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Sep 21, 2023

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Anthony Lux serves as CCLP's director of communications. His areas of expertise include institutional communications strategies, constituency growth and network activation for cause-driven organizations. Staff page ›

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PRESS RELEASE: Consumer Financial Protection Bureau announces groundbreaking plan to protect Americans from the devastating effects of medical debt

by | Sep 21, 2023

CCLP Statement, Development and Promotion, Equity work, Health, Media coverage, News, News Release, Research and Policy Analysis

CFPB Proposes Prohibiting Inclusion of Medical Debt on Consumer’s Credit Reports

 

The following announcement was jointly released by our partners at National Consumer Law Center, Community Catalyst, the National Association of Consumer Advocates, RIP Medical Debt, and U.S. PIRG.

WASHINGTON – Consumer advocates at the National Consumer Law Center (NCLC), Community Catalyst, Americans for Financial Reform, National Association of Consumer Advocates, RIP Medical Debt, U.S. PIRG, and Colorado Center on Law and Policy cheer today’s announcement that the Consumer Financial Protection Bureau (CFPB) is proposing a prohibition on the reporting of all medical debts on credit reports.

“Negative credit reporting is one of the biggest pain points for patients with medical debt,” said Chi Chi Wu, senior attorney at the National Consumer Law Center. “When we hear from consumers about medical debt, they often talk about the devastating consequences that bad credit from medical debts has had on their financial lives.  A bad credit score doesn’t just affect your ability to get credit, but also your employment prospects, insurance rates, and ability to get rental housing. Yet, as the CFPB has found, medical debt has limited predictive value for creditworthiness compared to other types of debts.”

NCLC filed a petition to the CFPB in September 2022 requesting that the CFPB start a rulemaking process to ban the reporting of medical debts on credit reports.  Community Catalyst also filed a petition to ban the reporting of medical debts in April 2023, for which U.S. PIRG filed a comment in support.

“We applaud the Biden-Harris administration for taking important steps to address the medical debt crisis in America,” said Emily Stewart, executive director, Community Catalyst. “This is an important milestone in our collective efforts and will provide immediate relief to people that have unfairly had their credit impacted simply because they got sick. Nobody, no matter where we live or how much money we have, should be forced to make the impossible choice between getting essential care and going into debt.”

Voluntary credit reporting changes by Equifax, Experian, and TransUnion instituted a one-year delay before including alleged medical debts on credit reports. The three credit bureaus also eliminated the reporting of unpaid medical debts less than $500 and removed paid medical debts. However, CFPB research highlighted the limitations of these changes, including that about half of consumers with medical debts on their credit reports would continue to have those debts reported after the voluntary changes and that consumers whose debt would be removed were more likely to be white and higher income.

“The voluntary changes by the credit bureaus were simply not enough,” said Julia Char Gilbert, Connelly Policy Advocate at Colorado Center on Law and Policy. “Patients with medical debts over $500 are often most vulnerable to the catastrophic harms of damaged credit reports, a key reason that Colorado moved to ban credit reporting of all medical debt. The CFPB’s decision to extend these protections to all Americans is a huge win for patients and their families.”

“Once again, the CFPB delivers for millions of consumers,” said Elyse Hicks, consumer policy counsel at Americans for Financial Reform “This is why it’s so important to defend the CFPB and ensure its continued survival in the face of attacks by corporate America.”

“With this thoughtful action, the Bureau will relieve patients of the burden that unpredictable and often confusing medical bills could negatively impact other aspects of their financial lives,” said Christine Hines, legislative director at the National Association of Consumer Advocates. “Removing credit reporting of shock medical debts will no doubt improve the financial well-being of millions of people.”

“As the leader of an organization committed to erasing burdensome medical debts, I’m thrilled to see this action taken by the CFPB,” said RIP Medical Debt CEO and president Allison Sesso. “This proposal ensures no one’s credit worthiness hinges on their necessary healthcare. And while this is a great stride, we need the federal government to also identify, absent credit reporting data, how we can continue to track the scale of this enormous crisis. Medical debts are often obscured from reporting when patients pay with credit cards or borrow money from friends/family.”

“As health care prices rise and patients are left shouldering more of the costs in out-of-pocket expenses, this announcement is welcome news,” said Patricia Kelmar, senior director of health care campaigns for U.S. PIRG.  “We’ve known for years that medical debt doesn’t predict credit defaults, nor does it accurately predict a person’s desire and willingness to pay off loans. In fact, CFPB’s own research showed that medical billing data on a credit report is ‘less predictive of future repayment than reporting on traditional credit obligations.’”

