The state of California passed a new law in May 2022 allowing low-income residents over the age of 50 to become eligible for Medi-Cal, regardless of their immigration status.
The full scope of Medi-Cal will cover more than just emergency care for residents. It will cover doctor visits, mental health care, preventative care, referrals, medicines, transportation and in-home services.
The California Health Care Foundation (CHCF) hosted a webinar about how to effectively communicate Medi-Cal expansion to older adults. CHCF funded focus groups with Latinx, Chinese, and Korean residents in Los Angeles who are newly eligible for the program. The purpose of this research was to inform community-based organizations, the California Department of Health Care Services, and other key stakeholders how best to get the word out about this new benefit.
Michele Cordoba, founding director of Vision and Strategy Insights, was the speaker for this Medi-Cal expansion qualitative research webinar report. She explained what the research was about and gave participants in-depth information about the ethnic focus groups. Cordoba is an experienced researcher and marketer who brings experience in the Spanish-language television industry. She manages her multicultural marketing and consulting firm, Visión Publicidad, specializing in consumer insights, strategic planning and creative development, particularly in the areas of civic engagement, issue advocacy and cause-related marketing.
The CHCF was interested in providing its partners in Los Angeles with information about the ethnic target groups in order tomaximize their message and encourage residents to enroll in the new program offered to them.
Twelve focus groups were conducted in June 2022, with a total of 65 participants in the study: 32 Latino/x, 17 Chinese, and 16 Korean who qualified under a low income. The key objective of this research was to help community-based organizations, like the California Department of Health Care Services, and other key partners that can improve outreach and enrollment efforts to residents. To this day, there has been little outreach and awareness about the Medi-Cal expansion for 50+ elderly residents. Research like these help target exact message outreach and motivate undocumented people to enroll in the new Medi-Cal expansion program.
According to Baseline Awareness of Medi-Cal Expansion 50+ about half of the Latinx residents reported hearing about the expansion. When the group was asked what the Medi-Cal expansion was, many were able to recall that it was for people 50 and over and for undocumented people only. One of the focus groups that is associated with My Health LA was more informed because of the clinics they frequent. Other focus group particiapants were informed because of a friend or family member, had seen it on the news, or had received a letter in the mail from Medi-Cal.
When the researchers asked Korean and Chinese residents about the expansion, they were less aware of the changes to full-scope Medi-Cal. Many of these participants expressed concern about whether enrolling could hurt their future immigration status because of the public charge rule. Other participants demonstrated concern about whether this program could be taken away easily under a new politician or administrator.
The Initial Motivation to Enroll in Full-Scope Medi-Cal question was given about a four to five rating by the focus group. Although many participants were “very motivated,” most of them had not taken that next step to enroll. The majority of Latinx respondents who were aware of the expansion said that they needed “more information” to start the process of enrolling.
When participants were shown the description for Medi-Cal expansion, almost all participants reacted positively. Although most participants met the criteria for age and status, most of them assumed they would qualify based on their household income. Many of them expressed hesitation and that they would need more details about the requirements once again.
Across the ethnic groups, Chinese and Korean folks were very appreciative of the new law. Latinx participants felt like the state was finally recognizing immigrants’ contribution to the economy by offering them expansion. Not only did they feel recognized, they also felt a sense of relief knowing it was full coverage rather than emergency Medi-Cal. According to the Latino Community Foundation, about 1.8 million Latinos are uninsured and they are currently not able to access health insurance due to fear or lack of funds.
Even though the Medi-Cal description of the expansion was effective, many participants still had a lot of questions and concerns regarding the program. They were also confused about whether they met income thresholds. Many of the participants really liked that they were able to provide them with specific examples of family size and income. Another concern was that the “free or low cost” was too vague and wanted more information about the services that are covered. The Chinese and Korean concerns were different. They were still wondering about its sustainability being changed by another political administrator. There were also strong fears of public charge repercussions.
Each group was shown a total of four communications materials in their native language. Two were short form social media posts and the other two were long form flyers and mail pieces. The Health Consumer Alliance was the flyer that performed the best among Latinx, Chinese and Korean participants. The flyer was detailed and comprehensive compared to short-form ads. It was also seen as more “complete” and informative. The participants also voiced that the Q&A on the flyer was easy to comprehend. It also highlighted their biggest concern: their immigration status.
One of their concerns with this flyer was that very few participants were aware of the possibility that Medi-Cal could take their homes. According to California’s Medi-Cal Recovery Program the state of California doesn’t just take anyone’s homes without any reason. “Your home however, can be subjected to an estate claim after your death.” This caused many participants to worry about the new expansion program. The flyer stated information about participants getting help in their native language, benefits under the new program and a website and phone number for more information. After exposing all the advertising posts with participants, they were asked again how motivated they were to enroll in the program. The majority across the groups reported saying they were “very motivated.” Those who had been “somewhat motivated” at the beginning of the research were also moved to being “very motivated” to enroll.
When Latinx participants were asked where they wanted to get information about the expansion, Latinx participants responded that they would like to get information on Spanish T.V, radio and clinics. They also noted that they would like to hear from “people like me” who had applied or already in the program. Chinese and Korean participants also stated that they would like to get information in T.V., newspapers, websites and Los Angeles Chinese Networks. Many of the participants said that social media would not be a good place for them. Most said they often ask their children to help them with technology.
The most important information CHCF obtained from this research was that participants wanted more details in the messaging for its trust and credibility. They also voiced that they needed to emphasize their connection to the California government and inform them that it’s a new law and a Medi-Cal program, that they need to include government officials and representatives of Medi-cal program as messengers, and most importantly, address any worry and concerns about immigration status.
When the individual turns 50 years of age they are automatically eligible to be enrolled in the new Medi-Cal program. Annual income is also one of the requirements for enrollment. annual income should be less than $18,755 for a single person, $25,268 for a family of two, $31,782 for a family of three and $38,295 for a family of four. If the family is larger, the income limit can be found at Medi-Cal benefit chart. Step three to getting covered is calling 1(800) 300-1506 or visiting Covered California, which works in partnership with the California Department of Health Care Services. If a person needs help with applying or still has questions, they can contact the Health Consumer Alliance or visit healthconsumer.org.