Making the case for Medicaid: 6 tips for speaking out
by: Berkeley Media Studies Group and FrameWorks Institute
posted on Monday, June 02, 2025
As we move ever closer to legislation that will significantly curtail the federal funds that flow to states, communities, and individuals for health and wellbeing, it’s vital that voices in the movement for health equity speak up consistently and effectively.
Harmonized framing is one of our most powerful forms of resistance in this moment — especially if our collective voice hits the right notes. Framing can either undermine or reinforce our advocacy goals, and the way we frame issues now can constrain or expand what’s possible in the future. As two organizations that study and share effective framing (the FrameWorks Institute and Berkeley Media Studies Group), we’re writing these “notes for the choir” because we’ve seen well-intentioned framing that worries us. And we’ve noticed silences that concern us even more: respected allies and trusted friends missing the opportunity to make a difference because they’re experiencing analysis paralysis when it comes to messaging.
In this post, penned as lawmakers consider legislation that would weaken Medicaid, SNAP, and the nation’s public health infrastructure, we’re taking the advice we often share with partners and peers: We’re joining forces, speaking up together, and naming what people can do right now.
We’re asking you to consider frame effects as you decide what to say to protect Medicaid and other programs that serve the people you care about — and then get out there and say it, now.
As you get to work, we hope you’ll keep these insights in mind:
1. You can mobilize without messaging.
Words matter, but in certain circumstances, timing and volume matter even more. This is especially true in a hyper-partisan moment when members of Congress are tuning out carefully crafted messages that seem to come from the other side. One counterweight to partisan loyalty is public pressure. If you can mobilize a constituency to tell legislators they want Medicaid to be robust, do it now. You don’t need to revise the suggested script yet again. The clogged phone lines, the crowds at standing-room only town halls, and protest actions will be the message: The people, your voters, want to protect Medicaid, and they’re watching what you do.
2. Avoid charity framing.
For those of us who know and care about the consequences of defunding Medicaid, it can be a natural impulse to look for ways to get others to care, too. Often, this shows up in messages that highlight the program’s service to a sympathetic group such as children, veterans, or the working poor. But highlighting participants’ worthiness or need is rhetorically vulnerable: It’s all too easy for opponents to conceptually separate “us” from “them,” claiming that people aren’t truly deserving and demanding that participants prove their worthiness. (Think work requirements, time limits, or penalties against states that allow undocumented people to enroll in Medicaid.) Plus: Do you truly believe that access to health care should be contingent on … anything? Do talk about the harm to come, but use strategic frames, like the ideas below.
3. Lead with shared values that evoke interconnection.
For the same reasons that charity framing won’t work, hyper-emotional appeals to the “devastating” or even deadly effects of Medicaid restrictions can backfire. Crisis framing heightens fear, which can lead quickly to us-versus-them thinking.
When you feel the urge to “get people to care,” back away from the doom-and-gloom and reach instead for the research-backed alternative: values-based messages that heighten the sense of shared fates and common cause. This message makeover might feel risky, but mounds of research and many years of practice show that framing with collective values increases support for sound health policies and programs.
For Medicaid, the value of interconnection is a good bet, because so many people, are, in fact, connected to this program: Nationally, about 1 in 5 people in the U.S. rely on Medicaid, and 2 out of 3 people in the U.S. are closely connected to someone who has benefited from Medicaid at some point. It’s wildly popular. We can be confident that reminding people of this interconnection will resonate across the country and even across political affiliation. The sample messages below demonstrate how to pull back the lens from individual harms the cuts will bring to show how Medicaid connects whole communities.
Leading with values also helps us demonstrate the care and concern that help us be seen as trustworthy messengers. This approach works because it’s authentic. When we ask our partners why they get out of bed in the morning to do their work, they talk about unity, interconnection, community, love, justice, and liberation. These deeply held beliefs motivate our daily efforts. Expressing them is key to reaching audiences who have stopped listening to anything that sounds like politics as usual.
4. Show the program in its broader landscape.
It’s vital to go beyond the immediate or obvious impacts of losing health care and find ways to widen the frame. While Medicaid is wildly popular, people are unlikely to recognize the ways it holds society together. We need to paint that picture so everyone can see its ripple effects. Describe the effects on communities, not just programs or patients. Here are two versions of what that might look like in messaging. The first focuses on the potential losses that would come with cuts; the second focuses on the shared gains from Medicaid.
Sample message: Ripple effects of cuts
“Medicaid is how we collectively ensure that health care is available everywhere and for everyone. It’s public health insurance for those who don’t get private health insurance from their job. As a program designed for public good, not private profit, Medicaid ensures that doctors’ offices, pharmacies, and hospitals are available in areas that aren’t densely populated or wealthy enough to have plenty of privately insured patients to sustain the services. In rural communities, especially, the loss of Medicaid payments will translate into closed clinics and hospitals, leaving everyone in the area with no place to go. The ripple effect will be felt by everyone whose work is connected to hospitals, clinics, pharmacies, or nursing homes, from doctors, nurses, and lab techs, to medical equipment providers and the mom-and-pop restaurants where hospital staff grab lunch. Drastic reductions to Medicaid will cause negative ripple effects on local and state economies. Politicians are hoping that the damage from these shockwaves hit after election-time, so people won’t notice what they’ve done. But we have the power to do something about it before our communities are harmed.”
