With Medical Debt Burdening Millions, a Financial Regulator Steps In to Help

10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

When President Barack Obama signed legislation in 2010 to create the Consumer Financial Protection Bureau, he said the new agency had one priority: “looking out for people, not big banks, not lenders, not investment houses.”

Since then, the CFPB has done its share of policing mortgage brokers, student loan companies, and banks. But as the U.S. health care system turns tens of millions of Americans into debtors, this financial watchdog is increasingly working to protect beleaguered patients, adding hospitals, nursing homes, and patient financing companies to the list of institutions that regulators are probing.

In the past two years, the CFPB has penalized medical debt collectors, issued stern warnings to health care providers and lenders that target patients, and published reams of reports on how the health care system is undermining the financial security of Americans.

In its most ambitious move to date, the agency is developing rules to bar medical debt from consumer credit reports, a sweeping change that could make it easier for Americans burdened by medical debt to rent a home, buy a car, even get a job. Those rules are expected to be unveiled later this year.

“Everywhere we travel, we hear about individuals who are just trying to get by when it comes to medical bills,” said Rohit Chopra, the director of the CFPB whom President Joe Biden tapped to head the watchdog agency in 2021.

“American families should not have their financial lives ruined by medical bills,” Chopra continued.

The CFPB’s turn toward medical debt has stirred opposition from collection industry officials, who say the agency’s efforts are misguided. “There’s some concern with a financial regulator coming in and saying, ‘Oh, we’re going to sweep this problem under the rug so that people can’t see that there’s this medical debt out there,’” said Jack Brown III, a longtime collector and member of the industry trade group ACA International.

Brown and others question whether the agency has gone too far on medical billing. ACA International has suggested collectors could go to court to fight any rules barring medical debt from credit reports.

At the same time, the U.S. Supreme Court is considering a broader legal challenge to the agency’s funding that some conservative critics and financial industry officials hope will lead to the dissolution of the agency.

But CFPB’s defenders say its move to address medical debt simply reflects the scale of a crisis that now touches some 100 million Americans and that a divided Congress seems unlikely to address soon.

“The fact that the CFPB is involved in what seems like a health care issue is because our system is so dysfunctional that when people get sick and they can’t afford all their medical bills, even with insurance, it ends up affecting every aspect of their financial lives,” said Chi Chi Wu, a senior attorney at the National Consumer Law Center.

CFPB researchers documented that unpaid medical bills were historically the most common form of debt on consumers’ credit reports, representing more than half of all debts on these reports. But the agency found that medical debt is typically a poor predictor of whether someone is likely to pay off other bills and loans.

Medical debts on credit reports are also frequently riddled with errors, according to CFPB analyses of consumer complaints, which the agency found most often cite issues with bills that are the wrong amount, have already been paid, or should be billed to someone else.

“There really is such high levels of inaccuracy,” Chopra said in an interview with KFF Health News. “We do not want to see the credit reporting system being weaponized to get people to pay bills they may not even owe.”

The aggressive posture reflects Chopra, who cut his teeth helping to stand up the CFPB almost 15 years ago and made a name for himself going after the student loan industry.

Targeting for-profit colleges and lenders, Chopra said he was troubled by an increasingly corporate higher-education system that was turning millions of students into debtors. Now, he said, he sees the health care system doing the same thing, shuttling patients into loans and credit cards and reporting them to credit bureaus. “If we were to rewind decades ago,” Chopra said, “we saw a lot less reliance on tools that banks used to get people to pay.”

The push to remove medical bills from consumer credit reports culminates two years of intensive work by the CFPB on the medical debt issue.

The agency warned nursing homes against forcing residents’ friends and family to assume responsibility for residents’ debts. An investigation by KFF Health News and NPR documented widespread use of lawsuits by nursing homes in communities to pursue friends and relatives of nursing home residents.

The CFPB also has highlighted problems with how hospitals provide financial assistance to low-income patients. Regulators last year flagged the dangers of loans and credit cards that health care providers push on patients, often saddling them with more debt.

And regulators have gone after medical debt collectors. In December, the CFPB shut down a Pennsylvania company for pursuing patients without ensuring the debts were accurate.

A few months before that, the agency fined an Indiana company working with medical debt for violating collection laws. Regulators said the company had “risked harming consumers by pressuring or inducing them to pay debts they did not owe.”

With their business in the crosshairs, debt collectors are warning that cracking down on credit reporting and other collection tools may prompt more hospitals and doctors to demand patients pay upfront for care.

There are some indications this is happening already, as hospitals and clinics push patients to enroll in loans or credit cards to pay their medical bills.

