Medical Debt on Credit Reports in 2026: What's Gone, What Still Counts, and Which States Go Further
A federal rule to wipe medical debt from credit reports was struck down in 2025, but bureau policies and a growing list of state laws still keep most of it off. Here is what counts in 2026 and what you can do.
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📐 Figures verified Sep 28, 2026 against the CFPB's October 2025 interpretive rule on state credit-reporting laws, the IRS rules for nonprofit hospitals (sections 501(r)(4) and 501(r)(6)), the CFPB on disputes and reporting timelines, the credit bureaus' medical debt policies as described by Experian, and the National Consumer Law Center's tracking of state laws. How we check numbers →
Paid medical collections, medical collections under $500 and medical debt less than a year past due don't appear on credit reports, under voluntary bureau policies. The 2025 federal rule that would have removed the rest was vacated, so larger unpaid medical collections can still appear, unless your state bans them. Fifteen states and Washington, D.C. restrict medical debt reporting.
Numbers That Matter
| Figure | Amount | Source | Verified |
|---|---|---|---|
| Nonprofit hospitals | Must have a written financial assistance policy and publicize it | IRS, section 501(r)(4) | Sep 28, 2026 |
| Reporting a patient to credit bureaus | An extraordinary collection action: not before reasonable efforts to check assistance eligibility, generally not until 120 days after the first post-discharge bill, with 30 days' written notice | IRS, section 501(r)(6) | Sep 28, 2026 |
| State medical-debt reporting laws | The CFPB says federal law overrides them (an interpretive rule, not binding on courts) | CFPB, Federal Register, Oct. 28, 2025 | Sep 28, 2026 |
| Collections on credit reports | Up to 7 years | CFPB | Sep 28, 2026 |
| Disputing an item that shouldn't be there | The bureau generally must investigate within 30 days | CFPB | Sep 28, 2026 |
What's Gone, What Still Counts
| Rule or policy | What it does | Status in 2026 |
|---|---|---|
| Bureau policy: paid medical collections | Deleted from reports once paid | In effect since July 2022 |
| Bureau policy: one-year wait | New medical collections don't appear until a year after they go delinquent | In effect since July 2022 |
| Bureau policy: under $500 | Medical collections under $500 aren't reported at all | In effect since April 2023 |
| CFPB rule (January 2025) | Would have removed medical bills from credit reports and barred lenders from using them | Vacated by a federal court in Texas, July 11, 2025 |
| CFPB interpretive rule (October 2025) | Says the Fair Credit Reporting Act overrides state limits on report contents | Not binding on courts; cited in challenges to state laws |
| State laws | Ban or restrict medical debt reporting | 15 states and D.C.; some are being challenged |
What's left on reports nationally: unpaid medical collections of $500 or more that are more than a year old, in states without their own ban.
Which States Go Further
According to the National Consumer Law Center's tracking, 15 states have laws that ban or restrict medical debt on credit reports: California, Colorado, Connecticut, Delaware, Illinois, Maine, Maryland, Minnesota, New Jersey, New York, Oregon, Rhode Island, Vermont, Virginia and Washington. Washington, D.C. added a ban on furnishing medical debt to credit bureaus effective August 20, 2026. Recent effective dates include Vermont (July 1, 2025), Oregon (January 1, 2026) and Virginia (July 1, 2026).
The laws aren't identical: some bar credit bureaus from including medical debt, others bar hospitals and collectors from reporting it, and some also bar lenders from using it. And they're contested. After the CFPB's October 2025 interpretive rule, a debt collection trade group sued to overturn Colorado's law, and similar challenges could follow elsewhere. Check your state attorney general's site for the current rule where you live.
How Scores Treat Medical Debt
- VantageScore 3.0 and 4.0 ignore medical collections entirely, paid or unpaid.
- FICO 9 and FICO 10 ignore paid collections and give unpaid medical collections less weight than other collections.
- FICO 8 and the Classic FICO scores most mortgage lenders still use count a medical collection like any other. Since September 9, 2026, lenders selling to Fannie Mae and Freddie Mac can use VantageScore 4.0 instead, so ask which model yours uses.
Before a Bill Reaches Collections
If the bill is from a nonprofit hospital, federal tax rules work in your favor. The hospital must have a written financial assistance policy, and reporting you to a credit bureau counts as an "extraordinary collection action" it can't take until it has made reasonable efforts to see whether you qualify for assistance, generally not until 120 days after the first bill following your discharge and only after 30 days' written notice. Ask for the financial assistance application, an itemized bill and a review of any insurance denial before paying.
Worked Example: Three Medical Bills
- A $1,800 emergency room bill went to collections 14 months ago, and Pat lives in a state without a ban. It's over $500 and more than a year old, so it can appear on Pat's reports and count on Classic FICO, though VantageScore ignores it. The hospital is a nonprofit, and Pat's income qualifies for a 50% discount under its assistance policy, cutting the bill to $900. Once paid, the bureaus delete the collection.
- A $420 lab bill in collections never appears on Pat's reports: it's under $500.
- If Pat lived in a ban state, such as Colorado or Minnesota, the $1,800 collection couldn't be reported under state law, subject to the pending challenges.
Discount levels vary by hospital policy and income. Pat is an illustration.
Decision Rules
If this, then that
- If a paid medical collection is still on your report → dispute it with each bureau showing it.
- If a medical collection under $500, or less than a year old, appears → dispute it; it shouldn't be there.
- If you live in a ban state → dispute any medical collection and cite the state law.
- If the bill is from a nonprofit hospital → apply for financial assistance before paying or settling.
- If you're applying for a mortgage with a medical collection → ask whether the lender uses VantageScore 4.0.
Mistakes to avoid
- Paying a bill before checking it against your insurance and the itemized charges.
- Putting a medical bill on a credit card, which turns protected medical debt into ordinary card debt.
- Assuming the federal rule wiped your medical debt; it was vacated.
- Ignoring a collection that's wrong instead of disputing it.
- Skipping the hospital's financial assistance application.
Related: the medical debt guide covers your options on unpaid bills; how to negotiate medical bills walks through the calls; how to read your credit report shows where collections appear; and which credit score mortgage lenders use explains the models.