The Medical Debt Trap: How Special Interests Killed Relief for 15 Million Americans

Just as Republicans are raising healthcare costs, the Trump administration is preventing medical debt reform.

In the United States, if you’re not lucky, having a health problem can derail your finances – and therefore your life. The healthcare system in this country is such a mess that most of us know as much already. Now, as Republicans in Congress insist on letting the Affordable Care Act (ACA) tax credits expire, raising health insurance costs for millions of Americans, accessing medical care is becoming more expensive for many of us.

“A lot more people are going to incur medical debt,” Julie Margetta Morgan, president of the think tank Century Foundation, told The New York Times.

But that’s not all. Because the Trump administration always outdoes itself, last week, the administration’s Consumer Financial Protection Bureau issued guidance prohibiting states from wiping medical debt from consumers’ credit ratings. This directive – coming at the exact moment when more people will be struggling to cover out-of-pocket medical bills as ACA credits and Medicaid are simultaneously slashed – is an important story to tell about how political corruption directly harms Americans’ health and our ability to make ends meet.

How did we get here? Just before Biden left office in January, the Consumer Financial Protection Bureau (CFPB) finalized a rule that it estimated would remove $49 billion in medical bills from the credit reports of about 15 million Americans. The rule prevented medical debt from appearing on credit reports or affecting credit scores. The rule also prohibited creditors from using medical debt as a factor in determining whether a borrower was eligible for credit. CFPB Director Rohit Chopra said at the time, “People who get sick shouldn’t have their financial future upended.”

As we all know, Americans who get sick often do have their financial futures upended. One study found that almost 60% of people who file for bankruptcy in the United States cited medical debt as a primary reason.

The Biden Administration’s effort was stopped in its tracks by industry groups, which sued over the new rule. A federal judge in Texas threw out the rule, so it never took effect. Consumer advocates had turned to the states, several of which passed protections barring medical debt from credit reports. But now, the Trump administration is blocking those laws.

Meanwhile, Republicans in Congress have continued to refuse Democrats’ attempts to revive expiring Affordable Care Act tax credits that would keep healthcare premiums lower for millions of Americans. According to a recent report from Center on Budget and Policy Priorities, 93% of marketplace enrollees received those tax credits, and because they’re now expired, premium costs will more than double. With the increased costs, according to CBPP, 3.8 million more people are projected to end up uninsured over the next decade.

It’s probably intuitive for most of us that unmanageable health costs keep millions of Americans in what Chopra called “a doom loop.” A CFPB research study from 2022 found that Americans held at least $88 billion in medical debt listed on credit reports. According to that research, medical debt is the most common item reported on consumer credit reports, and “two-thirds of the medical debts are the result of a one-time or short-term medical expense arising from an acute medical need.” Because medical billing systems are confusing, error-prone, and inefficient, the debts sent to collections are often mistakes. At no fault of their own, millions of Americans are saddled with debts that mar their credit score, which limits their ability to rent or buy a home, or, in some cases, even get a job.

Describing all the many moneyed interests – the pharmaceutical companies, health insurance companies, venture capitalists buying hospitals – that prioritize their profits over our well-being is beyond the scope of a single article. But look, even if we take just the narrowest view and focus only on the special interests that opposed the Biden-era rule that would have prevented medical debts from appearing on credit reports, from that alone, we get a very clear picture of rampant political corruption and how it harms us.

According to research from End Citizens United, major corporate lobbies are among those that submitted comments to the CFBC opposing the consumer-protection rule that would have wiped medical debt from credit reports. The largest among them is the U.S. Chamber of Commerce, which is such a colossal political force that it has spent $53,690,000 on lobbying just in 2025. Was all that lobbying related to medical debt? Definitely not. And yet, we all know that when a political lobby with that kind of money speaks, the Trump administration listens.

The End Citizens United research showed just how much money is spent on lobbying by the special interests that issued opposition to wiping medical debt from credit reports:

• ACA International (Association of Credit and Collection Professionals), which joined the suit to stop the Biden-era rule, has spent $590,000 on lobbying in 2025.

• Bank Policy Institute spent $2,170,000 on lobbying in 2025.

• Consumer Bankers Association spent $2,650,000 on lobbying in 2025.

• Consumer Data Industry Association, which spent $800,000 on lobbying in 2025.

• Experian, the credit agency, which was part of the lawsuit to stop the Biden-era rule, spent $1,080,000 lobbying in 2025.

All that money represents only one tiny sliver of the political spending special interests throw at influencing politicians to boost their profits. Millions of Americans are wondering how they’re going to afford medical care, and those special interests collectively have millions of dollars they can wield to get what they want. And they currently have an administration and Congress in Washington that’s willing to give it to them.