Scott Purcell, CEO of ACA International, said it would be wiser for the federal government to focus on making medical care more affordable. “Here we’re coming up with a solution that only takes money away from providers,” Purcell said. “If Congress was involved, there could be more robust solutions.”

Chopra doesn’t dispute the need for bigger efforts to tackle health care costs.

“Of course, there are broader things that we would probably want to fix about our health care system,” he said, “but this is having a direct financial impact on so many Americans.”

The CFPB can’t do much about the price of a prescription or a hospital bill, Chopra continued. What the federal agency can do, he said, is protect patients if they can’t pay their bills.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

USE OUR CONTENT

This story can be republished for free (details).

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

Subscribe to KFF Health News’ free Morning Briefing.

Don’t Forget…

Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

Recommended

  • Want to sleep longer? Adding mini-bursts of exercise to your evening routine can help – new study
  • Skincare – by Caroline Hirons
    Caroline Hirons’ book “Skincare” demystifies the world of skincare, helping you understand your skin and create a personalized routine. Take care of yourself with this must-read guide.

Learn to Age Gracefully

Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:

  • Grapefruit vs Lemon – Which is Healthier?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our Verdict

    When comparing grapefruit to lemon, we picked the lemon.

    Why?

    Grapefruit has its merits, but in the battle of the citrus fruits, lemons come out on top nutritionally:

    In terms of macros, grapefruit has more carbs while lemons have more fiber. So, while both have a low glycemic index, lemon is still the winner by the numbers.

    Looking at the vitamins, here we say grapefruit’s strengths: grapefruit has more of vitamins A, B2, B3, and choline, while lemon has more of vitamins B6 and C. So, a 4:2 win for grapefruit here.

    In the category of minerals, lemons retake the lead: grapefruit has more zinc, while lemon has more calcium, copper, iron, manganese, and selenium.

    One final consideration that’s not shown in the nutritional values, is that grapefruit contains high levels of furanocoumarin, which can inhibit cytochrome P-450 3A4 isoenzyme and P-glycoptrotein transporters in the intestine and liver—slowing down their drug metabolism capabilities, thus effectively increasing the bioavailability of many drugs manifold.

    This may sound superficially like a good thing (improving bioavailability of things we want), but in practice it means that in the case of many drugs, if you take them with (or near in time to) grapefruit or grapefruit juice, then congratulations, you just took an overdose. This happens with a lot of meds for blood pressure, cholesterol (including statins), calcium channel-blockers, anti-depressants, benzo-family drugs, beta-blockers, and more. Oh, and Viagra, too. Which latter might sound funny, but remember, Viagra’s mechanism of action is blood pressure modulation, and that is not something you want to mess around with unduly. So, do check with your pharmacist to know if you’re on any meds that would be affected by grapefruit or grapefruit juice!

    PS: the same substance is quite available in pummelos and sour oranges (but not meaningfully in sweet oranges); you can see a chart here showing the relative furanocoumarin contents of many citrus fruits, or lack thereof as the case may be, as it is for lemons and most limes)

    Adding up the sections gives us a clear win for lemons, but by all means enjoy either or both; just watch out for that furanocoumarin content of grapefruit if you’re on any meds affected by such (again, do check with your pharmacist, as our list was far from exhaustive—and yes, this question is one that a pharmacist will answer more easily and accurately than a doctor will).

    Want to learn more?

    You might like to read:

    Top 8 Fruits That Prevent & Kill Cancer ← citrus fruits in general make the list; they inhibit tumor growth and kill cancer cells; regular consumption is also associated with a lower cancer risk 🙂

    Enjoy!

    Share This Post

  • What Different Kinds of Hair Loss/Thinning Say About Your Health

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Dr. Siobhan Deshauer shows us different kinds of hair loss, what causes them, and what can be done about them:

    Many different causes

    Here’s how to tell them apart:

