
- Paying a different account by mistake. Two collectors can hold what looks like the same debt. Match the original creditor and date of service before paying.
- Disputing by phone only. A written dispute with copies is the record.
- Assuming a paid account will disappear automatically. Check each bureau after the stated period.
- Assuming the old ban exists. Many articles written in early 2025 describe the CFPB rule as law. It was vacated in July 2025.
Credit report questions
Can unpaid medical bills show up on my credit report?
Yes, in general. Federal law lets a collection account appear on a consumer report for seven years, counted from 180 days after the delinquency that led to the collection. What has changed over time is who is willing to report it. The three nationwide bureaus announced in 2023 that they had set a one-year wait before unpaid medical collections appear and had removed paid medical collections and those under $500.
Did the CFPB ban medical debt from credit reports?
It finalized a rule in January 2025, but the U.S. District Court for the Eastern District of Texas vacated it on July 11, 2025, in Cornerstone Credit Union League v. CFPB. The CFPB's own rule page says the court found the rule exceeded the Bureau's statutory authority and conflicted with the Fair Credit Reporting Act, and describes the rule materials as being for reference only.
Do state laws still limit medical debt on credit reports?
Some were enacted, but their enforceability is contested. A Consumer Federation of America summary dated July 11, 2025 counted 14 states with such laws. Since then the CFPB has said, in a non-binding interpretive rule dated October 28, 2025, that the FCRA generally preempts state laws that regulate the presence of medical debt on a report. On August 10, 2026 a federal district court in Texas held that the FCRA preempts a Texas law on out-of-network medical collections, and a lawsuit filed against Colorado's HB23-1126 asks a court to declare it preempted; no ruling in that case was found. Check the current status of your own state's law.
Can a hospital report my unpaid bill right away?
A nonprofit hospital facility covered by section 501(r) is limited. Reporting adverse information to credit bureaus is an extraordinary collection action, and the hospital must wait at least 120 days after the first post-discharge billing statement and give a written notice at least 30 days before starting one. A for-profit hospital is not subject to 501(r).
How do I dispute a medical collection on my credit report?
Dispute it in writing with the credit bureau and with the business that reported it. Under the Fair Credit Reporting Act the bureau generally has 30 days to reinvestigate, extendable to 45 if you send more information during the first 30 days, and must delete information it cannot verify. Keep copies of everything.
Does paying a medical collection remove it?
According to the three bureaus' 2023 announcement, medical collection debt that has been paid in full is no longer included on credit reports, a policy they said took effect July 1, 2022. That is a voluntary bureau policy, announced in a press release, so confirm it on each bureau's site before relying on it.
Primary sources and when they were checked
- Consumer Financial Protection Bureau, Prohibition on creditors and consumer reporting agencies concerning medical information (Regulation V): the January 2025 rule and the July 11, 2025 vacatur. Checked October 22, 2026.
- 15 U.S.C. 1681c (seven-year reporting period; 180-day start) and 1681i (reinvestigation), as published in the U.S. Code. Checked October 22, 2026.
- TransUnion newsroom, Equifax, Experian and TransUnion remove medical collections debt under $500 from U.S. credit reports, April 11, 2023. Checked October 22, 2026.
- Federal Trade Commission, Free credit reports. Checked October 22, 2026.
- CFPB interpretive rule, Fair Credit Reporting Act; Preemption of State Laws, 90 FR 48710 (October 28, 2025). Consumer Data Industry Association v. State of Texas, No. 1:19-CV-876-RP (W.D. Tex. Aug. 10, 2026), order on motion for summary judgment. ACA International and Fresno Credit Bureau v. Fulford, No. 1:25-cv-03530-RBJ (D. Colo.), amended complaint, January 9, 2026. Checked October 22, 2026.
- Consumer Federation of America, Does your state allow medical bills to appear on credit reports?, July 11, 2025; Colorado General Assembly, HB23-1126. Checked October 22, 2026.
- eCFR, 26 CFR 1.501(r)-6 (extraordinary collection actions; 120-day and 30-day rules) and 12 CFR 1006.30 (collector furnishing to consumer reporting agencies). Checked October 22, 2026.
General information, not legal advice. Laws and bureau policies change; confirm current rules with the CFPB, your state attorney general and each credit bureau. Prices only on this site: no diagnosis or treatment advice.
If a medical item is already with a collection agency, go next to the guide to a medical bill in collections, which sets out the dated steps for the first 30 days after the collector's first notice.