Practice Implications
The relationship between HIL and ACA knowledge seen in our study highlights the need for healthcare reform policies to more strongly emphasize supporting educational programs. While various assistance programs were established with the ACA to provide outreach and education [36] and were successful in reaching millions [37–39], there appears to specifically be a need for improved, culturally-appropriate outreach efforts in vulnerable settings, such as the low-income, Hispanic border community surveyed in this study. Additionally, this study underscores the need for outreach programs to increase general knowledge of health insurance (e.g., HIL), rather than simply providing a policy- specific education, such as determination of eligibility. Integrating health insurance education within health delivery systems, specifically those serving low-income communities (e.g., federally qualified health centers) will not only promote awareness of health insurance options but also promise to support more effective utilization of healthcare services. Several programs and tools have been recently developed and tested, with promising results in terms of enhancing HIL and assisting with healthcare coverage decisions.
