Medical Debt and Your Credit Report: What Actually Changed, and What Didn't

What got struck down

In 2025, the CFPB finalized a rule that would have barred credit reporting agencies from including medical debt information on credit reports and barred lenders from using it in most lending decisions (consumerfinance.gov). It didn't survive. A federal court vacated the rule in July 2025 after the CFPB itself and the plaintiffs suing over it jointly asked for that outcome, on the grounds that the rule went beyond what the Fair Credit Reporting Act actually authorizes. As of 2026, there's no federal rule keeping medical debt off your credit report.

What's still actually in effect

The part people mix up: the vacated rule was never the only thing limiting medical debt on your file. In 2023, Equifax, Experian, and TransUnion made their own voluntary changes to how they handle it, and those changes were never touched by the court case — they're still standing:

• Paid medical collections are removed entirely. Once you pay off a medical collection account, it comes off your report, regardless of the balance. That's a real change from how collections normally work — most paid collections used to stay visible for years even after being settled.
• Small medical collections don't get reported at all. Medical collection debt with an original balance under $500 is excluded from your report (newsroom.transunion.com).
• You get a full year before it shows up. Unpaid medical debt doesn't appear on your report until 365 days after it's sent to collections — far longer than the standard reporting window for other collections, which gives you time to negotiate, dispute, or work out insurance issues before it touches your score.

None of that requires a lawsuit or a new law. It's just the three bureaus' own policy, and it's been in place since 2023 regardless of what happens in court.

Where the gap actually is

What the vacated rule would have added — and what you don't have now — is a ban on lenders factoring in medical debt information even when it's not on your report, plus protection against medical debt above $500 or unpaid past a year. If you owe more than $500 and it's been sent to collections for over a year without being paid, it can still land on your file and stay there for up to seven years from the date of first delinquency, the same as any other collection account.

A few states have passed their own, broader protections — some ban medical debt reporting entirely regardless of amount — but which ones apply depends on where you live, and the legal status of several of those state laws is still being contested. Don't assume your state is one of them without checking; assume the bureau-level protections above are your floor unless you've confirmed otherwise.

What to actually do with a medical bill in collections

• Pay it off if you can, even partially through a payment plan — once it's paid, it comes off your report under the bureaus' policy, not just your score improving over time the way most paid collections work.
• Check the original balance. If it was under $500 when it was first reported, it shouldn't be on your report at all — if it is, that's worth disputing.
• Use the 365-day window. If a bill just went to collections, you likely have a year before it can appear. That's real time to negotiate with the provider, appeal an insurance denial, or set up a payment plan before it touches your file.
• Don't wait on federal protection that doesn't exist right now. Plan around the bureau policies and your state's actual law, not around a rule that got vacated.

Wherever you're starting from — a small balance you can pay off today or a larger one that's already aged onto your report — knowing which protections are real changes what's worth doing next. See what you may be eligible for →