Insuring Good Health: A Health Insurance Literacy and Navigation Project

University of Michigan School of Public Health

Since the Affordable Care Act (ACA) was
passed in 2010, the U.S. uninsured rate has
dropped significantly. Considerable
resources have been devoted to outreach
and enrollment of the uninsured. A new
occupational group, generically called
‘enrollment assisters’ (also known as
patient navigators, certified application
counselors), was created by the ACA to
provide no cost assistance to consumers
exploring health insurance options and
applying for coverage.

The use of enrollment assisters has been
shown to increase health insurance
enrollment rates in low-income communities.
Nationwide, many organizations are involved
in enrollment and outreach efforts with the
use of assisters.

Despite extensive outreach, nearly 28 million
people continue to remain uninsured,
especially non-white racial/ethnic groups
(African Americans, Latino/Hispanic
Americans, and immigrant populations).

The problem is particularly acute in states
that did not expand Medicaid through the

Health insurance enrollment is critical to
gains in health status in historically
marginalized racial/ethnic communities,
where large disparities persist. Some
community health centers (CHCs) and
federally qualified health centers
(FQHCs) continue to serve a high
percentage of uninsured patients. CHCs and
FQHCs are vital to meeting the health and
medical care needs of local communities.
CHCs and FQHCs face sustainability
challenges, particularly related to their
financial capacity, which can be augmented
by increasing the number of insured patients
that they serve.

Among the population eligible for some form
of coverage, the perceived high cost, lack of
awareness of ACA provisions, and low health
insurance literacy are primary reasons why
the uninsured remain without health
insurance coverage.

More about this project can be found at: