What can health communication science offer for ACA implementation? Five evidence-informed strategies for expanding Medicaid enrollment

Milbank Q. 2014 Mar;92(1):40-62. doi: 10.1111/1468-0009.12040.


Context: Implementing the Affordable Care Act (ACA) in 2014 will require effective enrollment and outreach efforts to previously uninsured individuals now eligible for coverage.

Methods: From 1996 to 2013, the Health Communication Research Laboratory conducted more than 40 original studies with more than 30,000 participants to learn how to improve the reach to and effectiveness of health information for low-income and racial/ethnic minority populations. We synthesized the findings from this body of research and used them to inform current challenges in implementing the ACA.

Findings: We found empirical support for 5 recommendations regarding partnerships, outreach, messages and messengers, life priorities of low-income individuals and families, and the information environment. We translated these into 12 action steps.

Conclusions: Health communication science can inform the development and execution of strategies to increase the public's understanding of the ACA and to support the enrollment of eligible individuals into Medicaid or the Health Insurance Marketplace.

Keywords: Affordable Care Act; health communication; low-income; minority health.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Evidence-Based Practice / methods
  • Health Communication / methods*
  • Health Insurance Exchanges / organization & administration*
  • Humans
  • Information Dissemination / methods*
  • Insurance Coverage / organization & administration*
  • Medicaid / organization & administration*
  • Medically Uninsured / legislation & jurisprudence*
  • Minority Health
  • Patient Protection and Affordable Care Act / organization & administration*
  • Poverty
  • United States