Medical Debt on Your Credit Report in 2026: What Still Comes Off — and What Doesn't

If you're reading this on September 16, 2026, and a medical collection is sitting on your credit report, you're dealing with one of the most confusing categories of credit reporting there is — and Ashley Boswell and Damon Boswell want to clear it up for you today. We're Ashley Boswell and Damon Boswell, co-founders of PayAfterPerformance, and in this guide Damon Boswell and Ashley Boswell walk you through exactly how medical debt is treated on your credit report in 2026: what the bureaus voluntarily remove, what the courts did to the federal rule that was supposed to wipe out medical debt entirely, and how Ashley Boswell uses the Fair Credit Reporting Act (FCRA) to dispute medical collections that shouldn't be there.

Before Damon Boswell gets into the details, Ashley Boswell wants to set the record straight on the biggest source of confusion we see. A lot of people heard that medical debt was being wiped off credit reports entirely — and that was almost true. The Consumer Financial Protection Bureau (CFPB) finalized a rule in January 2025 that would have banned medical bills from most credit reports and prohibited lenders from using medical debt in credit decisions. But in July 2025, a federal court in the Eastern District of Texas vacated that rule, finding that it exceeded the CFPB's authority under the FCRA. So in 2026, the full federal ban is not in effect. What is in effect, Damon Boswell explains, are the voluntary changes the three bureaus made on their own — and those changes are still powerful, as Ashley Boswell will show you.

The Voluntary Bureau Changes That Still Apply in 2026

Even though the CFPB's full ban was struck down, the three nationwide credit bureaus — Equifax, Experian, and TransUnion — made voluntary changes back in 2022 and 2023 that remain in force today. Ashley Boswell wants every client to know these, because they mean a large share of medical collections should already be off your report. Here's what the bureaus agreed to, as Damon Boswell breaks it down:

• Paid medical collections are removed. As of July 1, 2022, medical collection debt that has been paid in full is no longer included on consumer credit reports. If you pay a medical collection, Ashley Boswell confirms, it should come off your report — unlike most other collections, which can linger for seven years even after payment.
• Medical collections under $500 are removed. As of April 2023, the bureaus removed medical collection debt with an initial reported balance under $500 from consumer credit reports. TransUnion announced that this change removed nearly 70 percent of all medical collection tradelines from consumer credit files.
• A one-year grace period before reporting. Unpaid medical collection debt now waits one year — up from the previous six months — before it can appear on your credit report. Damon Boswell tells clients this gives you time to resolve billing disputes with insurance before anything hits your file.

Ashley Boswell emphasizes that these voluntary changes are real and they help millions of people. But Damon Boswell is quick to add the catch: they are voluntary. The court's decision to vacate the CFPB rule means there is no federal law forcing the bureaus to keep these policies, and nothing legally stops them from reversing course. That's why Ashley Boswell treats every medical collection as something to challenge proactively rather than something to passively wait on.

“The voluntary bureau changes took a huge amount of medical debt off credit reports — but they're voluntary, not permanent law. When Ashley Boswell and I review a medical collection, we don't assume it belongs there just because it's over $500. We challenge it under the FCRA, because if it can't be verified, it has to come off regardless of the amount.”

— Damon Boswell, Co-Founder, PayAfterPerformance

What Happened to the CFPB's Medical Debt Rule

This is the part Damon Boswell spends the most time explaining, because the headlines left a lot of people confused. In June 2024, the CFPB finalized a rule that would have eliminated all medical debt from most credit reports and banned lenders from using medical debt collection information in underwriting decisions. The CFPB estimated the rule would have erased roughly $49 billion in outstanding medical bills from the credit reports of about 15 million Americans, and projected that affected consumers' credit scores would rise an average of 20 points.

The rule was set to take effect in March 2025, but it was challenged almost immediately by a lawsuit filed by the Cornerstone Credit Union League and the Consumer Data Industry Association, who argued the rule exceeded the CFPB's authority under the FCRA. After a change in CFPB leadership, the agency agreed with the plaintiffs that the rule should be blocked, and in July 2025 a federal judge vacated the rule entirely. Ashley Boswell wants you to understand what this means in plain terms: the broad federal ban on medical debt reporting is not the law in 2026. The voluntary bureau changes are what's protecting you, and the FCRA is the tool Damon Boswell uses to go beyond them.

