Using Community Health Workers to Increase Awareness about the Affordable Care Act in a Rural Community

Background: The State of Texas has the highest rate (24%) of uninsured residents in the US. Rural communities in Texas are particularly at risk of being uninsured; in fact, in a recent health status assessment 25.7% of rural Madison County residents reported  not having health insurance of any kind. Of those who reported being uninsured, 85.5% said they could not afford insurance because it was too expensive. Due to this disparity, the Madison Health Resource Center collaborated with local health and social service providers to apply for funding from the Office of Rural Health Policy to increase awareness of the Affordable Healthcare Act (ACA). Currently, there are no certified application counselors in Madison County who can assist local residents in the ACA application process. Methods: To assist residents in enrolling in health insurance marketplaces, Madison County developed an ACA awareness campaign. They utilized two certified Community Health Workers and trained them as general educators to implement the campaign. Results: Since initiation in April 2013, general educators have conducted three health education events in the community, targeting low-income individuals. General educators partnered with local community organizations, churches, hospitals, social service providers, and emergency management personnel to plan and implement education activities. Over 43 individuals have participated in activities and 20 have been referred to additional resources to assist them in enrollment processes. In addition, more than 200 educational materials have been disseminated throughout the rural community. Overall, initial results of this project are positive and well-perceived within the community.