About one in four uninsured could be excluded from ACA

(HealthDay)—More than one in four of those eligible for new premium assistance tax credits under the Affordable Care Act (ACA) do not have a checking account and will not be able to receive premiums from insurance companies, according to a report published by Jackson Hewitt.

George Brandes, from Jackson Hewitt Tax Service Inc., and colleagues used data from the 2008 Survey of Income and Program Participation to generate national and state-level estimates of the number of non-elderly uninsured households that are considered unbanked (without a checking account).

The researchers note that 27 percent of uninsured Americans who are eligible for new premium tax credits under the ACA do not have a checking account. As many insurance companies intend to pay premiums directly through a checking account, this will undermine efforts to expand health coverage under the ACA. This effect will be larger for African-Americans and Hispanic-Americans, who are more likely to be unbanked. In states where the federal government operates a health insurance marketplace the impact will be disproportionately larger but can be addressed by requiring insurance companies to accept commonly used forms of payment available to unbanked Americans.

"Federal inattention to this issue may effectively hollow out efforts to enroll the uninsured," Brian Haile, senior vice president for Health Care Policy at Jackson Hewitt, said in a statement. "The negative effects will be disproportionately felt by African-Americans and Hispanic-Americans, groups who already experience significant health disparities. These findings should be deeply troubling for everyone who is working to improve minority access to health insurance coverage and medical care."

Jackson Hewitt has a limited commercial interest with prepaid debit cards.