    • Alopecia areata is an autoimmune condition where the immune system mistakenly attacks hair follicles, causing hair loss that can occur at any age and affects about 1 in 50 people. It often presents as smooth patches of hair loss and can be treated with steroid injections. Severe cases may require high-dose prednisone, which can restore hair growth over time.
    • Discoid lupus is an autoimmune disease that affects the skin, leading to inflammation, scarring, and permanent hair loss. Unlike alopecia areata, it causes visible damage to the scalp and hair follicles. This type of lupus typically does not involve internal organs, unlike systemic lupus. 
    • Telogen effluvium occurs when a major systemic shock, such as an infection, surgery, or significant stress, triggers many hair follicles to enter the resting phase simultaneously, resulting in delayed hair shedding. The condition is diagnosed with a “hair pull test” and is typically temporary, as the resting phase is followed by normal hair growth phases.
    • Allergic reactions to products, such as hair dye containing PPD, can cause hair loss due to scalp irritation and inflammation. An allergic response may trigger hair follicles to enter a resting phase, leading to hair loss by the same mechanism as telogen effluvium. Treatment with steroids can calm the reaction, and hair usually regrows after recovery.
    • Syphilis, a sexually transmitted infection, can present with varied symptoms, including hair loss in a distinct moth-eaten pattern. Hair loss due to syphilis is reversible and curable with penicillin treatment, with hair regrowth typically occurring a few months after treatment.
    • Biotin deficiency is rare due to its production by gut bacteria and presence in foods such as nuts, seeds, and beans such as soybeans. Deficiency can result from excessive consumption of raw egg whites, which block absorption. Severe deficiency causes hair loss and skin issues but can be treated effectively with biotin supplements.
    • Iron deficiency anemia can cause hair thinning along with symptoms like fatigue and breathlessness. It often results from inadequate dietary intake, but can also occur after heavy menstrual bleeding. Treatment with iron supplements, or blood transfusions in severe cases, can restore both hair and energy levels, leading to significant improvements.
    • Trichotillomania is a psychological condition marked by an uncontrollable urge to pull out one’s hair, often associated with anxiety or depression. Hair patches may show different stages of regrowth. While it can be challenging to manage, the condition can be treated with appropriate psychological and medical support.
    • Traction alopecia results from hairstyles that exert prolonged tension on the hair, causing it to thin or fall out. This type of hair loss can be prevented by reducing the strain on the hair. Loosening hairstyles and giving the scalp a break can help hair regrow over time.
    • Hypothyroidism causes symptoms like fatigue, dry skin, and hair thinning due to insufficient thyroid hormone production—however, it can be managed with diet, and if necessary, thyroid medications.
    • Zinc deficiency may also cause hair loss and a characteristic rash. Treatment with zinc supplements can significantly improve hair growth and other symptoms.
    • Medications, such as chemotherapy drugs, Accutane, and anti-seizure medications like valproic acid, are known to cause hair loss as a side effect. This type of hair loss is often reversible once the medication is stopped.
    • Male pattern hair loss, or androgenic alopecia, is influenced by testosterone and genetic risk factors—which, contrary to popular belief, can come from either or both sides of the family. Early onset, especially before age 40, is linked to an increased risk of heart disease. However, effective treatments are available, and early intervention is beneficial.
    • Female pattern hair loss is basically the same thing as male pattern hair loss (indeed, it is literally still androgenic alopecia), just a) almost always much less severe and b) with a gender-appropriate name. It affects up to 40% of women by age 50 and is characterized by thinning hair at the top of the head. It’s related to hormonal imbalances involving testosterone, such as those seen in PCOS and menopause, amongst other less common causes. Early treatment can be effective, and research is ongoing to develop more targeted therapies.

    Dr. Siobhan Deshauer advises, if you’re experiencing hair loss, to monitor other symptoms too if applicable, take photos for tracking, and consult a doctor early for diagnosis and potential treatment.

    For more on all of this plus visual illustrations, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    Take care!

    Share This Post

  • Head Over Hips

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    We’ve written before about managing osteoarthritis (or ideally: avoiding it, but that’s not always an option on the table, of course), so here’s a primer/refresher before we get into the meat of today’s article:

    Avoiding/Managing Osteoarthritis

    When the head gets in the way

    Research shows that the problem with recovery in cases of osteoarthritis of the hip is in fact often not the hip itself, but rather, the head:

    ❝In fact, the stronger your muscles are, the more protected your joint is, and the less pain you will experience.

    Our research has shown that people with hip osteoarthritis were unable to activate their muscles as efficiently, irrespective of strength.

    Basically, people with hip arthritis are unable to activate their muscles properly because the brain is actively putting on the brake to stop them from using the muscle.❞

    ~ Dr. Myles Murphy

    See: People with hip osteoarthritis have reduced quadriceps voluntary activation and altered motor cortex function

    This is a case of a short-term protective response being unhelpful in the long-term. If you injure yourself, your brain will try to inhibit you from exacerbating that injury, such as by (for example) disobliging you from putting weight on an injured joint.

    This is great if you merely twisted an ankle and just need to sit back and relax while your body works its healing magic, but it’s counterproductive if it’s a chronic issue like osteoarthritis. In such (i.e. chronic) cases, avoidance of use of the joint will simply cause atrophy of the surrounding muscle and other tissues, leading to more of the very wear-and-tear that led to the osteoarthritis in the first place.

