Shared research study link

Healthcare Messaging & Democratic Priorities in 2026

Understand how American voters perceive healthcare policy debates and Democratic messaging on Medicaid

Study Overview Updated Jan 15, 2026

Research question: Understand how American voters perceive healthcare policy debates and Democratic messaging on Medicaid-specifically reactions to Dem warnings about GOP Medicaid/SNAP cuts, what would drive votes in NH’s 2026 Senate race (Sununu vs. Dem), and whether “Republicans want to take away your healthcare” ads motivate. Research group: six U.S. adults (ages 26–63) in the “American Voters Healthcare Priorities” cohort across varied locales/roles (caregivers, small-business/finance, field tech, non-citizen Spanish speakers), providing 18 responses. What they said: most take an in‑between stance that leans toward believing Dem warnings when shown proof, distrust hype from both parties, and want receipts-bill text/CBO, precise dollar impacts, and timing-validated by ground‑level signals (pantry lines, clinic churn). Vote calculus is wallet‑first: they’ll consider Sununu or a Democrat who shows numbers, protects Medicare/Medicaid/SNAP and reproductive access, and delivers pragmatic plans on fentanyl, infrastructure, energy, housing, childcare, and immigration; generic “take away your healthcare” ads are tuned out unless localized, verified, and calmly delivered by trusted messengers.

Main insights: administrative mechanics (recertification, paperwork, work rules) are viewed as the primary way “reforms” become coverage loss; moral, local stories increase urgency but must be paired with verifiable specifics. Clear takeaways: use a receipt‑first, locality‑first approach-name the bill and section, display county/ZIP impacts and on‑screen premium/copay/drug deltas with implementation dates; deploy nurses/clinic directors/small employers as messengers; provide Spanish one‑pagers and a WhatsApp/phone line, plus exact vote info and accountability metrics. NH 2026: lead with measurable, funded cost‑of‑living plans; explicit safety‑net and reproductive protections; pragmatic public safety/immigration; and small‑business and grid/energy reliability solutions-delivered in a steady, non‑theatrical tone.

Participant Snapshots

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6 profiles

Lisa Ocana

Lisa Ocana, 30, is a married, Spanish-at-home office/sales admin for an agricultural equipment distributor on rural Fresno’s outskirts. Expecting her first child, she’s frugal, faith-grounded, and values durability, simplicity, transparent pricing, and time…

Bria Velasquez

Bria Velasquez is a 50-year-old, never-married homeowner in Albany, NY, working front-desk support at a small real estate brokerage. On under $25k, she budgets tightly, drives a 2009 Corolla, enjoys photography and walks, and prefers durable, transparent, n…

Angelica Mendez

Angelica Mendez, 37, is a rural Massachusetts finance leader in grocery wholesale. Married with one child, debt-averse, faith-led, and pragmatic. Buys on ROI and reliability, balances family, church, and community with data-driven work.

Tyler Fernandez

Tyler Fernandez is a 26-year-old, Spanish-first, U.S.-born farmworker in Pasco, WA. Single co-parent with one child, uninsured and without home internet, he prioritizes durability, fair prices, and in-person support, relying on family, routine, and word-of-…

Brenda Chandler

Brenda Chandler, 59, is a rural Oregon production worker and community-minded minimalist. Practical, value-focused, and plainspoken, she prizes durability, neighborly trust, and clear information, balancing thrift with small joys like quilting and canning.

Glen Gurrola

63-year-old bilingual auto-parts sales rep in Downey city, married with no children. Trust-focused, faith-driven, practical with money, health-conscious, and community-oriented. Chooses clear, durable solutions that save time and respect Spanish-language pr…

Lisa Ocana

Bria Velasquez

Angelica Mendez

Tyler Fernandez

Brenda Chandler

Glen Gurrola

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Demographic Overview No agents selected

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Participant Incomes US benchmark scaled to group size

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Source: U.S. Census Bureau, 2022 ACS 1-year (Table B19001; >$200k evenly distributed for comparison)

Media Ingestion

Connections appear when personas follow many of the same sources, highlighting overlapping media diets.