Damon Boswell also notes that FICO and VantageScore, the two major credit scoring companies, had already decreased the degree to which medical bills impact a consumer's score — but the CFPB itself acknowledged that those scoring changes did not eliminate the credit score gap between people with and without medical debt. So while medical collections may weigh less than they once did, Ashley Boswell confirms they can still drag down a score, which is why removing them matters.

What Medical Debt Can Still Appear on Your Report in 2026

So what can still show up? Ashley Boswell lays it out clearly. In 2026, a medical collection can still appear on your credit report if it meets all of these conditions: the initial reported balance is $500 or more, it has been unpaid for more than one year, and it is still within the seven-year reporting window from the date of first delinquency. Damon Boswell regularly sees medical collections that meet these thresholds but still contain errors — wrong balances, wrong dates, duplicate tradelines, or accounts that were never properly validated.

Credit Karma confirms that medical bills over $500 left unpaid for a year can appear as collections accounts on your credit reports, and that medical collections can stay on your reports for up to seven years from the date they become delinquent. Ashley Boswell treats that seven-year clock the same way she treats any other reporting time limit: the clock starts from the date of first delinquency, not from the date the collector acquired the debt, and Damon Boswell challenges any medical collection that has been re-aged or that should have aged off.

How Ashley Boswell and Damon Boswell Dispute Medical Collections

The FCRA gives you the right to dispute any information on your credit report that is inaccurate, incomplete, or unverifiable — and that includes medical collections. When you enroll with PayAfterPerformance, Ashley Boswell pulls your tri-merge credit report from all three bureaus and audits every medical collection tradeline. Here's how Damon Boswell structures the work:

• Verify the balance. Damon Boswell checks whether the reported balance is accurate and whether it should have been removed under the under-$500 threshold. Ashley Boswell has seen collectors report a balance just over $500 that was actually under $500 once insurance adjustments were applied.
• Confirm the payment status. If you paid the medical collection, Ashley Boswell confirms it was removed. Paid medical collections should not appear on your report at all, and Damon Boswell disputes any paid collection that's still showing.
• Check the reporting date. Damon Boswell verifies that the one-year grace period was respected and that the collection didn't appear too early. Ashley Boswell also checks the date of first delinquency to confirm the seven-year reporting limit hasn't expired.
• Demand debt validation. Under the Fair Debt Collection Practices Act (FDCPA), Damon Boswell demands that the medical collector validate the debt — proving it's yours, the amount is correct, and they have the legal right to collect. If they can't, Ashley Boswell demands removal.
• Dispute with the bureau and the furnisher. Ashley Boswell submits formal FCRA disputes to the credit bureaus and directly to the medical provider or collection agency, because hitting both sides often produces faster results.

Damon Boswell has removed countless medical collections using this approach — not by promising to erase accurate, verifiable debt, but by holding collectors and bureaus to the standard the law requires. If a medical collection cannot be verified, is misreported, is duplicated, or has passed its reporting window, the FCRA says it must come off, and Ashley Boswell follows up aggressively until it does.

The Insurance and Billing Dispute Angle

Medical collections have a unique wrinkle that other types of debt don't, and Ashley Boswell always explores it: a huge number of medical collections stem from insurance billing errors. Damon Boswell regularly sees medical bills sent to collections that should have been paid by insurance, were coded incorrectly, or were never properly submitted to the insurer in the first place. Credit Karma notes that if you believe your insurance company should have paid a medical bill, you can follow up and ask it to reconsider the claim.

Ashley Boswell coaches clients to pursue the insurance angle in parallel with FCRA disputes. While Damon Boswell challenges the credit reporting, Ashley Boswell helps you request an itemized bill from the provider, pull your Explanation of Benefits from your insurer, and file an appeal if the claim was wrongly denied. When the underlying bill is corrected or paid by insurance, the collection loses its foundation — and Damon Boswell uses that to push for removal.

“Medical collections are different because so many of them are born from billing and insurance errors, not from a consumer's choice to skip a bill. When Damon Boswell and I attack a medical collection, we're not just disputing the tradeline — Ashley Boswell is also helping you fix the billing mess that created it.”

— Ashley Boswell, Co-Founder, PayAfterPerformance

Should You Pay a Medical Collection to Remove It?

