Ghaddar S, Byun J, Krishnaswami J. Health insurance literacy and awareness of the Affordable Care Act in a vulnerable Hispanic population.
PATIENT EDUCATION AND COUNSELING 2018;
101:2233-2240. [PMID:
30220598 DOI:
10.1016/j.pec.2018.08.033]
[Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 08/25/2018] [Accepted: 08/29/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE
The Patient Protection and Affordable Care Act (ACA) has allowed millions of Americans to obtain coverage. However, many, especially minorities, remain uninsured. With mounting evidence supporting the importance of health insurance literacy (HIL), the purpose of this cross-sectional study is to examine the association between HIL and ACA knowledge.
METHODS
We conducted 681 in-person interviews with participants at a community health event along the Texas-Mexico border in 2015, after the conclusion of the ACA's second enrollment period. To assess HIL, we used the Health Insurance Literacy Measure, reflecting consumers' confidence to choose, compare, and use health insurance. We assessed ACA knowledge through the following question: "How much would you say you know about this health reform law?" Logistic regression was used to examine the association between HIL and ACA knowledge after controlling for several covariates.
RESULTS
Almost 70% of participants knew nothing/very little about the ACA. Multivariate analyses revealed that no/very little ACA knowledge was associated with low levels of confidence "choosing health insurance plans" (OR:0.55; 95%CI:0.40-0.75) (full sample) and "comparing plans" (OR:0.56; 95%CI:0.32-0.96) (U.S.-born sub-sample).
CONCLUSION
No/little ACA knowledge is associated with lower levels of HIL.
PRACTICE IMPLICATIONS
Promoting HIL is an essential step towards improving healthcare access.
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