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How one reporter explored the impact of medical credit cards on dental debt Date: 04/24/20

Manuela Tobias

By Mary Otto

Dental patients in need of costly procedures may turn to medical credit cards to pay for the services. But these cards, which often include deferred-interest provisions, can pose risks. If consumers do not fully understand the terms or fall behind on payments, they can end up facing inflated bills and crippling dental debts, as Fresno Bee reporter Manuela Tobias explained in a recent investigative piece.

Her story, which recounted troubles with the credit cards and advocate and legislators' efforts aimed at protecting consumers, was produced in partnership with The California Divide, a statewide media collaboration that seeks to raise awareness about poverty and income inequality through in-depth storytelling and community outreach.  

In this Q and A, Tobias offers insights into her work on the piece. She also shares advice with colleagues interested in investigating medical credit cards in their states.

Question: What got you started on this project?

Answer: I set out to write a story on the challenges of having bad teeth and navigating the state dental insurance system. The first person I interviewed had this wild story about her dentist pressuring her to take out $10,000 in credit. In talking to legal aid clinics, I learned she was not the only one. I ended up writing two separate stories, one about bad teeth and the other about out-of-pocket medical care put on high-interest credit cards.

Q: Patients offered you some harrowing accounts of their experiences with these credit cards. They described pain, humiliation and confusion about the terms of the cards, crippling debt. How did you find people who were willing to come forward with the details of their stories?

A: I found my sources through legal aid organizations, policy advocates and on Yelp, reading reviews of the companies I was investigating. While some were scared to talk, others were so shocked and angry at the system. They were eager to share their experiences with someone willing to listen.

Q: As you wrote, CareCredit Cards, the most popular medical credit cards in the country, are offered at 109,000 dental offices in the U.S. What did the dentists you interviewed have to say about these cards?

A: I found that dentists overwhelmingly favor the card. The California Dental Association, which represents over 27,000 dentists, endorses CareCredit. Prior to their availability, dentists would set up payment plans with patients that their offices didn’t always have the resources to manage and would lose patients by hounding them for payments. And, the company reminded us that a majority of their clients were able to pay off their debt in time to avoid interest altogether.

Q: As you reminded readers, CareCredit has been in trouble before, penalized in 2013 by the Consumer Financial Protection Bureau (CFPB) and the New York Attorney General for deceptive enrollment tactics. California lawmakers, who have been grappling with ways to protect consumers, passed a new law last year. Still, it sounds like advocates are still concerned about the cards. What did they tell you?

A: Advocates wanted the new legislation to ban deferred interest cards altogether, but what it does is to stop providers from signing people up in-house. These laws give people a right to sue and a right to certain penalties, but the people who are most affected are often the ones who usually have the least amount of access to attorneys, so advocates worry that the onus still lies on the consumer.

Q: What surprised you most in your reporting?

A: The fine print of these widely used cards surprised me most. If a patient doesn’t pay the borrowed amount in full within a certain time period, interest on the initial loan is charged, with rates of up to 29%. That is, even if someone paid off most of a $1,000 loan but they ran out of time, they will be charged interest on the entire $1,000.

Q: Have you heard from readers since the project ran? What has been the reaction to the piece?

A: I’ve heard from a handful of readers who were also surprised by a large bill for a credit card they didn’t know they had signed up for, whether at the dentist or the vet’s office. They mostly sought advice on how to move forward and get help. Overall, the reaction was very positive.

Q: Do you have any advice for reporters who want to take a look at the medical credit card story in their states? Where should they begin?

A: I would comb through the CFPB complaints database and request complaints from state oversight organizations, like the dental board. I would contact local legal aid and consumer protection organizations to see if this is a problem they’re seeing. And don’t underestimate what you can find on review sites and even places like GoFundMe.

Q: Are you planning to write more stories for the California Divide project?

A: Yes! I am one of the reporters on the project full-time, so all my stories center around poverty and inequality, specifically in the Central Valley.