“This will help millions of consumers whose credit reports contain medical debts, including Black consumers who are disproportionately burdened by medical bills,” said Berneta Haynes, senior attorney at the National Consumer Law Center. “The CFPB’s research found that 13.5 percent of consumers with credit reports – about 27 million Americans – have medical debts shown on their credit reports.”  Ms. Haynes is the author of a March 2022 NCLC report The Racial Health and Wealth Gap: Impact of Medical Debt on Black Families.

 

Since 1969, the nonprofit National Consumer Law Center® (NCLC®) has worked for consumer justice and economic security for low-income and other disadvantaged people in the U.S. through its expertise in policy analysis and advocacy, publications, litigation, expert witness services, and training.

Community Catalyst is a national organization dedicated to building the power of people to create a health system rooted in race equity and health justice, and a society where health is a right for all. We’re an experienced, trusted partner to organizations across the country, a change agent to policymakers at the local, state, and national level, and both an adversary and a collaborator to health systems in our efforts to advance health justice. We partner with local, state and national organizations and leaders to leverage and build power so that people are at the center of important decisions about health and health care, whether they are made by health care executives, in state houses, or on Capitol Hill. Together with partners, we’re building a powerful, united movement with a shared vision of and strategy for a health system accountable to all people.

Colorado Center on Law and Policy is a non-partisan, nonprofit advocacy organization dedicated to the vision that every Coloradan should have what they need to succeed. For 25 years CCLP has stood with diverse communities across Colorado in the fight against poverty through research, legislation and legal advocacy.

The National Association of Consumer Advocates (NACA) is a nationwide non-profit membership organization of private, public sector, legal services and non-profit attorneys, law professors, and law students whose primary interest is the protection and representation of consumers. Since its inception, NACA has focused on issues concerning unfair, deceptive, abusive and fraudulent practices by businesses that provide financial and credit-related services.

RIP Medical Debt is a national 501(c)(3) nonprofit that has acquired — and abolished — more than $10 billion of burdensome medical debt, helping 7 million families and addressing a major social determinant of health. RIP partners with individuals, faith-based organizations, foundations, corporations and government to empower donors by converting every dollar contributed into $100 of medical debt relief on average.

U.S. PIRG is an advocate for the public interest with PIRG affiliates in two dozen states. We promote policies that protect consumers and support the delivery of the high value healthcare we deserve.

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HEALTH:
HEALTH FIRST COLORADO (MEDICAID)

Health First Colorado is the name given to Colorado’s Medicaid program. Medicaid provides public, low-cost health insurance to qualifying adults and children. It is an entitlement program funded by the federal, state, and county governments and is administered by counties in Colorado. Those who are required to pay must pay a small co-pay when receiving certain health care services.

State Department: Department of Health Care Policy and Financing

Eligibility: Most adults 18 to 64 are eligible for Medicaid in Colorado if their household income is at or below 133% of the federal poverty limit (FPL). Pregnant women are eligible with incomes of up to 195% FPL, while children under 18 may be eligible if the live in a household with income at or below 142% FPL. Some adults over 65 may also be eligible for Medicaid.

Program Benefits: Through Medicaid, low-income Coloradans are eligible for a range of health care services at little to not cost. Services provided include doctors visits, prescription drugs, mental health services, and dental care. Co-pays for certain individuals may be needed for certain services.

Program Funding and Access: Colorado funds our Medicaid program through state and federal dollars. Medicaid is an entitlement program, which means that all who are eligible for Medicaid can access the program, regardless of the funding level in a given year. This does not mean that it is always easy to access Medicaid, even when eligible. And since the program is administered by counties, funding levels for county staff and other administrative roles can make it easier or harder for Coloradans to access the program. On top of this, not all medical providers accept Medicaid which limits the ability of Coloradans to seek health services even if enrolled, such as if the nearest provider is a 2+ hour drive away.

Note: This data is from before the pandemic and does not reflect changes in enrollment rules during the COVID-19 pandemic and public health emergency.

Statewide Program Access 2015-19: Over the study period of this report, an average of 89.0% of the population at or below 133% of FPL (i.e., the population who is likely to be eligible for Medicaid) were enrolled in Medicaid in Colorado.

FOOD SECURITY:
SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP)

The Supplemental Nutrition Assistance Program or SNAP helps low-income Coloradans purchase food by providing individuals and families with a monthly cash benefit that can be used to buy certain foods. SNAP is an entitlement program that is funded by the federal and state governments and administered by counties in Colorado.

