December 04, 2023

Senators Warren, Brown, Warnock Renew Push for DoD to Address Causes and Impacts of Service Members’ Medical Debt

“DoD should take steps to ensure it is collecting comprehensive data to identify the unique challenges that cause service members to acquire medical debt.” “CFPB’s actions to remove medical debt from credit reports will make a real difference for service members and their families.”

Text of Letter (PDF) | Text of DoD Response (PDF)

Washington, D.C. – U.S. Senators Elizabeth Warren (D-Mass.), Chair of the Senate Armed Services Committee’s Subcommittee on Personnel, Sherrod Brown (D-Ohio), Chair of the Banking, Housing, and Urban Development Committee, and Raphael Warnock (D-Ga.), Chair of the Banking Committee’s Subcommittee on Financial Institutions and Consumer Protection, sent a letter to Defense Secretary Lloyd Austin, urging the Department of Defense (DoD) to improve data collection and coordination between TRICARE and medical providers and debt collectors to better protect service members and their family members from financial harm caused by medical debt.

Last year, the Consumer Financial Protection Bureau’s (CFPB) Office of Servicemember Affairs issued its annual report on the financial challenges confronting service members and their families. The CFPB recommended  that DoD collect better data on the scope and impact of medical debt on service members. Earlier this year, Senator Warren sent a letter to DoD requesting information about the Department’s efforts to implement CFPB’s recommendations. In its response, DoD revealed that the agency has yet to take steps to collect data on medical debt incurred by service members. 

“We are concerned by the revelation that TRICARE still ‘does not currently collect data on medical debt’ and that existing data collection efforts are fragmented across different DoD systems and are ‘not complete enough to accurately report the extent or amount of medical debt among service members and their families,’” wrote the lawmakers. “We urge you to improve how DoD collects data on service members’ medical debt and strengthen DoD’s coordination with medical providers and debt collectors to better protect service members and their families from financial harm.”

In the letter, lawmakers also highlighted the need for DoD and TRICARE to increase outreach efforts to medical providers and debt collectors. DoD’s response revealed that providers may fail to follow billing rules or omit required forms or documentation, and that military services themselves have miscategorized the eligibility of a service member to receive care. 

“It has been over a year since CFPB issued its recommendations on service member medical debt, and while we appreciate that DoD has briefed the Senate and House Committees on Armed Services as required by the National Defense Authorization Act for Fiscal Year 2024, we are disappointed that DoD’s letter indicated that the Department has yet to act,” concluded the lawmakers. 

The lawmakers are calling on DoD to develop a centralized data reporting system to understand the full scope and impact of medical debt on service members and to provide lawmakers with a briefing on their implementation efforts no later than December 17, 2023.

The CFPB initiated a rulemaking process in September 2023 to remove medical debt and related collections information from credit reports and prohibit creditors from considering medical debts when making credit decisions. These actions would protect service members from abusive debt collection practices related to medical bills that may be erroneous and do not reflect creditworthiness.

Senator Warren has long fought to ensure that all have access to affordable health care and that aggressive debt collection practices don’t unfairly target patients:

  • In November 2023, at a hearing of the Senate Banking, Housing, and Urban Affairs (BHUA) Committee, Senator Warren discussed the impact of medical debt on servicemembers, highlighting complaints submitted by servicemembers to the Consumer Financial Protection Bureau (CFPB) about collection attempts for bills they did not owe.
  • In November 2023, Senator Warren highlighted the burden of medical debt on service members during a Senate Banking, Housing, and Urban Affairs Committee Hearing on ensuring financial protection for service members, veterans, and their families. 
  • In March 2023, Senator Warren, Chair of the Senate Armed Services Committee Subcommittee on Personnel, sent a letter to Department of Defense (DoD) Secretary Lloyd Austin, requesting information from DoD about its efforts to implement recommendations from the Consumer Financial Protection Bureau’s (CFPB) Office of Servicemember Affairs’ Annual Report to address servicemember medical debt.
  • On March 15, chairing her first hearing of the Senate Armed Services Subcommittee on Personnel, Senator Elizabeth Warren (D-Mass.) highlighted the importance of putting pressure on DoD to exercise its authority to waive civilian medical debt.
  • In March 2023, Senator Warren and Representative Castro (D-Texas) sent a letter to the Department of Defense’s Assistant Secretary for Health Affairs Dr. Lester Martinez-Lopez and Director of the Defense Health Agency Lieutenant General Telita Crosland, urging the agency to waive civilian patients’ medical debts incurred at military treatment facilities, using statutory authority established by the lawmakers’ provision in the Fiscal Year 2021 National Defense Authorization Act (NDAA).
  • In December 2022, Senator Warren and Representative Castro introduced the Financial Relief for Civilians Treated at Military Hospitals Act, legislation that would ensure that Military Treatment Facilities (MTFs) run by the Department of Defense (DoD) can continue to enhance military readiness without racking up huge bills for civilians receiving emergency medical care.
  • In August 2022, Senator Warren and Rep. Castro sent a letter to Secretary of Defense Lloyd Austin raising concerns that the Department of Defense (DoD) may be misleading or misinforming civilians about debt they incur when they receive emergency medical care at military health care facilities, and calling for improved billing practices to protect patients.
  • In March 2022, Senator Warren joined Senator Sherrod Brown (D-Ohio) in sending a letter to Consumer Financial Protection Bureau (CFPB) Director Rohit Chopra highlighting the growing medical debt burden faced by consumers. Specifically, the letter urges the CFPB to use its authority to address the growing medical debt burden faced by U.S. consumers, and establish an ombudsman position for consumer medical debt.
  • The FY 2021 National Defense Authorization Act (NDAA) included Senator Warren's provision, based on the Financial Relief for Civilians Treated at Military Hospitals Act, to give DoD the authority to waive medical debt when the civilian is unable to pay the costs of the care provided and the care enhances the knowledge, skills, and abilities of military healthcare providers.
  • Senator Warren originally introduced the Financial Relief for Civilians Treated at Military Hospitals Act in June 2020.
  • In January 2020, Senator Warren sent a letter to DoD and the Treasury Department requesting information about the collection of military hospital debt from low-income, civilian patients.

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