Reading level of Medicaid renewal applications

To examine compliance of Medicaid-renewal applications to established state guidelines for reading level of Medicaid-related materials.

We assessed the reading level of the 2008 Medicaid renewal applications by using 3 readability tests: Flesch-Kincaid Grade Level Index, New Fog Count, and FORCAST.

In 2008, 45 states and the District of Columbia had reading level guidelines for Medicaid-related materials. Of these, 24 (52.2%) states' Medicaid renewal applications failed to meet their guidelines on all 3 readability tests; in particular, 41 states (89.1%) failed the Flesch-Kincaid Grade Level Index. Only one state's application had a Flesch-Kincaid score below a 5th-grade reading level.

As health care reform unfolds, complying with established reading level guidelines for Medicaid-related materials is one simplification strategy that should be implemented to improve access for Medicaid-eligible families and prevent eligible children from losing coverage unnecessarily.