State Department: Department of Human Services

Eligibility: Currently, Coloradans qualify for SNAP if they have incomes below 200% FPL, are unemployed or work part-time or receive other forms of assistance such as TANF, among other eligibility criteria. Income eligibility for SNAP was different during the study period of this report than today—it was 130% FPL back in 2019 for example. The US Department of Agriculture uses the population at or below 125% FPL when calculating the Program Access Index (or PAI) for SNAP. We follow this practice in our analysis despite Colorado currently having a higher income eligibility threshold.

Program Benefits: SNAP participants receive a monthly SNAP benefit that is determined by the number of people in their household and their income. Benefit amounts decrease as income increases, helping households avoid a sudden loss of SNAP when their incomes increase, even by a minor amount. Benefits are provided to an Electronic Benefit Transfer (EBT) card that can be used to purchase eligible food items, such as fruits and vegetables; meat, poultry, and fish; dairy products; and breads and cereals. Other items, such as foods that are hot at their point of sale, are not allowable purchases under current SNAP rules.

Program Funding and Access: SNAP, like Medicaid, is a federal entitlement program. This means that Colorado must serve any Coloradan who is eligible for the program. As such, funding should not be a limit to how many Coloradans can be served by the program. However, funding for administration of SNAP at the state and county level can limit the ability of county human service departments to enroll those who are eligible. Other program rules and administrative barriers can make it difficult for Coloradans to receive the benefits they are legally entitled to receive.

Statewide Program Access 2015-19: Over the study period of this report, an average of 61.1% of the population at or below 125% of FPL (i.e., the population who is likely to be eligible for SNAP) were enrolled.

FOOD SECURITY:
SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN (WIC)

The Special Supplemental Nutrition Program for Women, Infants, and Children, also know as WIC, provides healthcare and nutritional support to low-income Coloradans who are pregnant, recently pregnant, breastfeeding, and to children under 5 who are nutritionally at risk based on a nutrition assessment.

State Department: Department of Public Health and Environment

Eligibility: To participate in WIC you must be pregnant, pregnant in the last six months, breastfeeding a baby under 1 year of age, or a child under the age of 5. Coloradans do not need to be U.S. citizens to be eligible for WIC. In terms of income, households cannot have incomes that exceed 185% FPL. Families who are enrolled in SNAP, TANF, Food Distribution Program on Indian Reservations (FDPIR), or Medicaid are automatically eligible for WIC. Regardless of gender, any parents, foster parents, or caregivers are able to apply for and use WIC services for eligible children.

Program Benefits: WIC provides a range of services to young children and their parents. These include funds to purchase healthy, fresh foods; breastfeeding support; personalized nutrition education and shopping tips; and referrals to health care and other services participants may be eligible for.

Program Funding and Access: WIC is funded by the US Department of Agriculture. The state uses these federal funds to contract with local providers, known as WIC Clinics. In most cases, these are county public health agencies, but that is not the case in all Colorado counties. Some WIC Clinics cover multiple counties, while others are served by multiple clinics. Private non-profit providers are also eligible to be selected as a WIC Clinic.

Statewide Program Access 2015-17: Between 2015 and 2017, an average of 52.2% of the population eligible for WIC were enrolled in the program in Colorado.

Financial Security:
Colorado Works

Colorado Works is the name given to Colorado’s program for Temporary Assistance to Needy Families or TANF. It is an employment program that supports families with dependent children on their path to self-sufficiency. Participants can receive cash assistance, schooling, workforce development and skills training depending on the services available in their county.

State Department: Department of Human Services

Eligibility: In general, Coloradans are eligible to enroll in TANF if they are a resident of Colorado, have one or more children under the age of 18 or pregnant, and have very low or no income. For example, to be eligible to receive a basic cash assistance grant through TANF, a single-parent of one child could not earn more than $331 per month, with some exclusions—and would only receive $440 per month (as of 2022). That said, there are other services provided by counties through TANF that those with incomes as high as $75,000 may be eligible for. In addition to these, participants in TANF are required to work or be pursuing an eligible “work activity” or work-related activity. Any eligible individual can only receive assistance if they have not previously been enrolled in TANF for a cumulative amount of time of more than 60 months—this is a lifetime limit that does not reset. Counties may have additional requirements and offer benefits that are not available in other counties in Colorado.

Program Benefits:  While the exact benefits that one is eligible for under TANF can vary, all qualified participants are eligible to receive a monthly cash payment, call basic cash assistance. Other than cash assistance, counties are have a lot of choice in how to use their TANF funding; generally a use of TANF funds is appropriate so long as it advances one or more of the four purposes of the program: (1) provide assistance to needy families so that children can be cared for in their own homes or in the homes of their relatives; (2) end the dependence of needy families on government benefits by promoting job preparation, work, and marriage; (3) prevent and reduce the incidence of out-of-wedlock pregnancies; and (4) encourage the formation and maintenance of two-parent families.

