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Medicaid enrollment and retention among eligible populations remains a challenge. We assessed health literacy-related features and content of Internet-based state Medicaid enrollment materials and resources. In February 2021, using established tools, we evaluated paper Medicaid enrollment applications and scope of enrollment resources (on-line enrollment option, toll-free telephone assistance, live chat function, instructional and/or informational audiovisuals). Forty (78.4%) English- and 28 (54.9%) Spanish-language paper Medicaid enrollment applications were available. Overall, document complexity was high as a large volume of information is required to apply for Medicaid coverage. An on-line Medicaid enrollment option was nearly universal. Medicaid government platforms were more likely to provide toll-free telephone assistance (n = 34; 66.7%) than a live chat function (n = 10; 19.6%). Eleven (n = 11; 21.6%) government platforms provided an instructional and/or informational Medicaid enrollment audiovisual resource. Our work suggests the need for states to leverage technology in creation of resources to match language and cultural needs of the diverse US population. Translation to Health Education Practice : Access to continuous health insurance coverage, comprehensive clinical care services, and evidence-based health education programming combined are essential in promoting both individual and community health.

Accessibility, Readability, and Document Complexity of Medicaid Enrollment Materials and Resources