Jan, 18, 2024

Rapid Message Test Insights to Inform 2024 Medicaid Renewal Messaging

Melissa Morales and Kevin Caudill, GMMB

The unwinding of the Medicaid continuous coverage requirement continues to have significant impacts on Medicaid enrollment across the country. State Medicaid agencies and their partners have been executing communications campaigns focused on Medicaid renewals for almost a year, leveraging a variety of communications tactics to reach members and mitigate churn. In the closing months of unwinding, states have an opportunity to apply lessons learned and fine-tune messaging to maximize communications. Effective communications will continue to be important as states return to routine renewal operations well beyond the unwinding.

To inform final communications pushes, GMMB conducted a rapid message test to gauge the persuasiveness of Medicaid renewal message themes. The rapid message test was executed through Grow Progress using a tool that delivers actionable findings on the effectiveness of message assets through survey-based randomized controlled trials, conducted with representative audiences. GMMB sought to gauge what messaging is most persuasive to members who are up for renewal in the coming months, with the intention that these findings will continue to be useful for states beyond the unwinding to reduce procedural terminations. Informed by these findings, GMMB has created refreshed messaging and social media resources, available for states to tailor to their own Medicaid programs. These materials are also available in additional languages.


The rapid message test was fielded from December 20 through 22, 2023, and conducted online and in English only. The audience was Medicaid members, nationwide, ages 19 through 64. Four messages were tested against a placebo unrelated to Medicaid. Each message, including the placebo, was seen by at least 600 respondents for a total sample size of 3,063. All messages started with the same statement followed by a distinct message emphasis, as seen below:

“You may have heard that Medicaid health insurance renewals happen every year. You will get a notice when it’s your turn to renew…

Message Emphasis:

  • …If you want to keep your Medicaid, it’s important to complete your renewal when you get your notice. Respond right away to keep your benefits.” (Referred to as “Keep” in the figures below.)
  • …If you do not complete your Medicaid renewal on time, you may have to reapply to get coverage. Respond right away to avoid the hassle.” (Referred to as “Reapply” in the figures below.)
  • …You may lose your Medicaid if you do not complete your renewal. Respond right away to avoid losing your benefits.” (Referred to as “Lose” in the figures below.)
  • …To keep your health coverage for doctor visits, prescriptions and more, you must complete your Medicaid renewal. Respond right away to make sure you can continue to get the care you need.” (Referred to as “Care” in the figures below.)


The persuasiveness of each message was determined by the respondent’s likeliness to complete their Medicaid renewal paperwork. The message placing an emphasis on keeping coverage and benefits was most effective overall, seeing a 4 percentage point (pp) message lift compared to the placebo (see Figure 1). The second most persuasive message overall placed an emphasis on access to care, like doctor visits and prescriptions, seeing a 3 percentage point lift (see Figure 1).

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A rapid message test at this scale allows the data to be broken down by demographic subgroups. In Figure 2, the scale on the bottom shows the persuasiveness of the messages, with less convincing on the left to more convincing on the right. The circles represent each of the four messages that were tested: “Keep,” “Reapply,” “Lose,” and “Care.” The surrounding boxes demonstrate demographic groups such as age, education level, income, and whether a respondent is from an urban or suburban area. Indicated beside each demographic group is the percentage point difference in measured persuasion compared to the baseline. Respondents who were ages 55 and older, for example, showed a 16 percentage point difference when responding to the “Keep” message emphasis testing.

The results showed that keeping coverage and benefits was the most effective message for many subgroups, including Black and Latino/a respondents (see Figures 2 and 3). Of note, Latino/a respondents were more likely to react negatively to the themes of losing coverage and needing to reapply (see Figure 3).

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Respondents who identified as Republicans were more likely to be motivated by the risk of losing Medicaid (see Figure 4).

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The message emphasizing access to care, like “doctor visits and prescriptions,” was most relevant to young adults (those ages 18 through 34) and respondents with no children. Figure 5 shows respondents with children in the graph on the left, compared to respondents without children on the right. Those with children prefer the message about keeping coverage, and showed a negative 4 percentage point difference in response to the message about renewing their coverage in order to access care.

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The rapid message test insights are intended to help states, and their partners, fine-tune targeted messaging where possible. Many states may find these insights reinforce existing communications. Others may find this useful for longer-term planning as these insights can apply to ongoing annual renewals.

States with limited time and resources can incorporate this messaging in simple and direct communications–such as sharing talking points with stakeholders, elevating key points when speaking with reporters, creating timely social media content, and updating website landing page headlines. Language should be adjusted, as needed, to lead with the message most likely to resonate with relevant target audiences.

New Resources

Updated key messages, and new social media graphics with customizable organic post copy are available on the SHVS Social Press Kit. Translated versions of the new resources are available on the SHVS Social Press Kit in Spanish, Chinese, French, French Creole, German, Gujarati, Hindi, Italian, Japanese, Korean, Polish, Portuguese, Russian, Tagalog and Vietnamese.