Jeff Fusco / Getty Images for NBC News Yolanda Williams leaves her home last month to catch a SEPTA bus at 7:20 AM on her way to Medical Billing and Coding training at the Kaplan Career Institute.

PHILADELPHIA -- On some days, Yolanda Williams says she wonders why it’s so hard to stay alive. “I’m working as hard as I can. Every time I talk to my boss I ask, ‘Is there any more work?’”

Williams works part-time as a home-health aide so that she can also attend the Kaplan school to study medical billing. For about 17 hours a week of work, at $10 an hour, she takes home about $298 every two weeks, which she uses to support her disabled husband and her 21-year-old daughter, both of whom are unemployed.

“I’m trying to go to school so I can get a better job, so I can get off welfare,” added Williams, who receives food stamps and Medicaid. “If that means I have to be on the bus 24 hours a day, I’ll do it.”

Her weekly toil – which includes nearly 30 hours on buses – underscores one of the truths of life for the millions of American living with poverty: it’s expensive to be poor.

Williams and her family live in north Philadelphia. She spends her check only on the essentials: rent, gas and electric, bus passes, a phone. She doesn’t have cable or internet.

"If you own a home, plus childcare, plus commuting costs you can be well above poverty and still not be able to make ends meet,” said Professor Scott Allard, an expert in poverty and the social safety net at University of Chicago. “You’re not doing anything wrong. You’re playing by the rules but you’re not making it."

Time is money

The expression “time is money” is especially true for the poor.

Jeff Fusco / Getty Images for NBC News Yolanda Williams prepares for her Medical Billing and Coding training class at the Kaplan Career Institute.

Those who earn little have to work long hours to make enough, and often spend more time than the well-off managing the basics of their lives. Not having paid sick days means losing wages when a loved one has a medical emergency, or child care falls through. Not having a washing machine means extra hours at the laundromat. And just getting to and from work can take hours.

Every Monday through Friday, and sometimes on the weekends, Williams leaves home at 7:20 a.m. and takes three public buses to school. She arrives at 9 a.m., and finishes at 2 p.m., sometimes lingering to finish homework. Then she leaves for work, taking three more buses to get to her client’s home in West Philadelphia.

The trip back to her house means two more buses, and arriving home around 10 p.m.

The 28 hours a week, spent waiting for, or riding, the bus, have become another part-time job. Because the agency that employs her requires she pick up her paycheck in person, she takes another two-hour, round-trip, bus ride every two weeks.

“I pretty much spend most of my time on the bus,” Williams said.

If Williams had a car, she could cut her travel time significantly. Low-income individuals and families in desperate need of a car often turn to so-called “buy-here-pay-here” car dealers, which typically offer high-mileage, used cars and in-house financing to those without good credit. Loans from these outlets carry an average interest rate of 24 percent, according to the Center for Responsible Lending, and the industry is little-regulated.

Health care

Studies show low-income people pay a larger share of their incomes for health care. Low-income workers are less likely to receive employer health insurance, or even sick pay, making a day off more costly. Medical care can quickly become medical debt, which can hound people for years, if not a lifetime.

While public programs like Medicaid and CHIP provide health care for low-income individuals and children, getting enrolled and staying on those programs can be tough. Moreover, many working poor earn too much to qualify for Medicaid, but not enough to purchase coverage.

That’s what happened to Williams two years ago after she lost her job as a bus driver. On unemployment, she applied for coverage through Philadelphia’s Health Care Partners, a Medicaid managed care organization. She was told she received too much unemployment income to qualify. When her unemployment benefits ran out, she applied again. A paperwork snafu delayed their enrollment for nearly a year. The delay had real health effects for the couple, both of whom have diabetes, a disease which disproportionately affects low-income people.

“We couldn’t afford to go to the doctor,” she said. “We didn’t have medicine. We were under control when we had medical insurance.”

Banking also is more expensive for poor people.

About 28.3 percent, or one in four American households, are what the FDIC calls “under” or “unbanked.” Underbanked households use a bank account, but also use alternative financial services, such as payday loans or check-cashing outlets. The unbanked don’t use any accounts at all.

According to the FDIC, 17 million adults in the U.S. live in unbanked households.

Jeff Fusco / Getty Images for NBC News Williams catches a SEPTA bus in the morning on her way to class.

Typically, the un or underbanked are low-income individuals or families. They rely on non-traditional banking services like check-cashing stores that carry fees that can add up to hundreds of dollars a month. Pre-paid debit cards — often the only kind of plastic low-income people with poor credit ratings can get -- also carry transaction and card-loading fees.

Williams uses a local check-cashing outlet to get her bi-weekly pay. She's charged a fee each time she cashes a check, but as she explains, why set up a bank or savings account when you can’t put anything in it?

“I know I work harder than $298,” she said. “Sometimes I get my check and I feel like crying. I’m not even in a rush to cash it, because you know they take a little bit more out when you cash it.”

Williams expects to graduate from her program this November. She’s confident that her two degrees, plus her experience as a home aid, will land her a full-time job with benefits and a living wage.

“When we both worked and were bringing home a nice pay, it was simple,” Williams said. “We had a car, we had life insurance, we had car insurance. We had enough to pay the bills with a little something left over.”

Now, she added, life is more complicated. “I don’t want to be on welfare any longer than I have to,” she said.

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