Studying Up on Health Care Literacy

December 3, 2013


The Affordable Care Act (ACA), with open enrollment for health insurance running from October 1, 2013, through March 14, 2014, may turn out to be as busy as April tax time for libraries. And as with taxes, those manning the reference desk are not expected to be experts or to help people complete the paperwork, but they do need to be able to direct them to appropriate resources. Librarians will also want to determine how to assist patrons who may have limited computer experience or aren’t health insurance savvy.

Patrons rely on library assistance

A 2011 study by the Institute of Museum and Library Services (IMLS) noted that 37% of library computer users go online to research health and wellness issues, including health insurance options, so it seems clear that many of the 45 million Americans who are uninsured will be looking to the library for help in finding information and signing up. The ACA requires US citizens, with a few exceptions, to have health insurance in 2014 or pay a noncompliance fee come tax time.

To ensure librarians have the help they need, several organizations have been offering online educational seminars that provide ideas for connecting with local community experts who can provide assistance. One such seminar reprised a 2013 ALA Annual Conference and Exhibition panel presentation, “Libraries and Health Insurance: Preparing for October 1,” with representatives from IMLS, the Centers for Medicare and Medicaid Services, OCLC’s WebJunction, and the National Network of Libraries of Medicine. The WebJunction event, online chat, and documents are archived at In addition, at, librarians can find contributions from WebJunction members, online seminars, articles, and news on health resources.

Web pages and FAQs

The Topeka and Shawnee County (Kans.) Public Library (TSCPL) created a useful web page that other libraries may want to mirror. It includes questions and answers, facts, upcoming programs, and links to helpful videos.

“I’m updating the page almost every day as I get more information about local events and find more contact information for locally trained navigators and certified application counselors,” says Lissa Staley, TSCPL librarian. “The library is actively at the table for local public health meetings, convening meetings of partners, and [we have] positioned ourselves as the go-to place for local information on this topic.”

Staley says the library has been training staff to refer people to; promoting nearby events; offering to let organizations—like the Kansas Insurance Department and the insurance commissioner’s office—hold public meetings; and referring visitors to trained people who can assist.

ALA also has prepared an ACA-specific page at with links to the ACA and government health care sites, as well as resources on providing health care information in libraries. ALA Librarian Karen Muller says this page “was one of the top 100 most popular pages on the ALA website in the late summer.”

Probably the most common questions that patrons want to know are:

  • What are my choices for health insurance?
  • How do I get it?
  • How do I use it?
  • How much will it cost me?

These are detailed in a discussion paper on the Institute of Medicine’s site.

Some libraries offered programming prior to the October launch to anticipate questions. The Waukegan (Ill.) Public Library (WPL) began in August with a multisession bilingual health literacy program and individual help for patrons to determine health care eligibility. The program was paid for by the Building Bridges through Health Navigation grant funded by the Health Care Foundation of Northern Lake County in partnership with the Alliance for Human Services.

Richard Lee, WPL’s executive director, told Liz Morris on WebJunction: “Knowing how to navigate the health care system is essential to our community, especially when almost 72,000 Lake County adults are uninsured. As a library, our mission is to ensure that our patrons have access to the information and resources that they need to be successful. When access to health care is a barrier to that success, we must do what we can to remove the obstacles. Health literacy has become one of our most important recent initiatives.”

Low-cost or no-cost programming

Short of getting a grant, however, there are many options to support programming and partnerships. Each state has a designated “navigator.” The navigators and in-person assistance (IPA) programs are certified to offer help with the marketplace, must be accessible for persons with disabilities, and cannot be connected to the health insurance issuers in their state. In other words, they are impartial. Navigators may also be able to provide handouts to your library, as they have for Geneva (Ill.) Public Library. “The fliers include contact information as well as addresses for the sites where certified specialists will be available to help one-on-one,” says Deb Walsh, head of adult services. “There is nothing unprofessional about making a reference referral—we do it all the time when the best source of information is determined not to be a library staff member or a library-owned resource.”

Other potential partners include representatives from local and state government, such as someone from a local congressperson’s office. Kathy Silks, project manager of PA Forward at the Pennsylvania Library Association, says PaLA “developed a task force of representatives from the PA Insurance Department, statewide medical organizations, the Center for Rural Pennsylvania, and others” to help librarians find the best resources to respond to consumer information needs.

At the Spokane County (Wash.) Library District, selected public service staff received training from Community-Minded Enterprises, a 501(c)(3) that is part of the in-person assisters who are trained and certified to help people apply and enroll in the plans. “After certification, we anticipate providing additional access to computers and modest direction to use, ” says librarian Debra Park.

Each library will have its own response to the demands of patrons. “At the local level, you have to decide your priorities,” says Susan Hildreth of IMLS.


Key Websites to Share with Patrons

The place to find out what your state offers, which website to use to sign up for health insurance, FAQs, and more.

The US National Library of Medicine and the National Institutes of Health provides this consumer-friendly, ad-free site to explains lots of health issues simply and clearly.

The Washington Post offered a series of articles about the ACA, but two were especially pithy:


Choosing a Plan

A Few Key Facts

Consumers are encouraged to sign up for health insurance online, but paper enrollments are accepted.

Consumers can call 800-318-2596 for help in English or Spanish about the health plans 24/7.

All states must have Navigator programs, which are required to conduct public education activities, distribute impartial information about qualified health plans (QHPs), facilitate enrollment in QHPs, and provide referrals as necessary.