Pawn loans, payday loans, check cashers, and other non-bank financial products provide a crucial credit source to lower income households, although empirical literature on how these “fringe banks” affect well-being is mixed. We test whether the Affordable Care Act's Medicaid expansion reduced demand for these controversial products by assisting households with medical expenditure risk. _x000D_ We show reductions in use of fringe banks result from increases in insurance and reductions in medical expenditures. We find that Medicaid eligibility decreases use of fringe bank products on average, particularly fringe credit products. Importantly, however, the effect of the Medicaid expansion on fringe bank use varies substantially by state. Using detailed information on state policies and machine learning, we show that how states expanded Medicaid is crucial to whether individuals in that state report improved financial outcomes as a result of the Medicaid expansion.