    So… How to deal with that?

    You probably can exercise

    It’s easy to get caught between the dichotomy of “exercise and inflame your joints” vs “rest and your joints seize up”, which is not pleasant.

    However, the trick lies in how you exercise, per joint type:

    When Bad Joints Stop You From Exercising (5 Things To Change)

    …which to be clear, isn’t a case of “avoid using the joint that’s bad”, but is rather “use it in this specific way, so that it gets stronger without doing it more damage in the process”.

    Which is exactly what is needed!

    Further resources

    For those who like learning from short videos, here’s a trio of helpers (along with our own text-based overview for each):

    And for those who prefer just reading, here’s a book we reviewed on the topic:

    11 Minutes to Pain-Free Hips – by Melinda Wright

    Take care!

    Share This Post

Related Posts

  • Want to sleep longer? Adding mini-bursts of exercise to your evening routine can help – new study
  • Calm Your Inflammation – by Dr. Brenda Tidwell

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    The book starts with an overview of inflammation, both acute and chronic, before diving into how to reduce the latter kind (acute inflammation being usually necessary and helpful, usually fighting disease rather than creating it).

    The advice in the book is not just dietary, and covers lifestyle interventions too, including exercise etc—and how to strike the right balance, since the wrong kind of exercise or too much of it can sabotage our efforts. Similarly, Dr. Tidwell doesn’t just say such things as “manage stress” but also provides 10 ways of doing so, and so forth for other vectors of inflammation-control. She does cover dietary things as well though, including supplements where applicable, and the role of gut health, sleep, and other factors.

    The style of the book is quite entry-level pop-science, designed to be readable and comprehensible to all, without unduly dumbing-down. In terms of hard science or jargon, there are 6 pages of bibliography and 3 pages of glossary, so it’s neither devoid of such nor overwhelmed by it.

    Bottom line: if fighting inflammation is a priority for you, then this book is an excellent primer.

    Click here to check out Calm Your Inflammation, and indeed calm your inflammation!

    Don’t Forget…

    Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

    Learn to Age Gracefully

    Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:

  • Revealed: The Soviet Secret Recipe For Success That The CIA Admits Put The US To Shame

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Today’s edition of 10almonds brings you a blast from the past with a modern twist: an ancient Russian peasant food that became a Soviet staple, and today, is almost unknown in the West.

    Before we get to that, let’s take a sneaky look at this declassified CIA memorandum from near the end of the Cold War:

    (Click here to see a bigger version)

    The take-away here is:

    • Americans were eating 2–3 times more meat than Soviets
    • Soviets were eating nearly double the amount of grain products and potatoes

    …and both of these statistics meant that nutritionally speaking, the Soviets were doing better.

    Americans also consumed more sugar and fats, which again, wasn’t the best dietary option.

    But was the American diet tastier? Depends on whom you ask.

    Which brings us to a literal recipe we’re going to be sharing with you today:

    It’s not well-known in the West, but in Russia, it’s a famous national comfort food, a bastion of health and nutrition, and it rose to popularity because it was not only cheap and nutritious, but also, you could eat it for days without getting sick of it. And it could be easily frozen for reheating later without losing any of its appeal—it’d still be just as good.

    In Russia there are sayings about it:

    Щи да каша — пища наша (Shchi da kasha — pishcha nasha)

    Shchi and buckwheat are what we eat

    Top tip: buckwheat makes an excellent (and naturally sweet) alternative to porridge oats if prepared the same way!

    Где щи, там и нас ищи (Gdye shchi, tam i nas ishchi)

    Where there’s shchi, us you’ll see

    Голь голью, а луковка во щах есть (Gol’ gol’yu, a lukovka vo shchakh yest’)

    I’m stark naked, but there’s shchi with onions

    There’s a very strong sentiment in Russia that really, all you need is shchi (shchi, shchi… shchi is all you need )

    But what, you may ask, is shchi?

