The Pentagon isn't tracking medical debt among troops despite federal recommendations that it should, and now Sen. Elizabeth Warren, D-Mass., the chairwoman of the Senate Armed Services Committee's personnel panel, wants to change that.
Warren has been pressing the Pentagon for an update on medical debt and wrote to Defense Secretary Lloyd Austin in March asking about recommendations from the Consumer Financial Protection Bureau, or CFPB, that called for better collection of the data to safeguard service members' financial stability and credit ratings.
But Under Secretary of Defense for Personnel and Readiness Gil Cisneros sent back this response: The Pentagon doesn't collect data on the medical debt owed by service members and their families. Troops can self-report debt, he added, but "the data is not complete enough to accurately report the extent or amount" of the total medical debt held by personnel.
Cisneros said the Defense Health Agency -- the arm of the Pentagon that oversees the military's private health program, Tricare -- provides support through counselors and assistance officers to troops with medical claims and issues with debt collection when the bills should have been paid by Tricare.
The response vexed Warren, who underscored the importance of medical debt in a follow-up letter to Austin Sunday. The debt can negatively affect military careers, hinder a service member from acquiring a security clearance and affect credit ratings -- preventing them from buying a house or a car or even renting a property.
Without the data, the DoD can't identify the issues that cause active-duty service members or their dependents to acquire such debt, especially when they have access to premium-free, no- or low-cost health care.
"This is why the CFPB's actions to remove medical debt from credit reports will make a real difference for service members and their families," Warren wrote.
Among the most common reasons service members rack up medical debt is when they are sent to specialists or other providers outside the military health system and these private providers incorrectly process their Tricare claims or simply send the bills directly to the service member.
Such was the case for Army Spc. Daysha Cartagena and her husband, Staff Sgt. Isaiah Cortez, who received bills totaling nearly $670,000 when their daughter was transferred from the military hospital at Fort Liberty, North Carolina, to private facilities for advanced medical care in Raleigh.
Warren cited the couple, whose case was profiled in June on Military.com, in her Dec. 3 letter to Austin.
"Given service members' frequent relocations, some service members may not discover these charges in a timely manner," Warren wrote.
A CFPB report published in June 2022 found that more than 5,000 troops and family members reported medical billing issues to the agency from 2018 to 2021. In 2021 alone, the CFPB received more than 1,500 complaints from service members about incorrect medical bills appearing on credit reports, according to the report.
About 54% of the complaints in 2021 were about attempts to collect medical debt the service members did not actually owe, according to the report.
Warren, who is largely credited for proposing the creation of the CFPB while she was a professor at Harvard University, told Austin in her Dec. 3 letter that she was disappointed that the DoD had failed to implement CFPB's recommendations in the year since the agency made them.
"In the [August] response, DoD claimed it would need to create a centralized reporting system or database in order to understand the full scope and impact of medical debt on service members. I urge DoD to develop such a system," she wrote.
In addition to Warren, the letter to Austin was signed by Sens. Sherrod Brown, D-Ohio, and Raphael Warnock, D-Ga.