It’s been more than a decade since the Affordable Care Act (ACA)—often referred to as Obamacare — was passed to address health insurance coverage, health care costs and preventive care. Among other things, the ACA contained provisions to help patients with low health literacy.

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Unfortunately, about half of adults in the U.S. consider themselves to have inadequate health literacy, according to Isaac Perez, a first-year medical student at the University of Texas Rio Grande Valley School of Medicine. Low health literacy can present barriers that complicate an already challenging process of choosing and enrolling in a health insurance plan.

“The ACA, although it’s done great things to expand access to health care—it does require some literacy, both about healthcare and about health insurance systems,” said Harold Pollack, PhD, a professor at the University of Chicago Crown Family School of Social Work, Policy and Practice.

Perez and Pollack recently spoke about helping patients navigate the health care system more effectively as part of an education session held during the November 2021 AMA Section Meetings.

Pollack and Perez discussed the National Action Plan to Improve Health Literacy, which was established by the Department of Health and Human Services to engage organizations, professionals, policymakers, communities, individuals and families in a linked, multisector effort to improve health literacy.

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The plan includes seven goals that can guide physicians and other health professionals as they seek to help their patients improve their own health literacy. The goals are to:

  • Develop and disseminate health and safety information that is accurate, accessible, and actionable.
  • Promote changes in the health care system that improve health information, communication, informed decision making, and access to health services.
  • Incorporate accurate, standards-based, and developmentally appropriate health and science information and curricula in child care and education through the university level.
  • Support and expand local efforts to provide adult education, English-language instruction, and culturally and linguistically appropriate health information services in the community.
  • Build partnerships, develop guidance and change policies.
  • Increase basic research and the development, implementation and evaluation of practices and interventions to improve health literacy.
  • Increase the dissemination and use of evidence-based health literacy practices and interventions.

Read about the three things to tell your patients about signing up at HealthCare.gov.

While the goals established in the national plan are lofty, Pollack explained that there are simple actions doctors and other health professionals can take to boost their patients’ health literacy, many of which relate to communications with patients.

While most physicians have limited time with patients, it’s important for doctors to remember how much weight their words carry. Even if the physician can’t provide detailed information on type 2 diabetes self-management, for example, they can still explain why the nurse or other health professional who will come to explain the management plan has just as much credibility as the physician on this aspect of care.

That simple statement can help ease a patient’s anxiety, enabling increased understanding and better self-care. It’s vital to have nurses and office clerical staff strive to help improve patient health literacy so that the full burden is not placed on the physician—or the patient, Pollack said.

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It’s also important to include resources around the waiting room with information about how patients can get help accessing health insurance information. The U.S. Department of Education, the Agency for Healthcare Research and Quality, and the National Institute of Child Health and Human Development are three government agencies that provide helpful patient-oriented information.

“Whatever health system you’re in, one of the most important things you want to do is try to identify what are best practices for helping our patients with literacy challenges to navigate the health system,” Pollack said. “It’s a really difficult place to be when you say, ‘I have a health problem, I’m bewildered, and I don’t understand what I’m supposed to be doing.’”

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