Getting the word out on the Affordable Care Act

Brown School’s Health Communications Research Laboratory helps communities get vital information where it needs to go

Getting through Congress the Affordable Care Act (ACA), the landmark health insurance legislation, in 2010 was challenging – but not nearly as challenging as implementing it.

With the deadline for first-time enrollment looming March 31, disseminating clear, concise information out to the very people the law is aimed at — low- to moderate-income individuals and racial/ethnic minorities — is becoming a necessity.

That’s where research from the Brown School’s Health Communication Research Laboratory (HCRL) at Washington University in St. Louis is helping. A new paper, “What Can Health Communication Science Offer for ACA Implementation? Five Evidence-Informed Strategies for Expanding Medicaid Enrollment,” published March 6 in the Milbank Quarterly, offers recommendations and strategies.


“Applying scientific findings to real-world challenges like the ACA is the goal of the work we do here,” said Matthew W. Kreuter, PhD, associate dean for public health, director of the HCRL and professor at the Brown School.

“Communicating effectively with low- and moderate-income families is the focus of research at the HCRL,” he said.

Through the research, the HCRL offers communities and policymakers five concrete recommendations – with 12 action steps – to improve the reach and effectiveness of ACA information, and, in turn, get people to act on it by signing up through the exchanges.

The five areas of recommendation are:

  • partnering with groups that already reach targeted populations, such as food stamps offices;
  • meeting and engaging people where they live and work, not just in health-care settings;
  • using personal stories to explain health insurance information and convey the importance of enrollment;
  • putting health in the context of higher-priority basic needs of vulnerable populations; and
  • understanding how people get their information.

Each of the recommendations has action steps that can be taken. “We believe this research offers new insights and concrete solutions that could aid in ACA implementation,” Kreuter said. “Providing strong empirical support may encourage a wider application of promising strategies.”

Kreuter is lead author on the paper, which also has Brown School contributions from Timothy McBride, PhD, professor; Charlene A. Caburnay, PhD, research assistant professor; Timothy Poor, HCRL publications editor; Vetta L. Sanders Thompson, PhD, associate professor; Hannah Perkins, public health research technician, and Christopher Casey, HCRL director of communications.

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To find out more about the work of the Brown School’s HCRL, visit