Publications / Effective Messaging About the Medi-Cal Expansion to Older Adults: Phase 2

Effective Messaging About the Medi-Cal Expansion to Older Adults: Phase 2

In May and June of 2022, Vision Strategy and Insights (VSI) conducted focus groups with Latino/x, Chinese, and Korean immigrants age 50 and over in Los Angeles County who were newly eligible for Medi-Cal. Focus groups probed participants’ awareness of the new opportunity to enroll in Medi-Cal and their reactions to various outreach materials. This effort yielded many insights into the messages, messengers, and types of information that most motivated participants to apply.

In December of 2022, VSI conducted Phase 2 of the study. New outreach materials were developed in all three languages based on Phase 1 findings and retested with a subgroup of participants from the summer. These additional focus groups also provided an opportunity to ask if participants had applied for Medi-Cal and what that experience was like.

Sample Outreach Flyers Available for Download

Emerging from Phase 2 are final versions of sample outreach flyers in Spanish, Korean, and Chinese (available for download below, along with an English version). These flyers are provided as Word documents so organizations can customize them as appropriate. When customizing these flyers, the following is recommended:

  • If you are a government office or agency, replace the graphic of the state of California with your logo or seal. The most trusted messenger about Medi-Cal was the government. A government seal or logo will increase the credibility of the flyer. Otherwise, symbols of the state of California were the most desired graphic element. (That said, participants did not consider graphics or pictures particularly important. They were more focused on the flyer’s content and information.)
  • There are two places (highlighted in yellow in the flyer) where you can insert contact information for local organizations that offer help with concerns or questions about public charge and with applying for Medi-Cal. Add organizations that provide in-language help, if possible. If you don’t want to customize the flyer in this way, delete those highlighted sentences.
  • Similarly, the “How Do I Apply?” section can be edited with more local information. The flyer currently features how to find local Medi-Cal offices or get enrollment help from statewide organizations and resources, like Covered California and the website. However, feel free to replace this with contact information for local agencies or organizations, such as community health centers or a county Medi-Cal office. Again, include phone numbers, websites, or office addresses where people can apply or get help in their own language. When possible, use .gov websites, as participants find those more credible than .com or .org sites.

Note that there are some differences across the Chinese, Korean, and Spanish versions of the flyer. These differences reflect additional feedback from certain language groups during Phase 2 (a memo summarizing key Phase 2 recommendations from VSI is available below) in addition to suggestions from community-based organizations that translated the flyers. For the most part, however, the documents are similar and reflect a set of key recommendations that apply to all language groups:

  • More (not less) information is better. Participants preferred outreach materials with more detailed information on Medi-Cal. Additional information assuaged worries and built trust and credibility.
  • Emphasize the connection to the California government. Participants liked knowing that the 50+ expansion was the result of a California law and that Medi-Cal is a government-run program. As noted above, government representatives are trusted messengers, and participants trust .gov websites more than .com or .org sites.
  • List the range of health care services covered under full-scope Medi-Cal. Dental, vision, general preventive wellness visits, and referrals to specialists were considered the most valued services by respondents.
  • Address worries about immigration status and public charge head-on. Say explicitly that enrolling in Medi-Cal will not affect current or future immigration status. Display this information prominently.
  • Provide multiple contact points, emphasizing language-specific options. Respondents wanted phone, online, and in-person options — specific to their language — to get more information or help. Not seeing language-specific options (like a website in Spanish or a Korean helpline) discourages them from trying to apply.
  • Emphasize that Medi-Cal is free or low cost.

Insights into the Application and Enrollment Experience

During Phase 2, those who had applied or enrolled in MediCal were asked about their experiences. Those who hadn’t yet applied were asked what barriers kept them from doing so. Below are some key takeaways from those conversations. Due to the small size of Phase 2 focus groups, which included a total of 24 participants (eight from each language group), more research would be needed to confirm if these observations are true at a broader population level. 

  • Several Spanishspeaking recruits had applied for, and some had secured, MediCal since the original focus groups. Only a few Koreanspeaking respondents and one Chinesespeaking respondent had applied for the program since participating in the groups.
  • Many of the respondents who were ultimately able to enroll were connected to a health care center or other community-based organization that helped guide them through the process, while most of those who remained unenrolled, particularly the Chinesespeaking respondents, did not have those connections.
  • Other barriers to applying included being hired recently, so they no longer needed or qualified for the program. Others didn’t perceive an immediate need for health care services. This last barrier could prove to be a formidable challenge in getting newly eligible Californians in their twenties, thirties and forties to enroll in 2024, as younger people tend to be particularly susceptible to the idea that they don’t need insurance if they are healthy.

If you have any questions or feedback on the outreach materials, contact CHCF Senior Communications Officer Anne Sunderland through the CHCF website. 

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