Out of Sight, Out of Mind: The Implementation and Impact of the Affordable Care Act in U.S. Farmworker Communities.

Farmworkers are a unique population within rural communities and are often overlooked and undercounted. They face significant disparities in health and health care access compared with the general rural population. One goal of the Patient Protection and Affordable Care Act (ACA) is to increase access to health care and health insurance for the country's most vulnerable and underserved populations. Farmworkers' numerous barriers to health care and health insurance remain, despite the ACA's progress. Apart from anecdotal accounts, we lack the necessary data to assess the ACA's impact on farmworker communities. This commentary imparts information about farmworker enrollment in and barriers to accessing health insurance, collected through individual conversations, focus groups, interviews, and informal surveys. Based on identified challenges and limitations, we make policy recommendations to assess and improve the implementation and relevance of the ACA in farmworker communities.