It is important to note that those eligible for TANF are also eligible for many of the other programs we’ve included in this report, such as SNAP, Medicaid, and CCCAP.

Program Funding and Access: Colorado funds its TANF program through funds received from the federal government through the Temporary Assistance for Needy Families block grant. Most of the federal funds are allocated by the state to counties, which are required to provide a 20% match of state funding. Federal and state rules allow the state and counties to retain a portion of unspent funds in a TANF reserve.

Statewide Program Access 2015-19: Over the study period of this report, an average of 50.7% of the population at or below 100% of FPL (i.e., the population who is likely to be eligible for TANF) were enrolled in TANF in Colorado.

EARLY LEARNING:
COLORADO CHILD CARE ASSISTANCE PROGRAM (CCCAP)

The Colorado Child Care Assistance Program provides child care assistance to low-income families and caregivers living in Colorado in the form of reduced payments for child care. It is a program funded by the federal, state, and county governments and is administered by counties in Colorado. The share owed by parents/caregivers is determined on a sliding scale based on the family’s income.

State Department: Department of Early Childhood Education

Eligibility: Counties set eligibility for families separately, but must serve families with incomes at or below 185% of the Federal Poverty Limit. Families accepted to the program are no longer eligible once their income exceeds 85% of the state median income. Parents or caregivers must be employed, searching for work, or engaged in another approved activity to be eligible for CCCAP. Parents and caregivers enrolled in Colorado Works (Temporary Assistance to Needy Families or TANF) or in the child welfare system are also eligible to participate in CCCAP. Generally, CCCAP serves families with children under 13, although children as old as 19 may be eligible under certain circumstances.

Program Benefits: If a family is eligible for CCCAP and has income, they may likely have to pay a portion of their child’s or children’s child care costs each month. The amount that families owe is based on their gross income, number of household members, and the number of children in child care in the household. As such, households tend not to experience a benefit cliff with CCCAP when they see their incomes increase

Program Funding and Access: Colorado funds the CCCAP program using federal dollars it receives from the Child Care and Development Block Grant program. The state allocates federal and state funds to counties using a formula that takes into account factors like current caseloads and the number of eligible residents. Assistance is available until the county’s funds are spent, so the number of families that can be served is often a function of how much funding is available and the income and composition of the household that applies. It is not uncommon for counties to overspend or underspend their allocations of funds. The state reallocates unspent funds from counties who underspent to those who overspent. While underspending could indicate a problem with the way a county administers its CCCAP program, it could just as likely be a sign that there are few providers in the county who participate in CCCAP—or a lack of providers generally.

Statewide Program Access 2015-19: Over the study period of this report, an average of 10.8% of the population at or below 165% of FPL and younger than age 13 (i.e., the population who is likely to be eligible for CCCAP) were enrolled in CCCAP.

Housing:
HUD rental assistance programs

The US Department of Housing and Urban Development (HUD) has three housing assistance programs that we look at together: Housing Choice Vouchers (Section 8), Project-based Section 8, and Public Housing. In Colorado, these programs provided assistance to over 90% of the households who received federal housing assistance from all HUD programs. Through federally funded, local or regional public housing agencies (PHAs) are the agencies that administer these programs, through not all are available in all counties. These are not the only programs available in Colorado that assist households afford the cost of housing, such as units funded through federal and state tax credit programs.

State Department: Department of Local Affairs

Eligibility: Generally, households with incomes under 50% of the area median income (AMI) of the county they live in are eligible for these rental assistance programs, although PHAs have discretion to select households with incomes at higher percentages of AMI. That said, HUD requires that 75% of new vouchers issued through the Housing Choice Voucher/Section 8 program in a given year are targeted to households with incomes at or below 30% of AMI. PHAs are also able to create criteria that give priority to certain types of households who are on waiting lists for these programs.

Program Benefits: These rental assistance programs help households afford the cost of housing by reducing their housing costs to around 30% of their household income. In the case of the Housing Choice Voucher program, the PHA pays the voucher holder’s landlord the remaining portion of the rent.

Program Funding and Access: Funding and access are both challenges for these rental assistance programs. In addition to limitations on the number of public housing units or housing vouchers a PHA can manage or issue, lack of funding compared to the need constrains the ability of PHAs to assist low-income households. In 2020, Coloradans were on waitlists for Housing Choice Vouchers for an average of 17 months. Waitlists also exist for the other rental assistance programs.

Statewide Program Access 2015-19: Over the study period of this report, an average of 21.1% of renter households with incomes at or below 50% AMI (i.e., the population who is likely to be eligible for HUD rental assistance programs) were living in subsidized housing.