Is Obamacare readable?

AP asks Ann to evaluate online training program

Forget everything you think or know about Obamacare.

Does it represent the country’s worst slide into socialism since our founding fathers tweedled their fifes and thumped their drums in 1776? Or does it offer a much-needed basket of rainbows and kittens to all Americans? Those questions are the least of our worries.

The real question is: Is it readable?

That’s the question Carla K. Johnson, Associated Press medical writer based in Chicago, asked me one day in August.

Can they read this?

Carla sent me four samples of text from an online training program. The program was developed for Illinois outreach workers who will help people sign up for insurance benefits under the new health law.

Many of the outreach workers, Carla told me, have a high school diploma or GED and no college education. Some have college degrees.

Will they be able to read it? Carla asked.

No, they won’t, I answered.

How do we know?

I used StoryToolz readability analyzer to study these passages:

“Payment of the penalty is through the federal income tax return and is $95 per individual and $285 per family in 2014 or 1% of family income whichever is greater. It will increase in future years.”

“Applicants expect that we keep information about them confidential, sharing it only with people who need the information to do their jobs.”

“Individuals must report changes in income to the Marketplace in order to assure that the premium tax credit is correct and the federal government is not overpaying on behalf of the consumer. This will help the consumer avoid a reconciliation at the end of the tax year in which they would have to pay back taxes. Additionally, consumers do not have to take the entire premium tax credit in advance of filing taxes.”

“Medicaid eligibility is organized by category or population each of which has different rules for how much income and resources you can have. For the most part, only citizens and qualified immigrants can qualify. The largest Medicaid categories covering most eligible individuals are Children under age 19, Parents raising children under age 19, Pregnant Women, Individuals 65 and older, and Persons with Disabilities.”

These passages weigh in at the 9.2nd, 11.8th, 12th and 14.5th grade levels on the Flesch-Kincaid grade level scale, respectively.

All are too difficult for outreach workers with high school diplomas and GEDs to read easily. But these passages will also put off workers with college degrees.

Some context on readability

Why?

More than four out of 10 Americans have basic or below basic prose skills, according to the U.S. Department of Education’s 2003 National Assessment of Adult Literacy (PDF).

That’s the latest in a series of NAALs.

These folks can sign forms, compare ticket prices for two events and look up shows in a TV guide. But they have trouble finding places on a map, calculating the cost of office supplies from a catalog and comparing viewpoints in two editorials.

If you’re writing at the 14.5th grade level, you’re reaching only 13% of your audience members.

The question for writers of this online training program is: Are you smart enough to write for a fifth grader?

How can we improve these passages?

It would be simple to make all of these passages easier to read by:

• Listing lists
• Making words shorter
• Tightening sentences
• Writing directly to the reader in the second person
• Covering people doing things instead of programs and procedures

Here’s what these passages might look like after editing for readability:

Before reading level: 9.2

Payment of the penalty is through the federal income tax return and is $95 per individual and $285 per family in 2014 or 1 percent of family income whichever is greater. It will increase in future years.

After reading level: 5.3

The 2014 penalty is whichever of these is more:

• $95 per individual
• $285 per family
• 1% of family income

Penalties will increase in the future. If you owe a penalty, you’ll pay through your federal income tax return.

Before reading level: 11.8

Applicants expect that we keep information about them confidential, sharing it only with people who need the information to do their jobs.

After reading level: 7.6

Keep information about applicants confidential. Share the information only with people who need it to do their jobs.

Before reading level: 12

Individuals must report changes in income to the Marketplace in order to assure that the premium tax credit is correct and the federal government is not overpaying on behalf of the consumer. This will help the consumer avoid a reconciliation at the end of the tax year in which they would have to pay back taxes. Additionally, consumers do not have to take the entire premium tax credit in advance of filing taxes.

After reading level: 8.5

You must report changes in your income to the Marketplace. That will ensure that your premium tax credit is correct and that the federal government doesn’t overpay on your behalf. This way, you can avoid having to pay back taxes at the end of the tax year.Also, you don’t have to take the entire premium tax credit before filing taxes.

Before reading level: 14.5

Medicaid eligibility is organized by category or population each of which has different rules for how much income and resources you can have. For the most part, only citizens and qualified immigrants can qualify. The largest Medicaid categories covering most eligible individuals are Children under age 19, Parents raising children under age 19, Pregnant Women, Individuals 65 and older, and Persons with Disabilities.

After reading level: 5.1

Are you eligible for Medicaid? That depends on who you are, how high your income is and how many other resources you have. The largest groups of people who qualify for Medicaid are:

• Children under 19
• Parents raising children under 19
• Pregnant women
• People 65 and older
• People with disabilities

Before	Reading level	After	Reading level
Payment of the penalty is through the federal income tax return and is $95 per individual and $285 per family in 2014 or 1% of family income whichever is greater. It will increase in future years.	9.2	The 2014 penalty is whichever of these is more: $95 per individual $285 per family 1% of family income Penalties will increase in the future. If you owe a penalty, you’ll pay through your federal income tax return.	5.3
Applicants expect that we keep information about them confidential, sharing it only with people who need the information to do their jobs.	11.8	Keep information about applicants confidential. Share the information only with people who need it to do their jobs.	7.6
Individuals must report changes in income to the Marketplace in order to assure that the premium tax credit is correct and the federal government is not overpaying on behalf of the consumer. This will help the consumer avoid a reconciliation at the end of the tax year in which they would have to pay back taxes. Additionally, consumers do not have to take the entire premium tax credit in advance of filing taxes.	12	You must report changes in your income to the Marketplace. That will ensure that your premium tax credit is correct and that the federal government doesn’t overpay on your behalf. This way, you can avoid having to pay back taxes at the end of the tax year.Also, you don’t have to take the entire premium tax credit before filing taxes.	8.5
Medicaid eligibility is organized by category or population each of which has different rules for how much income and resources you can have. For the most part, only citizens and qualified immigrants can qualify. The largest Medicaid categories covering most eligible individuals are Children under age 19, Parents raising children under age 19, Pregnant Women, Individuals 65 and older, and Persons with Disabilities.	14.5	Are you eligible for Medicaid? That depends on who you are, how high your income is and how many other resources you have. The largest groups of people who qualify for Medicaid are: Children under 19 Parents raising children under 19 Pregnant women People 65 and older People with disabilities	5.1

Read the AP story.

How readable is your copy?
Are you reaching the readers you hope to reach?

And thanks!

Thank you to Shirley Skeel, media relations manager for The University of Puget Sound, for recommending me to Carla.

Get the word out with clear, compelling copy

Each day, your readers are bombarded with 5,000 attempts to get their attention. That’s nearly 2 million messages a year. Is your copy getting through to your tired, busy, distracted audience?

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