Questions and Responses

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3 questions

Response Summaries

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3 questions

Word Cloud

Persona Correlations

Overview

Respondents are pragmatically skeptical of partisan advertising but generally inclined to accept Democratic warnings about Medicaid/SNAP cuts when those warnings provide concrete mechanics, local dollar-level impacts, and verifiable documentation. Across income, geography and language groups the decisive credibility cues are: bill numbers/CBO-style tables, line-item and date-specific effects, and operational explanations of how changes translate into lost coverage (recertification windows, paperwork, work rules, broadband barriers). Effective messaging ties a local, human story (clinic staff, EMTs, pantry lines) to a clear household-dollar consequence and a specific policy remedy (continuous eligibility, phase-ins, explicit consumer protections). Loud, fear-first creative without receipts tends to be tuned out; channels and framing must be adapted by demographic (Spanish-language WhatsApp/one-pagers for Hispanic respondents; ROI and systemic analysis for higher-income/business respondents; local clinic/faith-leader messengers for rural working-class).

Total responses: 18

Key Segments

Segment	Attributes	Insight	Supporting Agents
Spanish-speaking Hispanic respondents	language: Spanish ethnicity: Hispanic/Latino needs: Spanish-language materials, operational outreach, simple one-pagers activation gap: high concern, lower policy literacy	They require Spanish translations plus operational, action-oriented materials (one-page summaries, local contacts, WhatsApp) and respond to exact names, numbers and dates. Messaging that pairs a local testimonial with a Spanish-language one-pager and clear next steps increases trust and usability.	Glen Gurrola, Tyler Fernandez
Rural, mid/older-age, working-class respondents	locale: rural age: 50+ occupation: manual/trades or retired concern: pantry lines, clinic hours, ambulance/ER load	This group interprets policy through observable local effects and administrative friction. They see paperwork, recertification cadence and broadband limits as primary mechanisms of coverage loss; local messengers (clinic staff, pastors) and concrete examples of timeline and dollar impacts are persuasive.	Brenda Chandler
Lower-income women / caregivers (urban or agricultural)	income: <$25k–$75k roles: caregivers/parents, administrative or service jobs concerns: prenatal/postpartum care, Medi-Cal/county clinics, CalFresh/EBT	Caregivers prioritize immediate out-of-pocket effects (copays, missed prenatal care, grocery budgets). They distrust theatrical ads and will act on messaging that spells out exactly how family budgets and local clinics will be affected and what protections will prevent harm.	Lisa Ocana, Bria Velasquez
Higher-income, small-business / finance professionals	income: $100k+ occupation: CFO / business owner / finance concerns: systemic cost drivers, accountability, ROI and timelines	Analytically oriented: they demand bill language, scoring, and systemic explanations (PBMs, consolidation). They respond to data-rich messages showing fiscal impacts, timelines, and how policy changes affect small-business costs and market dynamics.	Angelica Mendez
Non-citizen / non-voter adults (Spanish-language)	voter status: non-citizen / not voting language: Spanish orientation: civic but operationally focused	Even when not voting, they require crisp local impacts and straightforward Spanish one-pagers. They treat political information like vendor/customer information and prefer exact dates, dollar impacts and local contact points over abstract or emotional appeals.	Glen Gurrola

