Effects of the Affordable Care Act on the Use of Alternative Financial Services Providers

Awarded Scholars:
Katie Fitzpatrick, Seattle University
Anne Fitzpatrick, University of Massachusetts, Boston
Project Date:
Jun 2017
Award Amount:

Findings: Effects of the Affordable Care Act on the Use of Alternative Financial Services Providers; Katie Fitzpatrick, Seattle University, and Anne Fitzpatrick, University of Massachusetts, Boston

Co-funded with the Robert Wood Johnson Foundation

Prior to the Affordable Care Act (ACA), approximately 41 percent of working-age individuals struggled with medical bills and/or medical debt, and those in low- and moderate-income (LMI) households were at greater financial risk. Compared to households at higher income levels that nearly exclusively use banks, LMI households often use alternative financial service (AFS) transaction and credit products. AFS transaction products include non-bank remittances, check cashing services, and money orders; AFS credit products include payday loans, pawn loans, auto-title loans, tax refund anticipation loans, rent-to-own contracts, etc.

Economists Katie Fitzpatrick and Anna Fitzpatrick will examine the extent to which the ACA affected the decisions of LMI households to use AFS products. They will study whether expanding Medicaid coverage decreased the demand for AFS products by providing protection from large medical bills and increasing the financial inclusion of low-income households in the mainstream financial system. They will also explore whether the the need for AFS products changed due to the higher quality plans offered in the individual market to those previously uninsured.


RSF: The Russell Sage Foundation Journal of the Social Sciences is a peer-reviewed, open-access journal of original empirical research articles by both established and emerging scholars.


The Russell Sage Foundation offers grants and positions in our Visiting Scholars program for research.


Join our mailing list for email updates.