News & Updates

IMI Reports 39% of State Medicaid Enrollment Forms Have Higher-Than-Recommended Reading Levels


July 29, 2022



Washington, DC - New research from the Institute for Medicaid Innovation (IMI) indicates that Medicaid enrollment form readability sometimes exceeds recommended reading level standards.  IMI conducted a review and analysis of state Medicaid enrollment forms from all 50 states and the District of Columbia finding that 39% of state forms (20 total) exceeded the recommended reading levels.  The American Medical Association (AMA) recommends a maximum 5th grade reading level.

Our research builds on previously published studies by analyzing more current 2020 state Medicaid enrollment forms to evaluate a) individual form sections, b) compliance with recommended national and state reading levels, and c) differences in readability levels between states that utilized the Centers for Medicare and Medicaid Services (CMS) (“CMS-developed”) form and states that created their own (“state-developed”) forms.  We found on average that states who did not utilize the CMS-developed form exceeded the recommended reading levels especially on the instructional, signature, and auto re-enrollment/continuous enrollment sections.

State Medicaid enrollment forms serve as a critical access point for individuals seeking health care service coverage through the Medicaid program.  Readability levels above the recommended levels has the potential to impact enrollment into Medicaid by making it difficult for individuals to complete the form accurately and easily.  Enrollment packets written at or below the recommended 5th grade reading level for health materials would facilitate timely access to preventive services and other health care, which could ultimately prevent the need for more costly types of care.

The complete report with all national and state-level findings can be found here.

About the Institute for Medicaid Innovation

The Institute for Medicaid Innovation (IMI) is a 501(c)3 nonprofit, nonpartisan research and policy organization that provides independent, nonpartisan information and analysis to inform Medicaid policy and improve the health of the nation.

Media Contact

Drew Thies
DThies@MedicaidInnovation.org