Accessibility of the Affordable Care Act (ACA) marketplace websites.

The Affordable Care Act (ACA) mandated that creation of online health insurance websites to ease the complex process of shopping for and enrolling into coverage. Ensuring that these sites are not only available but also meet digital accessibility standards is important so that individuals with disab...

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Bibliographic Details
Published in:Journal of Communication in Healthcare Vol. 15; no. 4; pp. 316 - 324
Main Authors: Thornton, Michele, Mushtare, Rebecca, Rescigno, Francesca, Brightman, Kaitlin
Format: research tables/charts Journal Article
Published: Taylor & Francis Ltd Dec2022
Online Access:View this record in EBSCOhost
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      dt: Dec2022
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      pub: Taylor & Francis Ltd
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        10.1080/17538068.2022.2046899
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        atl: Accessibility of the Affordable Care Act (ACA) marketplace websites.
      aug:
        au:
          Thornton, Michele
          Mushtare, Rebecca
          Rescigno, Francesca
          Brightman, Kaitlin
        affil: Health Services Administration, Department of Marketing and Management, State University of New York at Oswego, Oswego, NY, USA
      sug:
        subj:
          Patient Protection and Affordable Care Act
          Health Insurance Exchanges
          World Wide Web
          Health Services Accessibility
          Insurance Coverage
          Human
          Content Analysis
          Quantitative Studies
          Descriptive Statistics
          T-Tests
          Qualitative Studies
          Healthcare Disparities
      ab: The Affordable Care Act (ACA) mandated that creation of online health insurance websites to ease the complex process of shopping for and enrolling into coverage. Ensuring that these sites are not only available but also meet digital accessibility standards is important so that individuals with disabilities are able to access healthcare services and efficiently obtain insurance coverage. We evaluated each of the marketplace sites in 2020 to assess whether they are digitally accessible. We employed a custom audit tool based on a subset of the Web Content Accessibility Guidelines (WCAG) 1.0 and 2.0 AA and used content analysis to compare the site's accessibility statements with best practices. Nearly all of the ACA marketplace websites have significant room to improve their digital accessibility. Notable technical problem areas include lack of text equivalents for images, difficult site navigation, and lack of optimization for mobile use, particularly on those pages that provide instructions on how to get in-person help. Given that access to health insurance is a primary predictor of access to health care – sites must be easy to use and accessible to all individuals regardless of ability. Barriers to online enrollment, such as those identified in this work, may exacerbate disparities in quality of care, treatment continuity and affordability for individuals with mental and physical disabilities. Entities providing health-related online information & engagement should be aware of actionable opportunities to improve digital accessibility to optimize the enrollment process for both maintaining coverage and assisting those that remain uninsured.
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    language: English
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