Shared Mindsets

Trait	Signal	Agents
Demand for concrete specifics	Across segments respondents consistently ask for bill numbers, CBO-like tables, line-item impacts, dates and local counts as credibility signals before accepting claims.	Angelica Mendez, Brenda Chandler, Glen Gurrola, Lisa Ocana, Bria Velasquez
Leaning to believe Democratic warnings when evidenced	Most place themselves 'in-between' but trend toward believing warnings about harm when messages include verifiable mechanics and local impacts-they expect real downstream consequences.	Brenda Chandler, Bria Velasquez, Angelica Mendez, Lisa Ocana, Tyler Fernandez
Administrative mechanisms seen as primary harm pathway	Respondents repeatedly point to recert deadlines, paperwork, work requirements and digital access gaps as the practical levers that turn policy changes into lost coverage.	Angelica Mendez, Brenda Chandler, Lisa Ocana, Bria Velasquez
Fatigue with theatrical, fear-first messaging	Loud, doom-scare ads with sirens and abstract claims are often tuned out. Quiet, factual, locally-rooted communications are preferred.	Brenda Chandler, Lisa Ocana, Bria Velasquez, Angelica Mendez
Local stories plus moral framing increase credibility	Vivid local anecdotes (pantry lines, clinic staff witness accounts) make technical claims feel real and motivate attention across demographics.	Brenda Chandler, Lisa Ocana, Bria Velasquez
Wallet-first voting calculus	Across age and geography, respondents prioritize cost-of-living effects (premiums, copays, groceries, heating) over abstract ideology when evaluating healthcare policy messages.	Angelica Mendez, Glen Gurrola, Bria Velasquez, Tyler Fernandez, Lisa Ocana

Divergences

Segment	Contrast	Agents
Higher-income small-business / finance vs Lower-income caregivers	Higher-income respondents emphasize systemic drivers (PBMs, consolidation, ROI and fiscal scoring) and want analytic evidence; lower-income caregivers focus on immediate out-of-pocket impacts and local clinic/prenatal consequences.	Angelica Mendez, Lisa Ocana, Bria Velasquez
Spanish-speaking/non-citizen respondents vs English-speaking rural working-class	Spanish-speaking and non-citizen respondents prioritize translated operational materials and WhatsApp/local contacts; English-speaking rural working-class respondents prioritize faith-leader/clinic messengers and visible local effects like pantry lines and EMT loads.	Glen Gurrola, Tyler Fernandez, Brenda Chandler
Younger, pragmatic field workers vs Older, faith-oriented rural respondents	Younger field/tech workers express pragmatic activation needs (how to get help, where to vote) and less policy detail; older rural respondents combine faith identity with strong support for specific protections and want local, human anecdotes tied to policy mechanics.	Tyler Fernandez, Brenda Chandler
Skeptical-but-persuadable vs Demanding-analytic	Some respondents are tuned-out skeptics who will accept claims only with simple local proofs; others are demanding analysts who require bill text/CBO-like scoring before being persuaded.	Brenda Chandler, Angelica Mendez, Glen Gurrola

Recommendations & Next Steps

Overview

Voters are skeptical but will engage when shown receipts: bill numbers, sections, dates, and local dollar impacts. Build a receipt-first content system, pair it with trusted local messengers, Spanish one-pagers/WhatsApp, and focus on wallet-first issues. For NH 2026, lead with cost-of-living, safety-net protections, fentanyl/public safety, infrastructure, and clear reproductive-policy assurances-delivered in a quiet, factual tone.

Quick Wins (next 2–4 weeks)

#	Action	Why	Owner	Effort	Impact
1	Receipt-first ad + explainer template (bill#, dates, $ impact)	Respondents demand specifics and tune out theatrics; this format increases credibility and attention.	Creative + Policy	Low	High
2	Spanish one-pager + WhatsApp hotline (localized)	Spanish-speaking audiences want simple one-pagers, local contacts, and WhatsApp for Q&A.	Localization + Field	Low	High
3	Local messenger brief kit (clinic/EMT/faith leaders)	Trusted local voices plus moral, concrete stories boost credibility without theatrics.	Comms + Field	Med	High
4	Quiet-tone creative style guide	People are tired of scare ads; calm, factual delivery earns attention.	Creative	Low	Med
5	NH 2026 cost-of-living one-pager	Wallet-first voters want numbers, timelines, and pay-fors on premiums, energy, housing, childcare.	Policy + Comms (NH)	Low	Med
6	Local impact calculator MVP (county/ZIP)	Transforms national claims into local, personalized impacts that drive action.	Data/Eng	Med	High

Initiatives (30–90 days)