Sample message: Ripple effects of robust access
“Our communities are stronger and healthier when people can get the medical care they need when they need it. Two out of three of us are close to someone whose life is made better by Medicaid. We know that medical care benefits patients, but it goes further than that because Medicaid’s benefits ripple out to all of us. When a doctor’s office is able to accept Medicaid as insurance, those reimbursements help them keep their doors open and their nurses and physicians’ assistants paid. In our communities with only a few clinics and doctors’ offices, Medicaid dollars are a lifeline to everyone. And the positive ripple effects of public health insurance go further: When a family has Medicaid to cover their child’s doctor visits, they can spend their paycheck on the other things their families need — like groceries, gas, and rent — which keeps whole communities afloat. Our communities are stronger when patients, workers, and suppliers have local health care options — and keeping Medicaid strong is part of that.”
5. If you can, talk about Medicaid as one way to “unrig” the health care system.
If the message is true to your view and possible in your role, consider connecting Medicaid to the powerful idea that “the system is rigged.” Wide swaths of the U.S. population agree on this idea — conservatives, progressives, and independents alike — though when it comes to who is rigging the system, how, and why, thinking is widely varied and typically vague. Because this mental model is at once vibrant and lightly sketched, it’s vital that our messages fill in the details. Specifically, we need to name the system, say how it’s rigged, say who benefits from it and who is harmed, and, crucially, point to ways to rebalance the scales. In the case of Medicaid: Health care is the system; it’s rigged in favor of those who profit from private health insurance, at the expense of those who are locked out or priced out of that system; and protecting Medicaid is one way we can help people get the care they need.
Sample message: Rigged system
“Medicaid is one of the ways that, as a nation, we came together to rebalance a health insurance system that is rigged to protect industry profits at the expense of people’s health and well-being. For decades, there were no fair options for people who were locked out or priced out of private health insurance. Medicaid is how we offer essential health insurance for those who don’t get coverage from their job — and it has positive ripple effects across the health care system that benefit us all. We still have more work to do to make sure everyone has a full and fair chance to see a doctor when, where, and how they need to; we certainly don’t want to go backwards in terms of being sure people are covered. That’s just common sense. We can’t let our leaders rig the system against ordinary people in favor of profit-hungry health insurance companies, private equity firms buying up hospitals, and ultra-wealthy individuals who don’t want to pay their fair share in taxes. By uniting to demand that our representatives choose policies that support everyone, like a robust Medicaid program, our collective power can protect Medicaid and the other programs that keep communities safe and healthy.”
6. Say clearly what people can do right now.
Two audiences need to hear our message about Medicaid cuts: lawmakers who can stop the cuts and the constituents who will insist they do so. The message both audiences need to hear is the same; only the ask is different. Both audiences need to understand that the situation is severe, but not inevitable. They need to know that a choice is being made to defund Medicaid — a choice that will take care away from tens of millions of people, causing harm in every state and further rigging the health care system in favor of wealth for the few, not health for the many. Most importantly: We can stop it. For our partners and the public, the call to action is to collectively contact their elected officials via calls, visits, or direct actions, demanding they oppose these cuts. For members of Congress, the direct request is to vote against cutting Medicaid.
Framing forward
While we’ve focused this post on Medicaid, much of it applies equally well to cuts aimed at SNAP (formerly known as food stamps), the Centers for Disease Control and Prevention, and other planks in the foundation of our nation’s health. No matter which of these you’re defending, you’re doing work that needs to be both fast and well-framed. We hope you know you can turn to us for support.
We’ll admit that we momentarily hesitated to make recommendations — only because we haven’t tested them to the extent we typically do. While we’d like the luxury of more research, we can’t afford it: Fast-moving legislation threatens to tear down programs and institutions at the foundation of community wellbeing, and whatever the policymaking outcome, the meaning-making work won’t end there. The urgency of the situation prompted us to refuse to let the perfect be the enemy of the good and to offer these reminders of effective framing and strategic communication.
The scope and speed of the attack on the institutions that protect and promote our health can be daunting, but we are not defenseless. As a field, we have a history of successfully tackling significant challenges together. Let’s build on that history with framing that bends the longer-term narrative arc toward health justice.
About Berkeley Media Studies Group and FrameWorks Institute
For decades, Berkeley Media Studies Group and FrameWorks Institute have exchanged framing insights and built on each other’s work. We are grateful to be working more closely together now thanks to the Robert Wood Johnson Foundation’s Mindsets Consortium.