The Trump administration’s Consumer Financial Protection Bureau (CFPB) issued guidance yesterday prohibiting states from wiping medical debt from consumers’ credit ratings.

The guidance deems that federal law overrides any state law that limits the inclusion of medical debt on individuals’ credit reports. The move could exacerbate the crippling effects of skyrocketing medical costs and hand financial industry groups a potential assist in their ongoing lawsuits to block these state-level protections.

Despite the fact that more than 90 percent of Americans have health insurance, medical debt in the United States has risen to an estimated $220 billion, larger than the entire economies of many states and impacting around 100 million Americans. Many of these individuals live in the South or low-income communities, and fifteen million of them have these medical bills listed on their credit reports. Financial institutions use this debt to cut consumers out of the financial system by claiming they’re too unreliable to receive a loan or other financial assistance.