#	Initiative	Description	Owner	Timeline	Dependencies
1	Receipt-Based Messaging System integrated with Ditto	Componentize creatives (bill #, section, dates, local counts, $ deltas, Plan B) and manage variants via Ditto for rapid iteration across segments and geos.	Product/Eng + Creative	Weeks 0–6: schema, templates, Ditto sync; Weeks 6–12: scale to priority states (incl. NH)	Ditto API access, Policy review of bill text/CBO tables, Legal/compliance sign-off
2	Local Data Pipeline + Dashboard	Ingest bill text, CBO-like scoring, and county-level metrics to auto-generate local counts, dates, and household-level $ impacts.	Data/Eng	Weeks 2–8: data ingestion + QA; Weeks 8–12: county dashboards + API	Access to bill text and fiscal notes, County/clinic data partnerships, QA process and monitoring
3	Segmented Channel Program (Spanish, rural, small-biz)	Deploy Spanish one-pagers + WhatsApp; rural radio/print with clinic/faith messengers; ROI-focused email for small-biz on PBMs, premiums, energy.	Comms + Field	Weeks 4–12: pilots; Month 4+: statewide rollout	Localization vendor, Clinic/faith partner MOUs, Media buys (radio/OTT/print)
4	NH 2026 State Playbook	One-pagers and talking points on cost of living, safety-net protections, fentanyl/public safety, grid/heating/broadband, immigration pragmatism, reproductive protections; include funding and timelines.	Policy (NH) + State Program	Weeks 0–4: draft; Weeks 5–8: field-test + refine	NH-specific data (energy costs, clinic capacity), State partner feedback, Legal messaging review
5	Storybank + Consent Workflow	Collect grounded local stories (pantry, clinic, recert churn) with clear consent; produce low-drama testimonial assets.	Field + Comms	Weeks 2–12 (ongoing)	Partner clinics/faith orgs, Privacy/consent protocols, Editing capacity
6	Test-and-Learn Lab (creative x targeting)	A/B test quiet vs. fear-first, receipt density, messenger types, and channel mix; optimize to persuasion and trust lift.	Research + Growth	Weeks 4–10: test waves; Month 3+: continuous optimization	Survey/panels access, Attribution setup, Budget for paid tests

KPIs to Track

#	KPI	Definition	Target	Frequency
1	Receipt Credibility Lift	Pre/post change in perceived message trustworthiness among target segments after exposure to receipt-first ads	+15% lift vs control	Biweekly
2	Explainer Engagement	CTR and time-on-page for local receipt explainers (bill #, dates, $ deltas)	CTR ≥ 3.5%, avg. time ≥ 40s	Weekly
3	Spanish Asset Impact	Engagement rate for Spanish one-pagers and WhatsApp connections completed to a live helper	+25% engagement vs baseline; 200+ hotline connects/mo in priority geos	Weekly
4	Time-to-Publish Local Receipt	Turnaround from bill passage to localized ad + one-pager live	< 48 hours (80% of cases)	Per event
5	Persuasion Lift (Wallet Issues)	Change in candidate/support intent on cost-of-living and safety-net protection items in NH target voters	+3–5 pts lift vs control	Monthly
6	Partner Distribution Footprint	Active clinics/faith groups distributing assets and participating in storybank	50+ partners in NH; 150+ nationally in pilot states	Monthly

Risks & Mitigations

#	Risk	Mitigation	Owner
1	Data inaccuracies in local counts or $ impacts undermine trust	Two-layer QA (policy + data), source links in creatives, rollback protocol within 2 hours	Data QA Lead
2	Overuse of negative framing reduces persuasion over time	Pair every warning with a Plan B fix and pay-for; maintain 60/40 fix-to-warning ratio	Comms Director
3	Limited access to trusted local messengers	Micro-grants + MOUs with clinics/faith orgs; simple onboarding and media training	Field Partnerships
4	Translation or tone misses alienate Spanish-speaking audiences	Certified translators, community review panel, WhatsApp feedback loop	Localization Lead
5	Legal exposure on claims (healthcare cuts, vote records)	Pre-clear language with counsel, cite bill/section on-screen, maintain documentation archive	Legal/Compliance
6	Ditto/Claude integration instability delays publishing	Staging environment, health checks, rollback to static templates	Product/Eng

Timeline

Weeks 0–2: Quick wins live (templates, style guide, NH one-pager, initial Spanish assets).
Weeks 2–6: Build Ditto-integrated receipt system, start data pipeline and storybank; launch first A/B tests.
Weeks 6–12: Scale local calculators, expand partner distribution, optimize channel mix; publish NH playbook v2 with measured ROI.
Month 4+: Ongoing optimization, additional states, deeper small-biz and rural segments.