    Our culinary cultural ambassador Nastja is here to offer her tried-and-tested recipe for…

    …Russian cabbage soup (yes, really—bear with us now, and you can thank us later)

    There are a lot of recipes for shchi (see for yourself what the Russian version of Lifehacker recommends), and we’ll be offering our favorite…

    Nastja’s Nutritious and Delicious Homemade Shchi

    Hi, Nastja here! I’m going to share with you my shchi recipe that is:

    • Cheap
    • So tasty
    • Super nutritious*
    • Vegan
    • Gluten Free

    You will also need:

    • A cabbage (I use sweetheart, but any white cabbage will do)
    • 1 cup (250g) red lentils (other kinds of lentils will work too)
    • ½ lb or so (250–300g) tomatoes (I use baby plum tomatoes, but any kind will do)
    • ½ lb or so (250–300g) mushrooms (the edible kind)
    • An onion (I use a brown onion; any kind will do)
    • Salt, pepper, rosemary, thyme, parsley, cumin
    • Marmite or similar yeast extract (do you hate it? Me too. Trust me, it’ll be fine, you’ll love it. Omit if you’re a coward.)
    • A little oil for sautéing (I use sunflower, but canola is fine, as is soy oil. Do not use olive oil or coconut oil, because the taste is too strong and the flashpoint too low)

    First, what the French call mise-en-place, the prep work:

    1. Chop the cabbage into small strips, ⅛–¼ inch x 1 inch is a good guideline, but you can’t really go wrong unless you go to extremes
    2. Chop the tomatoes. If you’re using baby plum tomatoes (or cherry tomatoes), cut them in half. If using larger tomatoes, cut them into eighths (halve them, halve the halves, then halve the quarters)
    3. Chop the mushrooms. If using button mushrooms, half them. If using larger mushrooms, quarter them.
    4. Chop the onion finely.
    5. Gather the following kitchenware: A big pan (stock pot or similar), a sauté pan (a big wok or frying pan will do), a small frying pan (here a wok will not do), and a saucepan (a rice cook will also do)

    Now, for actual cooking:

    1. Cook the red lentils until soft (I use a rice cooker, but a saucepan is fine) and set aside
    2. Sauté the cabbage, put it in the big pot (not yet on the heat!)
    3. Fry the mushrooms, put them in the big pot (still not yet on the heat!)

    When you’ve done this a few times and/or if you’re feeling confident, you can do the above simultaneously to save time

    1. Blend the lentils into the water you cooked them in, and then add to the big pot.
    2. Turn the heat on low, and if necessary, add more water to make it into a rich soup
    3. Add the seasonings to taste, except the parsley. Go easy on the cumin, be generous with the rosemary and thyme, let your heart guide you with the salt and pepper.
    4. When it comes to the yeast extract: add about one teaspoon and stir it into the pot. Even if you don’t like Marmite, it barely changes the flavour (makes it slightly richer) and adds a healthy dose of vitamin B12.

    We did not forget the tomatoes and the onion:

    1. Caramelize the onion (keep an eye on the big pot) and set it aside
    2. Fry the tomatoes and add them to the big pot

    Last but definitely not least:

    1. Serve!
    2. The caramelized onion is a garnish, so put a little on top of each bowl of shchi
    3. The parsley is also a garnish, just add a little

    Any shchi you don’t eat today will keep in the fridge for several days, or in the freezer for much longer.

    *That nutritious goodness I talked about? Check it out:

    • Lentils are high in protein and iron
    • Cabbage is high in vitamin C and calcium
    • Mushrooms are high in magnesium
    • Tomatoes are good against inflammation
    • Black pepper has a host of health benefits
    • Yeast extract contains vitamin B12

    Let us know how it went! We love to receive emails from our subscribers!

    Don’t Forget…

    Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

    Learn to Age Gracefully

    Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:

  • Ready to Run – by Kelly Starrett

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    If you’d like to get into running, and think that maybe the barriers are too great, this is the book for you.

    Kelly Starrett approaches running less from an “eye of the tiger” motivational approach, and more from a physiotherapy angle.

    The first couple of chapters of the book are explanatory of his philosophy, the key component of which being:

    Routine maintenance on your personal running machine (i.e., your body) can be and should be performed by you.

    The second (and largest) part of the book is given to his “12 Standards of Maintenance for Running“. These range from neutral feet and flat shoes, to ankle, knee, and hip mobilization exercises, to good squatting technique, and more.

    After that, we have photographs and explanations of maintenance exercises that are functional for running.

    The fourth and final part of the book is about dealing with injuries or medical issues that you might have.

    And if you think you’re too old for it? In Starrett’s own words:

    ❝Problems are going to keep coming. Each one is a gift wanting to be opened—some new area of performance you didn’t know you had, or some new efficiency to be gained. The 90- to 95-year-old division of the Masters Track and Field Nationals awaits. A Lifelong commitment to solving each problem that creeps up is the ticket.

    In short: this is the book that can get you back out doing what you perhaps thought you’d left behind you, and/or open a whole new chapter in your life.

    Get your copy of Ready to Run from Amazon today!

    Don’t Forget…

    Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

    Learn to Age Gracefully

    Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails: