Introduction
Federal legislators are moving swiftly to pass a bill that would cut over $625 million from Medicaid, the country’s public, state, and federally funded health insurance program for low-income people. If passed, the Congressional Budget Office estimates that 10.3 million people will lose their access to Medicaid nationwide by 2034.
Across the country, people are raising their voices to demand that their representatives save this vital program.
Medicaid, including California’s version known as Medi-Cal, is widely used and immensely popular. Millions of families, veterans, workers, and health care providers rely on the program for primary care visits, medications, mental health care, prenatal care and births, emergency services, and other vital services that keep them healthy. By providing medical care and other supports, Medicaid keeps our communities going by keeping kids in classrooms, roofs over people’s heads, and food on the table.
Lawmakers in Congress want to cut the program to fund tax breaks for billionaires. The cuts to Medicaid and Medi-Cal would have drastic impacts on the health and well-being of our communities.
Across the country, people are raising their voices to demand that their representatives save this vital program. In doing so, especially in speaking to the media, they may get some tough questions. This resource provides sample responses to hard questions.
While the responses focus on California’s Medi-Cal, many answers will apply in states across the country. Use the suggested answers as is, or tailor them to address the specific programs and/or needs of your community. See the “Tips for Developing Effective Messages” section at the end for general guidance on how to structure your answers.
Answers to hard questions about:
We know people are paying attention to Medicaid, and for good reason: The stakes are high, and the decisions being made right now will impact millions. With information moving faster than most people can track, it’s more important than ever to speak clearly about a program that upholds public health. Below are examples of how to talk about Medicaid using strong, values-based communication principles.
The responses below are structured using BMSG’s message development framework to ensure that each response is values-driven, solution-oriented, and applies a systemic lens to emphasize the context for the cuts.
Budgets and fiscal responsibility
Q: What would you say to taxpayers who are worried about the growing share of the state's budget going to Medi-Cal?
A: We, as Californians, pride ourselves on looking out for one another. We don’t walk away from people when they’re sick or struggling. That’s not just compassion — it’s common sense. Medi-Cal is how the state delivers care to more than 15 million residents, including children, older adults, veterans, and working families. That share of the budget is growing because of exorbitant drug prices and because more people are living longer and managing complex health needs.
Medi-Cal prevents more serious health problems by providing access to primary and preventive care. By catching illnesses early and helping people manage chronic conditions, Medi-Cal reduces unnecessary hospitalizations, which saves money and lives. We are proud of these investments because they reflect how we live our lives as Californians and that fairness, dignity, and shared responsibility matter to us. Ultimately, the real challenge isn’t how much we spend — it’s how we spend it. We should be expanding access, not cutting care. At the end of the day, ensuring that everyone can get health care when they need it is just common sense; it keeps people out of emergency rooms, increases access to preventive and lifesaving care, and remains one of the most efficient ways to save lives.
States rolling back inclusion for undocumented immigrants
Q: Why should California taxpayers fund health care for undocumented immigrants when legal residents still struggle to get timely care?
A: Let’s be clear: Immigrants are our neighbors, coworkers, and community leaders. That’s why a strong majority of Californians support including them in coverage. We understand that health care is a basic need — something everyone deserves, regardless of their background. That’s just common sense. Right now, we’re having this conversation because common sense is under attack to give tax breaks to billionaires. Yet we know Californians want smarter, more compassionate policies that reflect our shared values. Medi-Cal not only protects individual health — it protects public health. All in all, ensuring that everyone, including people who have had the courage to migrate here to seek better lives for themselves and their families, have access to Medi-Cal keeps people out of emergency rooms, increases access to preventive and lifesaving care, and remains one of the most efficient ways to save lives.
Q: If we did not spend our budget on health care for undocumented immigrants, would we still have budgetary issues?
A: The real issue isn’t whether we care for one group or another — it’s whether we’re building a system that works for everyone. Health costs are rising for everyone because decision-makers have underfunded public programs while allowing corporations to reap enormous profits. This shapes California’s health budget and contributes to rising costs, workforce shortages, and underinvestment in prevention. These challenges can’t be solved by scapegoating one group — they require solutions grounded in shared responsibility. Californians believe that everyone should be able to see a doctor when they’re sick, not just because it's fair, but because it's how we keep our communities safe and strong.
