The Health Literacy report issued in 2004 by the Institute of Medicine (IOM) was a wakeup call to action, which resonated with many in both the public and private sectors. The report defined health literacy as “the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions,” and found that 90 million American adults “may lack the needed literacy skills to effectively use the U.S. health care system.” Reviewing efforts to advance health literacy since the IOM report, the authors of this article find substantial progress. Since the IOM report was issued, commitment to advancing health literacy has grown within federal health agencies. Numerous professional schools and societies are working to educate health professions in their schools and through continued medical education. Research support in the area of health literacy has increased significantly and more data has become available. The authors suggest, nonetheless, that the scope of progress is not broad enough and the pace is not fast enough. There remains a pressing need to advance population-based measures and indicators of a health-literate public. In addition, researchers need to build partnerships in primary and secondary education to work collaboratively on finding ways to introduce essential health curricular components. Finally, they note that the recent experience with Medicare Part D enrollment highlights the need to engage consumers in the process of developing meaningful health communication regarding complicated information. The challenges posed by the IOM report were daunting and will clearly require sustained efforts over several decades, including significant commitment of time and resources.