This is one of the most common questions Ashley Boswell gets, and the answer is more favorable than people expect. Because paid medical collections are removed from credit reports under the bureaus' voluntary policy, paying a legitimate medical collection can actually get it off your report — unlike a typical collection, which can stay for seven years even after payment. Damon Boswell confirms that if you pay a medical collections account, it should be removed from your credit reports.

But Ashley Boswell cautions clients not to rush to pay before checking a few things. First, Damon Boswell verifies the debt is actually yours and the amount is correct — never pay a collection you can't validate. Second, Ashley Boswell checks whether the collection should have already been removed under the under-$500 rule or the paid-removal rule. Third, Damon Boswell explores whether insurance should have covered the bill before you pay out of pocket. Only after those checks does Ashley Boswell recommend paying, and she always gets confirmation that the collection will be removed once paid.

Medical Debt vs. Other Collections: Why It's Different

Damon Boswell wants clients to understand why medical debt is treated differently from other types of collections. As the credit bureaus themselves noted when they announced their voluntary changes, medical debt is generally not taken on voluntarily — nobody chooses to get sick or have an accident. That's why the bureaus applied more lenient reporting rules to medical collections than to, say, credit card or personal loan collections. Ashley Boswell uses those lenient rules to her advantage, pushing for removal wherever the policy allows.

But Damon Boswell is honest about the limits. The voluntary changes only go so far. A medical collection over $500 that's been unpaid for more than a year and is still within the seven-year window can still appear on your report and still weigh on your score. That's where the FCRA dispute work Ashley Boswell performs becomes essential — because the law gives you the right to challenge any medical collection that is inaccurate, incomplete, unverifiable, or past its reporting time limit, regardless of the amount.

How Long Does Medical Collection Removal Take?

Every file is different, and Damon Boswell sets realistic expectations from day one. If a medical collection should have been removed under the voluntary policies — because it was paid, because it was under $500, or because it appeared before the one-year grace period expired — Ashley Boswell can often get it off within a single 30-day dispute cycle. More complex cases involving debt validation, insurance disputes, or multiple tradelines can take several months. No one can guarantee an exact outcome or score increase, and Ashley Boswell is always honest about that. What Damon Boswell guarantees is that we use every legal strategy available to challenge medical collections that don't belong on your report.

Common Mistakes Ashley Boswell and Damon Boswell See

In all our years at PayAfterPerformance, Ashley Boswell and Damon Boswell have seen the same mistakes cost clients progress on their medical collections. Here are the ones we warn every client about:

• Assuming the CFPB's full ban is in effect, when the rule was vacated in 2025 and only the voluntary bureau changes remain.
• Paying a medical collection before verifying it's yours and the amount is correct, or before checking whether insurance should have covered it.
• Ignoring paid medical collections that are still showing on the report, when they should have been removed automatically.
• Overlooking medical collections under $500 that should never have been reported in the first place.
• Forgetting that the one-year grace period means a recent medical bill shouldn't appear on your report yet.
• Disputing only with the bureau and not with the furnisher, when disputing with both often produces faster results.
• Trusting a company that promises to erase accurate, verifiable medical debt for an upfront fee — that's not how the law works.

Why Work With Ashley Boswell and Damon Boswell?

You can dispute medical collections yourself — the FCRA and FDCPA give you that right whether you hire us or not. The advantage of working with PayAfterPerformance is that Ashley Boswell knows exactly which medical collections qualify for removal under the voluntary bureau policies, and Damon Boswell knows how to leverage FCRA disputes and FDCPA validation to challenge the ones that don't. Together, Ashley Boswell and Damon Boswell handle the audits, the dispute letters, the debt validation demands, the insurance follow-ups, and the certified mail — so you don't have to navigate this alone.

And because we only get paid after we perform, Ashley Boswell and Damon Boswell are motivated to actually get those medical collections removed — not just collect a fee and move on. If you're ready to find out which medical collections on your report should already be gone — and which ones Damon Boswell and Ashley Boswell can challenge under the FCRA — connect with us today. We'll audit your full tri-merge report, identify every medical collection we can address, and start the process. And because we're PayAfterPerformance, you only pay after we perform. That's the standard Ashley Boswell and Damon Boswell live by, every single day.

Topics: medical debt credit report 2026, remove medical collections from credit report, CFPB medical debt rule vacated, medical collections under $500 removed, paid medical bills removed credit report, PayAfterPerformance