Assessing Community Members' Knowledge and Sources of Information about the Affordable Care Act: A Telephone Survey

Background: Almost half (49%) of Americans report not having enough information to understand the Affordable Care Act (ACA). This lack of awareness may be more pronounced in South Carolina (SC) because the state has opted out of specific ACA components (e.g., Medicaid expansion). To guide educational strategies of SC stakeholders, the purpose of this study was to examine people’s knowledge and sources of ACA information.

Methods: A randomized telephone survey of 509 SC residents was conducted between November and December 2013. The survey contained 34 multiple-choice items to assess demographics and knowledge/sources of ACA information. Descriptive and parametric statistics were used to analyze data.

Results: Most respondents were female (51%), Caucasian (46%), employed (61%), and had a college degree (47%). Individuals either somewhat understood (40%) or had a poor understanding (37%) of the ACA. Respondents also had low average knowledge scores (M=5.21 out of 9). Individuals who were 18-26 (p=.009), without a college degree (p=.0001), with incomes <$20,000 (p=.0001), and/or were unemployed (p=.048) were significantly less knowledgeable about the ACA. Most (55%) reported television news as their most common source of ACA information and almost 50% reported being open to using the local library for ACA information.

Conclusions: ACA educational efforts in SC should be tailored to people with less knowledge about the ACA. Using television news to communicate about the ACA and partnering with public libraries may help increase people’s awareness of and access to reliable ACA information.