Of the countless security clearance denial and revocation cases that cross my desk each year, a considerable number involving financial issues contain at least an element of medical debt.

Statistically-speaking, this isn’t surprising. Most American adults have had outstanding medical bills at some point in their lives, and medical debt is a leading cause of personal bankruptcies. Forbes reported last year that “[f]ully half of Americans [currently] carry medical debt, up from 46% in 2020, according to new data from Debt.com, a consumer financial education company.” And of those, 57% “owe at least $1,000, driven by diagnostic tests, hospitalizations, and emergency room visits.”

As I’ve pointed out previously on Clearancejobs, type of debt matters for security clearance holders and applicants – but only to a point. Medical debt will garner you more sympathy and leeway than general consumer debt (and definitely more than debt incurred for luxuries, as opposed to necessities), but that’s only half the battle. The other half of the equation is demonstrating that you acted reasonably and responsibly after incurring the charges. Without that, the government will argue that you’re likely to take the same lackadaisical approach toward your obligations in safeguarding classified information. And ultimately medical debt alone can still be a security risk if the clearance holder is leveraged to the hilt; major debtors are ripe targets for foreign intelligence services.

Fortunately for some clearance holders with medical debt, relief – albeit the temporary kind – is on the way. According to the Wall Street Journal, this summer, the country’s biggest credit-reporting firms – Equifax, Experian, and TransUnion – plan to remove most medical debt from peoples’ credit reports that was paid after debt collectors got involved. Previously, even collections accounts that had been paid could remain a black mark on your credit report for up to seven years.

More critically, the Journal reports that moving forward new medical debt won’t be added to people’s credit files for a full year after being sent to collections.

Neither of these changes impact the obligation of security clearance applicants to report such debt on the government’s SF-86 form, as applicable. But for the majority of security clearance-holders now enrolled in the government’s continuous evaluation (CE) program, the impact of this new change is still enormous.

The biggest problem I’ve seen with CE is not that it flags data previously unknown to the government, but rather that it flags the information more rapidly, thereby eliminating the often-substantial period of time between periodic reinvestigations that the clearance-holder could previously use for mitigation. Pre-CE, a clearance-holder who incurred delinquent medical bills might have years to pay them off and rebuild financial stability before the government became aware of the issue during a periodic review and requested evidence of resolution; now, it could be a matter of months. This is particularly true for individuals whose debts are reduced to civil court judgments. Public records are easy pickings for the CE program’s data scraping tools.

Assuming you don’t have a periodic reinvestigation imminently on the horizon, incurring delinquent medical debt after July 2022 may mean that the good old days are back: some breathing room to pay-off or pay-down the debt before security officials come a-knocking. But don’t take that time for granted. Waiting to resolve debts until a year-long reprieve has run is quite literally kicking a gift horse in the mouth.



This article is intended as general information only and should not be construed as legal advice. Although the information is believed to be accurate as of the publication date, no guarantee or warranty is offered or implied. Laws and government policies are subject to change, and the information provided herein may not provide a complete or current analysis of the topic or other pertinent considerations. Consult an attorney regarding your specific situation. 


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Sean M. Bigley retired from the practice of law in 2023, after a decade representing clients in the security clearance process. He was previously an investigator for the Defense Counterintelligence and Security Agency (then-U.S. Office of Personnel Management) and served from 2020-2024 as a presidentially-appointed member of the National Security Education Board. For security clearance assistance, readers may wish to consider Attorney John Berry, who is available to advise and represent clients in all phases of the security clearance process, including pre-application counseling, denials, revocations, and appeals. Mr. Berry can be found at https://www.berrylegal.com/.