With just four months to go for uninsured Americans to sign up for health insurance under the Affordable Care Act, doubts remain about whether the millions of consumers who do not have bank accounts will be able to use credit, debit or prepaid cards to pay for health care premiums.

The law allows insurance companies to determine what forms of payment they will accept from the uninsured. Some insurers have already said they will not accept credit, debit or prepaid cards for recurring payments. Their resistance is driven by the fact that Obamacare, as the law is known, requires insurers to keep premiums and administrative costs low; accepting payments via plastic requires them to pay interchange fees that generally range between 1% and 3%.

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