messaging about participating in new health insurance exchanges

The newly formed Georgia Alliance for Health Literacy seeks to promote awareness and informed decision-making about new health insurance opportunities for people who currently lack health insurance.  The Affordable Care Act (ACA) enables those opportunities.  We're seeking public  campaign materials for increasing awareness of, or for motivating participation in, ACA insurance exchanges.  We'd like to identify any such materials that conform to best health literacy practices.   Please post those resources to this list, or sent them to DRUBIN@UGA.EDU.

Thanks much for collaborating in this effort to increase acces to health care by applying health literacy principles.  

Don Rubin

Center for Health & Risk Communication

University of Georgia 


Hi Don,

I really hope you get some responses here. I have seen very little material to help uninsured people to learn about and sign up for helath insurance. And I have heard very little about efforts to educate people and help them enroll when the time comes.

Has anyone addressed this in Adult Basic Education programs?

However, the official website is pretty good:

Has anyone used this? Any thoughts on it?

My fingers are crossed for more input on this!


Hello, friends,

This is a big issue! There's much that needs to be done to reach out to people who are eligible. Given their demographics (mainly SES), we know they are at risk of having low literacy skills. Plus, they will have little to no experience with health insurance and maybe even health care. Therefore, they're very likely to have low health literacy as well.

I looked at and did a reading level analysis on some text. It's at "grade" level 13. The target for plain language materials is about level 7-8 and for low literacy materials, level 4-6. (We know that reading level is not the only factor in text's comprehensibility or usefulness, but it's still a place to start.)  So the text I randomly tested is a long way from being easy to understand for most of the people we need to reach.

I work at a hospital that serves the most vulnerable populations. It would be great if we could do outreach. But we're busy trying to figure out how we'll serve the influx of new folks and trying to make our own organization more health literate. It's too bad the ACA didn't include support for developing reader-friendly recruiting materials!

Audrey Riffenburgh, Senior Health Literacy Specialist, University of New Mexico Hospitals, Albuquerque, NM

Here is a little information about what is happening in Arkansas regarding the Health Insurance Exchange.  To assist people who are newly eligible for health insurance in Arkansas, the Arkansas Insurance Department is using in-person assisters (IPA guides) to help people with low health literacy to understand their choices and make informed decisions. The training curriculum for the IPA guides is being designed to address low health literacy. The Arkansas Department of Health is assisting the Insurance Department by hiring approximately 300 benefits technicians will be employed across the state to serve as IPA guides and guide supervisors. The benefits technicians will be responsible for conducting public education activities, determining eligibility, assisting consumers in understanding insurance choices and facilitating participant enrollment. Starting July 15, interested individuals can apply on-line at More information on the new insurance program is available at  It is important to note that in Arkansas, persons eligible for "Medicaid expansion" will be provided with private insurance that will be paid for with Medicaid dollars. Also, the Arkansas IPA guides are in addition to the federally-funded "Navigators".   Hope this is helpfu.

Jennifer Dillaha, MD

Medical Advisor for Health Literacy and Communication

Arkasnas Deparement of Health

Don, you may find some useful resources on Enroll America ( I believe they may have some examples of materials, but they also have some great research and polling information on what words seem to reach people and which words seem to turn them off. We in Colorado are currently working on this as well!

Jeanine Limone Draut

This is just more feedback, not an answer since I don't have one.  The frustrations around this issue are very understandable, but one thing to keep in mind regarding HIE "marketing information" is whether your state is going to offer its own exchange, is allowing the federal program to be initiated, or has come up with some sort of hybrid.  The implementation (and thus associated documentation) will vary accordingly.  (Ohio, where our health plan is planning to offer an HIE product, falls into the hybrid category.)  It has only been in the last few weeks that federal program facilitators completed requirements for the actual enrollment FORMS.  Planning for training of HIE navigators is currently in the works for the federal program.  I honestly don't know what the ACA requirements are for the states that are doing their own thing, but am reasonably confident they would be different from the federal and hybrid versions.   -shb     

The Insititute of Medicine Roundtable on Health Literacy just posted a Discussion Paper called, "Helping Consumers Understand and Use Health Insurance in 2014." It is designed to present basic information that can be used to help people understand their health insurance options. The paper is a resource for those who will be helping consumers make important decisions—for patient navigators, community organizations, employers, media, educators, and any individual or organization working to improve understanding of options for health insurance. I believe a second paper, targeting consumers themselves, is in the works.

To access a copy of the paper, go to


A group of us from multiple states, affiliated with Cooperative Extension, the outreach unit of land-grant universities, are currently pilot testing theory-based, research-based health insurance literacy education interventions.  We have created, and pilot tested in 10 states, a teaching guide and consumer guide to making smart health insurance literacy choices. We are analyzing the data from consumers and educators to guide modifications. We will be incorporating the final health insurance literacy measure that will be released by the American Institues for Research this summer. We've been building on the work of Consumers Union. 

We will be ready to share the curriculum and prepare people to teach with it by the end of the summer. We've talked to people who want to use it in adult education, at clinics, etc. We plan to offer training sessions in late August-September. Upon completion of learning sessions, participants will have access to the educational materials and will determine their commitment to working with us to complete a second stage pilot test during the fall.

We're looking at how to market the curriculum to both professionals and consumers. We'd be very interested in determining if there's a campaign that could be used in these states.

Bonnie Braun, PhD, Faculty Scholar, Horowitz Center for Health Literacy, University of Maryland School of Public Health

Thanks, Cindy, for the resource, "Helping Consumers Understand and Use health Insurance in 2014."

And thanks, Bonnie for telling us about your curriculum!

It sounds like each state will be doing things a bit differently, but it would be nice to learn what other states are doing in terms of how they are doing outreach, how they are ttraining their navigators and In-Person Assiters, etc.

Does anyone know if there is any nationwide Navigator organization, platform, listserve....any way for then to share ideas?

We'd love to hear from states what you are doing in this regard!

Affordable Care Act enables different types of health care opportunities for the people. Through which they are able to get sufficient and enough support on health insurance terms. Basically we have found different types of loopholes under new health insurance programs; therefore we need to go for a better one; under which we have found different new strategies and beneficial opportunities to repair our health system. But still in some regions people are unable to understand the importance of health insurance; as a result they are suffering from the lack of quality health insurance programs. In my point of view participating in a new health insurance exchange program would be risky as we are not aware about the positive terms of the insurance program. Therefore Affordable Care Act would be far better. So instead of visiting in a medical care center at regular basis; it is quite better to have a health insurance program that ultimately supports our health expenses.