How readable are spanish-language medicaid applications?

Julie S. Hansen, Lorraine S. Wallace, Jennifer E. DeVoe

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Nationally, Hispanics comprise nearly onequarter of all non-elderly Medicaid recipients. We evaluated readability, layout characteristics, and document complexity of state-issued Spanish-language Medicaid enrollment applications. We located and analyzed Internetbased Spanish enrollment applications from 37 states and the District of Columbia. We calculated the readability of each Medicaid enrollment application ''Signature'' page using the Spanish Lexile Analyzer. We assessed application layout characteristics utilizing the User-Friendliness Tool, and we evaluated document complexity using the PMOSE/IKIRSCH scale. The average Lexile score estimated an 11th-12th grade reading level (M = 1184, SD = 192) for ''Signature'' pages of enrollment applications. Most applications used small font size and lacked adequate white space. Document complexity ranged from level 3 (moderate) to level 5 (very high); the majority of applications ranked at level 4 (high). Spanish-language Medicaid enrollment applications should be revised to adhere to low-literacy guidelines, which may improve the accessibility of Medicaid coverage for eligible Spanishspeaking families.

Original languageEnglish (US)
Pages (from-to)293-298
Number of pages6
JournalJournal of Immigrant and Minority Health
Issue number2
StatePublished - Apr 2011


  • Health literacy
  • Literacy
  • Medicaid
  • Readability
  • Spanish

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health


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