Medical debt on credit reports in 2026: what's actually in force

If you read a headline in January 2025 saying medical debt was being wiped off credit reports, the rule behind it existed on paper for about six months. A federal court vacated it in July 2025 before it ever took effect, and the federal government has since argued that states can’t fill the gap either.

What’s left in 2026 is a patchwork: voluntary policies at the three big bureaus, scoring models that discount medical debt in different ways, and state laws whose reach depends on lawsuits still being decided. The protections that do exist are real, and a medical collection that slipped past them is a reporting error you can dispute.

The short history, in dates

The CFPB’s own archived announcement now carries a note explaining the vacatur. The court found the rule exceeded the Bureau’s authority and conflicted with the FCRA, which allows medical debt information to be furnished and considered when it’s coded so it doesn’t reveal the provider or the nature of the services.

What the bureaus still keep off your report

The voluntary bureau policies are the protection most people actually benefit from. Under them, Equifax, Experian and TransUnion don’t report a medical collection if:

• It’s been paid. Paying removes it entirely, which isn’t the case for non-medical collections.
• Its initial reported balance was under $500. NCLC describes these as never reported, even if unpaid and in collection.
• It’s still inside the one-year wait. Unpaid medical collections can’t appear until a year has passed, which gives you time to sort out insurance and billing problems first.

These are company policies, not federal law. The bureaus adopted them voluntarily and could in principle change them. NCLC’s September 2026 update still describes all three in the present tense and urges consumers to check their reports for compliance, so a medical collection that breaks these rules is worth disputing.

Say your reports show these three medical collections:

All three are reporting errors under the bureaus’ own policies. Four months from now, the hospital bill could legitimately appear if it’s still unpaid. Disputes for items like these are covered in how to dispute a credit report error.

How scores treat the medical debt that remains

The medical collections that can still appear are unpaid, at least $500 at the start, and more than a year into collections. Score versions handle them differently:

• FICO 8: counts them like any other collection. The medical discount exists only in newer versions.
• FICO 9 and the FICO 10 suite: count them with less weight than other collections, according to myFICO.
• VantageScore 3.0 and 4.0: don’t use medical collection data at all, per VantageScore’s 2022 announcement.

That gap matters at the mortgage stage. Older FICO versions used by many mortgage lenders don’t get the newer medical treatment. The version-by-version breakdown is in how collections affect your score.

State laws: real, but contested

According to the National Consumer Law Center’s tracker, updated September 21, 2026, 15 states plus the District of Columbia have laws limiting medical debt in credit reports. They include large states such as California, New York and Illinois, and D.C.’s law was enacted in August 2026. The laws differ in scope and in whom they restrict, so one state’s protection may look nothing like another’s.

Whether those laws hold up is still being fought out:

• The CFPB says they’re preempted. Its October 2025 interpretive rule argues the FCRA leaves no room for states to keep categories like medical debt off reports. The rule itself says it “does not have the force or effect of law.” NCLC argues the reasoning is wrong and that courts, not the CFPB, will decide.
• Courts have split. The First Circuit held in 2022 that the FCRA didn’t preempt Maine’s medical debt law; Maine later broadened that law, and the question is back in federal court there. In August 2026 a federal court in Texas held a Texas law preempted and barred its enforcement, while rejecting the industry’s broadest preemption theory and declining to defer to either CFPB interpretive rule. NCLC reports a separate challenge to Colorado’s law.

So if you live in a state with a medical debt law, it may protect you, but don’t count on it without checking current status. Your state attorney general’s consumer protection office is a good place to confirm whether your state’s law is in force.

Medical debt that doesn’t look medical

The protections above apply to medical collections reported as medical. Some health care debt doesn’t show up that way:

• A medical bill paid with a regular credit card is now card debt. If the card goes unpaid, it’s reported like any other card.
• Medical credit cards and payment plans run by lenders are generally reported as credit accounts, with ordinary late-payment rules.
• A medical collection missing its medical coding may be getting treated as a regular collection. If you know a collection is from a provider, compare how each bureau labels it.

What to do now

1. Pull all three reports from AnnualCreditReport.com (free weekly) and flag every collection from a hospital, physician group, lab, ambulance service or medical billing company.
2. Sort each one using the three tests: paid, under $500 at the start, or less than a year since it went to collections. Any that meet a test shouldn’t be there.
3. Dispute the ones that shouldn’t be there with each bureau that shows them, and include proof of payment or the date the account went to collections if you have it.
4. For a new medical collection, use your debt validation rights within 30 days and ask the provider for an itemized bill. Insurance and billing mistakes happen, and the one-year wait exists to give you time to catch them.
5. For a legitimate unpaid medical collection of $500 or more, paying it removes it under the bureau policy. Ask the provider or collector whether a financial assistance program or reduced settlement is available first.
6. If a bureau or collector won’t fix a clear error, a complaint to the CFPB creates a record, and the company is expected to respond.

For the bigger picture of what else shifted in credit scoring over the last two years, see what changed in credit scoring in 2025 and 2026.