An estimated 14 percent of English-speaking adults in the United States have below-basic literacy, or an inability to perform simple reading tasks. But 35 percent have only basic or below-basic health literacy. That means more than 77 million people have difficulty with common health-related reading tasks. Health literacy involves the ability to obtain, process, and understand the health information necessary to make appropriate decisions, and it's clearly essential to selecting health insurance. More Americans are enrolling in federal and state-based marketplaces, but being insured is only the beginning when it comes to reducing health disparities related to literacy.