Learning about the Affordable Care Act



Health communication researchers from an array of disciplines are teaming up with the Richland County (S.C.) Library to help give people information about the Affordable Care Act. The law, also known as Health Care Reform and Obamacare, has some requirements that people need to know to make health care, insurance and financial decisions. Andrea Tanner, associate professor in the School of Journalism and Mass Communications, is leading the University of South Carolina’s research into what people know, think they know and need to know about the new health care law. The goal is to identify messages and distribution sources to disseminate to Richland County residents.

What is the scope of your role in this project?

“Our interdisciplinary team of researchers from USC is working with the Richland County Library on a project funded by the Knight Foundation. The ultimate goal is to facilitate and help people in Richland County get information about the Affordable Care Act in a nonpartisan way. There’s a lot of confusion and overall lack of understanding regarding the ACA. This is especially true in South Carolina, a state that is not participating in the health insurance exchange and opting out of Medicaid expansion.

“USC’s part of this project is to conduct formative research. In year one of the project, we assessed the knowledge, perceptions and communications sources and needs about the ACA among people in Richland County. Using the findings from this research, we then developed strategies to reach people in the community. We’ve done a telephone survey of Richland County residents and we’ve also completed a series of focus groups with people around the county. Because most people trust the information they receive from the library, we’re trying to make the Richland library a hub of ACA information.” 

Do you have any idea of what people know or what they think about the Affordable Care Act?

“We asked people in Richland County how well they understand the ACA, and only about 20 percent say they fully understand it, and that’s across socioeconomic factors and other demographics. A majority of folks say they don’t know that much about the ACA or maybe know a little bit about it. Our focus group findings indicated that Richland County residents are interested in knowing more about costs, eligibility and how to sign up. They want to receive this information through a person they know and trust. Local media, particularly local television, was also seen as an effective way to reach people about the ACA.

“We also asked people their likelihood of searching for information over the next six months. Nearly half said they were likely or very likely to do that. They don’t feel like they understand it that well and they want more information. From our standpoint, that was good because there is a need for this information.” 

What is the next step in your research?

“Now that we’ve finished data analysis, in year two of our project our team will focus on developing, implementing and evaluating an evidence-based ACA health education and health literacy program tailored to Richland County residents who recently acquired health insurance through the Health Insurance Marketplace. There are many Richland County residents who signed up for health insurance through the ACA, but don’t have the health literacy skills to understand concepts, such as insurance premiums, or where to go to receive medical treatment.” 

Where are people getting their information?

“The most often used sources are cable television and local and other broadcast news channels and family and friends. When we asked them about their most important sources of ACA information and what they were hearing about it, 60 percent said they were hearing mostly bad things about it, which is not surprising. What is particularly interesting is that few people are getting information from doctors, from their employers, from health insurance companies. However, those are the people, those are the sources that they want to hear it from.” 

Have you done a project on this scale before?

“Yes, I just completed a similar project where I collaborated with science and health communication researchers across campus to investigate S.C. residents’ knowledge, perceptions and communication needs about clinical trial participation. The number of people participating in clinical trials across the United States is dreadfully low, and there is such a need for people to participate in that type of research. We were examining what people in South Carolina know and think about clinical trials and their likelihood of participating in one. We are in the process of making recommendations about how to educate and communicate with the general public about the importance of clinical research.”


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