Implementation of the Affordable Care Act ACA of 2010 will result in significant changes to the U S health care system Among its many provisions the ACA will extend access to health care coverage to millions of Americans who have been previously uninsured Many of the newly eligible health insurance consumers will be individuals of low health literacy some speakers of English and others more comfortable using languages other than English Health insurance terms such as deductible co insurance and out of pocket limit are difficult to communicate even to those with moderate to high levels of health literacy and so health exchanges will face challenges as they attempt to communicate to the broader community In addition to having to convey some of these basic and yet complex principles of insurance state exchanges will be attempting to adapt to the many changes to enrollment and eligibility brought about by ACA The Institute of Medicine IOM convened the Roundtable on Health Literacy that brings together leaders from the federal government foundations health plans associations and private companies to discuss challenges facing health literacy practice and research and to identify approaches to promote health literacy in both the public and private sectors The roundtable sponsored a workshop in Washington DC on July 19 2011 that focused on ways in which health literacy can facilitate state health insurance exchange communication with potential enrollees The roundtable s workshop focused on four topics 1 lessons learned from existing state insurance exchanges 2 the impact of state insurance exchanges on consumers 3 the relevance of health literacy to health insurance exchanges and 4 current best practices in developing materials and communicating with consumers Facilitating State Health Exchange Communication Through the Use of Health Literate Practices summarizes the presentations and discussion that occurred during the workshop The report provides an overview of health insurance exchanges presents evidence on the extent to which consumers understand underlying health insurance concepts and describes the relevancy of health literacy to health insurance reform and how health literacy interventions can facilitate the implementation of health insurance reforms The report also provides a review of best practices in developing materials and communicating with consumers and concludes with reflections on the workshop presentations and discussions by members of the roundtable and its chair Further information is provided in the appendixes the workshop agenda Appendix A workshop speaker biosketches Appendix B and testimony provided by the organization America s Health Insurance Plans AHIP Appendix C