Effective Messaging About the Medi-Cal Expansion to Older Adults

Results from Focus Groups with Newly Eligible Californians in Los Angeles

Michele Cordoba, Vision Strategy and Insights


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—As of May 1, 2022, California expanded eligibility for full-scope Medi-Cal benefits to all adults age 50 or older with low incomes, regardless of immigration status. To gain insights on effective messaging to raise awareness about this Medi-Cal expansion and to motivate enrollment, the California Health Care Foundation engaged a research firm, Vision, Strategy and Insights (VSI), to conduct message testing with newly eligible Latino/x, Chinese, and Korean immigrants in Los Angeles County.

VSI conducted 12 focus groups from May 24 to June 9, 2022, with 65 total participants: 32 Latino/x, 17 Chinese, and 16 Korean. In addition to probing about general awareness of the Medi-Cal program and the new opportunity to enroll, focus group participants  reacted to outreach materials currently in use by community-based organizations and the California Department of Health Care Services.

Key Findings and Recommendations 

  • Mixed awareness, high interest. About half of Latino/x participants reported having heard something about the expansion. Awareness was lower among Chinese and Korean participants. Regardless of prior awareness, participants welcomed news of the expansion.
  • Cautiously motivated. Most respondents expressed that they were “very motivated” to apply, and their motivation grew as they learned more. Nevertheless, most expressed a need for more information before taking that step.
  • More information (not less) is better. Participants preferred outreach materials with more detailed information on Medi-Cal, the benefits and services they would receive, and the eligibility requirements. More information assuages worries and builds trust and credibility.
  • Emphasize the connection to the California government. Respondents liked knowing that the source of Medi-Cal is the California government and that the new opportunity to enroll is because of  a law that is not subject to erratic changes.
    • Specify that the Medi-Cal expansion to 50+ regardless of immigration status is a new law.
    • Specify that Medi-Cal is a government program.
    • Include .gov websites whenever possible (instead of .com or .org).
    • Use government officials or representatives of the Medi-Cal program as messengers.
  • List the range of health care services covered. 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. Respondents wanted phone, online, and in-person options to get more information or help.

A slide presentation from VSI with more detailed findings as well as a one-page summary of key findings are available for download below.

Also available below is a sample outreach flyer that illustrates one way to organize and present the most important pieces of information for consumers, as identified by this study. In phase two of this project, CHCF will work to improve this piece based on other best practices, including reducing the reading level, and will conduct additional user testing. The final version will be made available in multiple languages.