For the 'Unbanked' in Wash., a Barrier to Accessing Obamacare

Nov 18, 2013

Washington’s health exchange has been a bright spot in the slipshod rollout of Obamacare, but one requirement for signing up could be a barrier to the very people the new law is supposed to serve.

To sign up for coverage on WAHealthPlanFinder.org, you have to make your first payment by credit card, debit card or electronic funds transfer from a bank account.

But recent studies show about one-fourth of Washington households are either “unbanked” with no access to an account, or “underbanked" with limited access. The number of those affected is even higher in low-income and minority communities to which many of the exchange’s target audience belong.

The exchange allows people to use pre-paid debit cards, but that solution is generating a lot of pushback. Pediatrician Ben Danielson, who sits on the exchange board, said the cards often come with fees and hard-sell tactics designed to hook consumers.

“I don’t feel great about the idea of being part of a process that further promotes the use of things that I think have been so predatory on marginalized, under-resourced populations for such a long time,” he said.  

Advocates like Marcy Bowers, director of the Statewide Poverty Action Network, said relying on those cards effectively raises the cost of health insurance.

“There is something that is sort of at the heart of this that’s about justice,” she said. “For something as critical as health care, we shouldn’t be asking people who are already struggling to be paying more.”

The law requires insurance companies to accept paper payments like money orders or cashier’s checks, and Washington consumers can pay those companies directly. But they have to make their first payment on the exchange via an electronic method.

The exchange reports that 21,671 people completed applications last month but aren’t considered enrolled because they haven’t paid yet. One board member wondered aloud how many of those people don’t have a way to pay.

The exchange is looking into some temporary fixes, like having third parties pay the first bill for people. But board members say it’s probably too late to make real changes during the current enrollment period.