Four Barriers to Coverage Retention
Audiences may face one, several, or all four. Each requires a different response.
Unawareness
Unawareness
Don’t know H.R. 1
applies to them
Confusion
Confusion
Know something changed, not what
Fear
Fear
Afraid of what
enrolling leads to
Paralysis
Paralysis
Aware but still won’t
and less effort
Unawareness:
The information exists. Most people just never see it.
Where the Info Lives Now
Govt websites, English-language news, official notices by mail
General policy language that doesn’t signal personal impact
English only, high literacy, legal and policy jargon
Trusted community messengers don’t know either
Official notices arrive unread, misunderstood, or ignored
How We Close the Gap
Reach
Meet them in the channels they use daily
Making it Relevant
“This affects you specifically, here’s how”
Translation
Plain language, right language, right literacy
Messenger Training
The promotora knows before the community
Notice Navigation
Equip messengers to explain what notices mean
Where People Actually Get it
WhatsApp groups, ethnic radio, Facebook communities
Word of mouth from someone in the same situation
ES ZH VI KO TL
Spoken word, visual materials, low literacy
Promotoras, CHWs, faith leaders, clinic navigators
Food banks, clinics, libraries - places people bring mail for help
Where the Info Lives Now
Govt websites, English-language news, official notices by mail
How We Close the Gap
Reach
Meet them in the channels they use daily
Where People Actually Get it
WhatsApp groups, ethnic radio, Facebook communities
Where the Info Lives Now
General policy language that doesn’t signal personal impact
How We Close the Gap
Making it Relevant
“This affects you specifically, here’s how”
Where People Actually Get it
Word of mouth from someone in the same situation
Where the Info Lives Now
English only, high literacy, legal and policy jargon
How We Close the Gap
Translation
Plain language, right language, right literacy
Where People Actually Get it
ES ZH VI KO TL
Spoken word, visual materials, low literacy
Where the Info Lives Now
Trusted community messengers don’t know either
How We Close the Gap
Messenger Training
The promotora knows before the community
Where People Actually Get it
Promotoras, CHWs, faith leaders, clinic navigators
Where the Info Lives Now
Official notices arrive unread, misunderstood, or ignored
How We Close the Gap
Notice Navigation
Equip messengers to explain what notices mean
Where People Actually Get it
Food banks, clinics, libraries - places people bring mail for help
Aware and Informed
Knows what changed and what it means for them.
Most people who will lose coverage don’t know the rules have changed. The information exists. This campaign puts it in the right hands, in the right language, through the people they already trust, before the deadline hits.
Confusion: Five clarity gaps and how to close them
They’ve heard something changed. They don’t know what it means for them.
Source of Confusion
Doesn’t know if it applies
“I heard something changed but I don’t know if it’s me”
Can’t decode the notice
“I got a letter but I don’t know what it’s asking me to do”
Has conflicting information
“I’ve heard different things from different people”
Work requirement is unclear
“I don’t know if I qualify, what counts, or who’s exempt”
Doesn’t know if they’re done
“I think I already did something but I’m not sure it was enough”
How We Close the Gap
Messenger identifies their specific situation and says plainly: yes or no, this applies to you, here’s why.
Plain-language guides that translate what notices and forms are actually asking, step by step.
Trusted messenger corrects misinformation directly, with a source they trust.
Simple explainers: who’s exempt, what counts as work, how to report it, what happens if you can’t.
Messenger helps them check their status and confirms what’s complete and what still needs to happen.
Where They Get Clarity
Personalization
One-on-one with a navigator
Decoding
Food bank or clinic where they brought the notice
Myth-Busting
Community meeting, faith setting
Process Clarity
CHW at enrollment appointment
Confirmation
Follow-up call or text after appointment
Source of Confusion
Doesn’t know if it applies
“I heard something changed but I don’t know if it’s me”
How We Close the Gap
Messenger identifies their specific situation and says plainly: yes or no, this applies to you, here’s why.
Where They Get Clarity
Personalization
One-on-one with a navigator
Source of Confusion
Can’t decode the notice
“I got a letter but I don’t know what it’s asking me to do”
How We Close the Gap
Plain-language guides that translate what notices and forms are actually asking, step by step.
Where They Get Clarity
Decoding
Food bank or clinic where they brought the notice
Source of Confusion
Has conflicting information
“I’ve heard different things from different people”
How We Close the Gap
Trusted messenger corrects misinformation directly, with a source they trust.
Where They Get Clarity
Myth-Busting
Community meeting, faith setting
Source of Confusion
Work requirement is unclear
“I don’t know if I qualify, what counts, or who’s exempt”
How We Close the Gap
Simple explainers: who’s exempt, what counts as work, how to report it, what happens if you can’t.
Where They Get Clarity
Process Clarity
CHW at enrollment appointment
Source of Confusion
Doesn’t know if they’re done
“I think I already did something but I’m not sure it was enough”
How We Close the Gap
Messenger helps them check their status and confirms what’s complete and what still needs to happen.
Where They Get Clarity
Confirmation
Follow-up call or text after appointment
Clear on what to do
Knows their situation, their next step, and why.
Confusion is resolved person by person, situation by situation.
Generic messaging doesn’t cut it. The messenger has to know enough to make it specific.
Inside the fear barrier: three distinct fears
Each fear needs a different message. Conflating them weakens both.
Fear Type
Visibility
“Staying enrolled means being seen”
Data Sharing
“My data will reach federal agencies”
Public Charge
“Enrolling will count against my case”
What They’re Actually Afraid of
Any interaction with the system creates exposure and increases the risk of being targeted.
Enrollment creates a record ICE or DHS can access through state-federal data-sharing channels.
Using Medi-Cal or CalFresh will be held against them in an immigration case. Often misinformation.
Message Job
Reframe the Risk
You’re already in the system. Leaving removes coverage, not exposure.
Draw a Hard Line
YCA law bars sharing enrollment data with immigration enforcement.
Correct the Record
These programs are explicitly excluded from public charge rules.
Fear Type
Visibility
“Staying enrolled means being seen”
What They’re Actually Afraid of
Any interaction with the system creates exposure and increases the risk of being targeted.
Message Job
Reframe the Risk
You’re already in the system. Leaving removes coverage, not exposure.
Fear Type
Data Sharing
“My data will reach federal agencies”
What They’re Actually Afraid of
Enrollment creates a record ICE or DHS can access through state-federal data-sharing channels.
Message Job
Draw a Hard Line
YCA law bars sharing enrollment data with immigration enforcement.
Fear Type
Public Charge
“Enrolling will count against my case”
What They’re Actually Afraid of
Using Medi-Cal or CalFresh will be held against them in an immigration case. Often misinformation.
Message Job
Correct the Record
These programs are explicitly excluded from public charge rules.
Breaking from Paralysis: From knowing to doing
Fear is addressed. The person still hasn’t acted. These are the remaining friction points.
Friction Point
Process Feels too Complicated
“I don’t know where to start”
No Specific Next Step
“I don’t know who to call”
Waiting for Someone to Say Go
“I need someone I trust to confirm”
No One They Know Has Done it
“I haven’t seen it work”
Can’t Navigate the Process Alone
“What if I get it wrong?”
The Response
Simplification
Break it into one step, not five. “The only thing you need to do today is…”
Specificity
Name the number, the place, the person. “Call 211. Ask for Medi-Cal renewal help.”
Proximity
The trusted messenger is present at the moment of decision.
Social Proof
“Maria did it last week. I can introduce you.”
Accompaniment
The messenger doesn’t just inform. They walk through it together.
Where It Happens
One-on-one with a navigator or CHW who breaks it down in person
211 call, clinic front desk, county office walk-in
Community event, food bank, faith service, wherever the messenger already is
WhatsApp group, neighbor, someone from the same community who did it
Side by side at clinic, library, or CBO office
Friction Point
Process Feels too Complicated
“I don’t know where to start”
The Response
Simplification
Break it into one step, not five. “The only thing you need to do today is…”
Where It Happens
One-on-one with a navigator or CHW who breaks it down in person
Friction Point
No Specific Next Step
“I don’t know who to call”
The Response
Specificity
Name the number, the place, the person. “Call 211. Ask for Medi-Cal renewal help.”
Where It Happens
211 call, clinic front desk, county office walk-in
Friction Point
Waiting for Someone to Say Go
“I need someone I trust to confirm”
The Response
Proximity
The trusted messenger is present at the moment of decision.
Where It Happens
Community event, food bank, faith service, wherever the messenger already is
Friction Point
No One They Know Has Done it
“I haven’t seen it work”
The Response
Social Proof
“Maria did it last week. I can introduce you.”
Where It Happens
WhatsApp group, neighbor, someone from the same community who did it
Friction Point
Can’t Navigate the Process Alone
“What if I get it wrong?”
The Response
Accompaniment
The messenger doesn’t just inform. They walk through it together.
Where It Happens
Side by side at clinic, library, or CBO office
Stay Enrolled
Renewed coverage. Knows what to do next.
Not every person hits every friction point.
Messenger training prepares for all five so none goes unaddressed.