National Academy of Medicine

Amplifying the Voice of the Underserved in the Implementation of the Affordable Care Act

By Kavita Patel, Ruth Parker, Antonia Villarruel, Winston Wong
June 21, 2013 | Discussion Paper

In April 2013, in collaboration with the Connecticut Health Foundation, the Institute of Medicine’s (IOM’s) Roundtable on the Promotion of Health Equity and the Elimination of Health Disparities convened a public workshop with community leaders and health policy makers on the implications of the Patient Protection and Affordable Care Act (ACA) for health equity. Among the most powerful presenters were two community organizers based in Connecticut who described both the appetite of the underserved for information about opportunities for health insurance coverage and the prevailing confusion among these families and communities regarding the ACA. Even among the law’s strongest supporters and the architects of ACA implementation, there was concern—if not dread—that the goal of expanding health coverage for the underserved would be sidetracked by misinformation, a lack of community trust, and a lack of coordinated and consistent messaging around the potential benefits of the new law.

Earlier in the spring of 2013, the IOM Roundtable on Health Literacy convened a meeting in Washington, DC, and invited speakers to describe their organizations’ efforts to assimilate the “attributes” of a health literacy sensitive organization. Although the focus of this convening was not the ACA per se, a prevailing theme was the importance of the patient voice in the health care delivery system and the need for organizations to adopt programs that consistently incorporate this voice.


Disclaimer: The views expressed in this paper are those of the authors and not necessarily of the authors’ organizations, the National Academy of Medicine (NAM), or the National Academies of Sciences, Engineering, and Medicine (the National Academies). The paper is intended to help inform and stimulate discussion. It is not a report of the NAM or the National Academies. Copyright by the National Academy of Sciences. All rights reserved.