We solve problems by bringing people in, not pushing them out, and that’s especially important when it comes to health. Ultimately, we shouldn’t be balancing the budget on the backs of families that are doing their best to stay healthy. The real path forward is to build on what is working in Medi-Cal: It keeps people out of emergency rooms, increases access to preventive and lifesaving care, and remains one of the most efficient ways to save lives. Most Californians already support health coverage for all Californians, including people who are immigrants, because they know it’s about more than politics — it’s about keeping our families and communities strong. That’s not just good policy — it’s who we are.
Q: How do you respond to claims that Medi-Cal coverage encourages more undocumented immigrants to enroll in the program?
A: Let’s be clear: Immigrants are our neighbors, coworkers, and community leaders. A strong majority of Californians support including people who are undocumented in coverage because we understand that health care is a basic need — something everyone deserves access to, regardless of their background. We’re having this conversation because certain members of Congress want to cut Medi-Cal so they can give tax breaks to the rich. That is the wrong direction for our policy and our budget. Californians want smarter, more compassionate policies that reflect our shared values. The real strain on our system comes from chronic underfunding and decisions shaped by powerful health insurance companies that prioritize profit over people’s health and well-being.
When Medi-Cal is strong, it keeps hospitals open, supports health workers, and eases pressure on emergency rooms for people who are undocumented and all Californians. That’s why improving the system means investing in what we know works: preventive care and streamlined services that make it easier for everyone to get care when and where they need it. Most Californians already support health coverage for all Californians, including people who are undocumented, because they know it’s about more than politics — it’s about keeping our families and communities strong. That’s not just good policy — it’s who we are.
Equity
Q: If Congress cuts federal Medicaid funding, then what? How will the state protect vulnerable Californians without going bankrupt?
A: Almost 15 million people rely on Medi-Cal in California, many with complex health needs. If the program is cut, people will experience delays in care or lose access altogether, which means people will get sick instead of seeing a doctor when they need to. Some will die as a result. And it will ultimately cost millions of dollars as people go to emergency rooms instead of seeing their primary care provider. When people are sick, they can’t work, go to school, or enjoy time with their families, which has a ripple effect across California.
If we want a healthy state where all people can thrive, we need to ensure that everyone can get the services they need, when and where they need them. Preserving Medi-Cal saves lives AND money. Fortunately, the majority of people support saving Medi-Cal, so we’re not alone. Together, we can fight to preserve this vital program that keeps our state going.
Quality of care
Q: Doctors already say Medi-Cal doesn’t pay enough. Isn’t expanding enrollment without raising provider rates just worsening care?
A: All patients should be able to access health care when and where they need it, and health care providers deserve to be compensated fairly when they deliver that care. We can achieve both when Medi-Cal is well-funded and expanded to meet everybody’s needs. For example, by preserving Medi-Cal, people in rural areas will be better able to get the care they need because their hospitals will be able to remain open. We’ll also retain and grow our health care workforce, particularly in primary care.
Lawmakers can preserve Medi-Cal by insisting that corporations pay their fair share in taxes, rather than lining the pockets of the rich with tax breaks. By doing so, we can fund Medi-Cal at a level that allows all patients to enroll and appropriately pays providers for their services.
Q: What do you say to Medi-Cal patients experiencing long wait times or denied treatments?
A: Long waits are the result of policymakers inadequately funding Medi-Cal. With the major cuts being proposed by Congress right now, this problem will get worse, not better. When you don’t fund Medi-Cal, patients are denied life-saving care. We can’t serve the health care needs of millions of people by taking away their access to the doctors, nurses, clinics, and medications they need to stay healthy. To shorten wait times and ensure that all people receive the care they need, we must ensure that Medi-Cal is funded to make our health care system inclusive and more efficient.
Competing health priorities
Q: Why prioritize supporting Medi-Cal over addressing homelessness, housing, or public safety?
A: This question assumes we can only do one thing at a time, but the reality is that all these issues are connected. You can’t expect someone to stay employed or stable in housing if they can’t treat a chronic illness. Similarly, we've all seen stories of someone losing their home because of skyrocketing medical costs, not because people aren’t trying, but because they can’t get the support they need. That’s why protecting Medi-Cal is so important: It’s a foundation that supports everything else, including housing stability, public safety, and long-term community well-being.
At the heart of it, Californians believe in smart, interconnected solutions. We understand that we thrive when people can see a doctor and have a roof over their heads. After all, dignity means recognizing that all of these needs are essential. We don’t have to choose, and the good news is that when we address all these issues together, our community will be healthier. Medi-Cal helps prevent homelessness, reduces ER use, and supports mental health and addiction recovery. That’s exactly why it’s so widely supported — not just by voters, but by doctors, hospitals, and community health workers who see the difference it makes every day. Keeping care accessible doesn’t mean ignoring housing or safety — it means starting where the need is most urgent and where the impact will ripple outward.
Tips for developing effective messages
When it comes to developing messages — to talk about saving Medi-Cal or any critical health issue — we recommend the following simple formula:
- Name the problem (What’s wrong?);
- Include a values statement (Why does it matter?);
- Name the solution (What should we do, and who should do it?); and
- Pull back the lens to illustrate the context (How does this issue connect to others?).
Although these components do not have to be in this order, every successful message should contain them. Once you have answered these questions, you will have the core of your message, which then can be expanded or distilled, depending on the format you plan to use to deliver it.
Here's a guide for what to include in each message component:
1. Name the problem.
Clearly state what’s at stake with proposed Medi-Cal cuts and how they will harm health in your community. Who stands to lose coverage or face new barriers to care? Be ready to describe how children, older adults, people with disabilities, or working families are at risk. Use relevant data or local examples to show how these cuts would disrupt access to care and deepen the impact on people who are already facing barriers to health.
Speaking of data, remember: Even though you might be tempted to share a lot of the available data on Medi-Cal, be selective. After all, you can’t be comprehensive and strategic at the same time. Instead, focus on the aspect of cutting Medi-Cal that you are concerned about and connect the data to outcomes people can see.
You can’t be comprehensive and strategic at the same time.
2. Say why it matters.
Use shared values to describe why you are concerned about cuts to Medi-Cal. BMSG’s research shows that the values component is often absent in news stories about health; solutions are named but rarely justified with values. The answers above include values by stating, “We are proud of investments in Medi-Cal because they reflect our values of fairness, dignity, and shared responsibility,” and “Keeping Medi-Cal well-funded is about keeping our families and communities strong. That’s not just good policy — it’s who we are.”
Public health practitioners may point to data, for example, describing how many people could lose coverage or how many children rely on Medi-Cal, but numbers alone don’t explain why saving Medi-Cal matters. That’s an expression of the problem, not its broader meaning for our state or nation. Values statements help connect Medi-Cal to shared beliefs: that everyone deserves a fair shot at staying healthy, that we take care of one another, and that no one should be denied care because of where they live or how much they earn. Naming these values connects with others who feel the same and helps build support to protect and strengthen Medi-Cal. Remind people that Californians care for one another (pride of place), and community health is enhanced when everyone has what they need to avoid disease (interconnection), and that we have excelled at finding ways to improve the system so people can avoid getting sick in the first place (ingenuity).
3. Emphasize the solutions.
A common message pitfall is that messengers often expend so much energy describing the problem that when the inevitable question about the solution is asked, they are ill-prepared to answer it or run out of time to describe it. Your message should include a specific, feasible solution, in this case, stopping the cuts to Medi-Cal. Focusing on the solution can invigorate your audience and remind others that we can work together to stop the cuts to Medi-Cal.
4. Use a landscape lens.
We also recommend using a systemic lens as you craft your message. This means zooming out to show the broader context: how policy decisions, funding choices, and structural conditions shape health outcomes. In contrast to portrait-style stories that focus on individual behavior, systemic or “landscape” messaging helps remind audiences that public health isn’t just about personal choices; it’s about the environments we live in, the policies that govern care, and the resources our communities can access. This shift in focus supports public health goals by pulling back the lens to see the context of a given problem, including its root causes, to find its solution.