Medical Debt on Your Credit Report in 2026: What Still Shows and What You Can Fight

Did a federal rule remove medical debt from credit reports?

No. The CFPB finalized a rule that would have removed medical debt from credit reports, but on July 11, 2025, a federal court in the Eastern District of Texas vacated it at the joint request of the CFPB and the groups that had sued over it. The rule is not in effect. If a company is selling you help based on a new federal medical debt law, it is selling you something that does not exist.

What actually protects you today is a set of voluntary policies the three credit bureaus adopted in 2022 and 2023. Those policies were never part of the rule, so the court decision did not touch them. They keep a lot of medical bills off credit reports, but they are bureau policy rather than federal law, which means you should verify your own reports instead of assuming the policies were applied correctly.

What medical debt can still show on your report in 2026?

Under the current bureau policies, the only medical collections that should appear on your credit report are unpaid ones of $500 or more that are at least 12 months old. Every other medical collection is supposed to stay off. Here is how the policies work.

• Paid medical collections should not appear on your report at all, no matter how large the balance was.
• Medical collections with an initial balance under $500 are not reported.
• An unpaid medical collection cannot be reported until a full year has passed, so you have time to sort out the bill with the provider or your insurer first.
• What still shows: unpaid medical collections of $500 or more that are at least 12 months old.

Do medical collections still hurt your credit score?

It depends on which scoring model a lender pulls, and the gap is real. VantageScore says its 3.0 and 4.0 models stopped using medical collection data entirely at the end of January 2023, so a medical collection does not touch those scores. In FICO scoring, an unpaid medical collection over $500 still counts in FICO Score 9 and the FICO Score 10 suite, just with less impact than in older FICO versions such as FICO 8. All of those FICO versions ignore a collection reported with an original amount under $100. The same hospital bill can weigh lightly with one lender and heavily with the next.

Does your state protect you more than the bureaus do?

Fifteen states and Washington, D.C. have their own laws restricting medical debt on credit reports, according to the National Consumer Law Center's list, updated September 21, 2026: California, Colorado, Connecticut, Delaware, Illinois, Maine, Maryland, Minnesota, New Jersey, New York, Oregon, Rhode Island, Vermont, Virginia, and Washington. I am in Texas, and I want my Texas readers to hear this plainly: Texas is not one of them. Here at home, the voluntary bureau policies are the protection you have.

One caveat matters even if you live in one of those states. On October 28, 2025, the CFPB issued an interpretive rule saying the Fair Credit Reporting Act generally preempts state laws that touch on broad areas of credit reporting, and it named state limits on medical debt as one example. That rule is the agency's reading, not a court ruling. The CFPB itself wrote that the FCRA does not authorize it to give legally binding views on preemption, and that anyone who wants to apply preemption to a particular state law can litigate the question in court. Apart from the Texas case below, NCLC knew of only one other lawsuit making that argument against a state medical debt ban as of September 2026, filed by the debt collection industry against Colorado's law.

Texas got its own ruling. On August 10, 2026, in CDIA v. Paxton, a federal court in the Western District of Texas held that the FCRA preempts a narrow Texas law that barred credit reports from including debts left over from surprise out-of-network medical bills. My separate guide to medical debt in Texas, linked below, covers that case. In the other direction, a federal appeals court held in 2022 that the FCRA does not preempt Maine's medical debt law, so the courts have not settled this. Do not build your whole plan on a state law alone. The bureau policies and your federal dispute rights are the ground that is not moving.

What can you still dispute on a medical collection?

Your dispute rights under the Fair Credit Reporting Act did not go anywhere when the CFPB rule died. You can challenge any medical collection that is inaccurate, outdated, or unverifiable, for free, directly with each bureau. And because the bureau policies define what is even allowed to appear, a medical entry that breaks those policies is worth flagging too. Watch for these.

• A medical collection you already paid that is still reporting. Paid medical collections should not appear at all.
• A medical collection with an initial balance under $500 that is on your report anyway.
• A medical collection reporting before it was 12 months old.
• A balance that is wrong, inflated by fees, or already covered by insurance according to your records.
• A collection that is not yours, or the same bill reported by two different agencies at once.
• A date of first delinquency that is newer than reality, which stretches the seven-year clock past what the law allows.

Should you pay a medical collection that is reporting?

Paying can do more for a medical collection than for other kinds of collections, because under current bureau policy a paid medical collection should come off your report entirely. Regular collections can keep reporting as paid for the rest of their seven-year window. So if a medical collection of $500 or more is accurate and weighing on the score your lender uses, paying it does not just update the status. Under the bureaus' policy, the entry should disappear.

Be honest with yourself about the order of operations, though. Verify the bill first, dispute anything inaccurate first, and only pay what you truly owe. Nobody, including me, can remove a medical collection that is accurate, current, and verifiable while it sits unpaid, and anyone who promises that is not being straight with you. What a done-for-you service like mine handles is the verification and dispute grind across all three bureaus. Every one of those steps is also free to do yourself.