Research Study Narrative

Healthcare Messaging & Democratic Priorities in 2026

Objective and context. We set out to understand how American voters perceive healthcare policy debates-especially Medicaid-and which Democratic messages credibly move them. Across questions, the throughline is pragmatic skepticism: people lean toward believing Democratic warnings about cuts, but only when backed by receipts (bill numbers, sections, CBO-style tables), local consequences, and clear dollar impacts.

Cross-question learnings with evidence. On warnings about GOP-led cuts to Medicaid/SNAP, most respondents place themselves “in-between,” trending toward belief when mechanics are specific and local. As Brenda Chandler put it: “I mostly believe them, with a squint... if Republicans are pushing a bill that trims eligibility or adds hoops, I assume people will fall through.” Angelica Mendez demanded documentation: “I don’t trust anyone’s talking points until I see the bill text and the CBO table.” Ground-level observations drive credibility-Lisa Ocana cited pantry lines spiking after recertification and a friend losing CalFresh over “one form.” Administrative friction (recert deadlines, paperwork, work requirements, broadband gaps) is seen as the primary harm pathway.

Campaign creative that vaguely claims “Republicans want to take away your healthcare” gets tuned out. What breaks through is verifiable specificity (bill number/section/link), dollarized personal impact (premiums/copays/drugs), and localized effects (which clinic, hours, wait times). Calm, neighborly tone and trusted local messengers (nurses, clinic directors, EMTs, small employers) are preferred. “Name the bill and the section,” urged Mendez; Glen Gurrola wanted “dates and dollars for LA County... clinic hours cut,” while Bria Velasquez asked for “Real numbers on screen.”

In the NH 2026 Senate frame, voters are wallet-first and competence-oriented. They prioritize measurable plans with numbers, timelines, and pay-fors that cut household and small-business costs (healthcare, energy, housing, childcare), protect Medicare/Medicaid/SNAP, and bolster reliable infrastructure. Public safety (fentanyl) and pragmatic immigration (work permits, faster processing, targeted enforcement) matter. Tone should be steady, not theatrical: “Show me the numbers... one page with dates and dollars. If it is buzzwords, no thanks,” said Gurrola.

Persona correlations and nuances

Spanish-speaking respondents (Gurrola, Tyler Fernandez): Need Spanish one-pagers, WhatsApp hotlines, exact names/numbers/dates; operational access is as important as persuasion.
Rural, older working-class (Chandler): Believe what they can see-pantry lines, clinic hours, EMT load; local messengers and concrete timelines/dollar impacts persuade.
Lower-income women/caregivers (Ocana, Velasquez): Focus on immediate out-of-pocket changes and prenatal/clinic access; distrust scare ads but act on clear, local protections.
Higher-income small-biz/finance (Mendez): Demand bill text, scoring, and systemic drivers (PBMs, consolidation); want ROI, timelines, enforcement.
Non-citizens/non-voters (Gurrola): Won’t be mobilized to vote but amplify practical information if it’s clear, local, and in Spanish.

Recommendations

Adopt a “receipt-first” messaging system: Put bill #/section, dates, local counts, and $ deltas on-screen; link to text. Pair every warning with a fix and pay-for.
Localize at county/ZIP level: Name clinics, hours, wait-time changes; use calm, plain language and trusted local messengers.
Spanish accessibility: Publish Spanish one-pagers and stand up a WhatsApp hotline staffed for Q&A.
NH 2026 playbook: One-pagers on premiums, energy, housing, childcare; explicit safety-net protections; fentanyl/public safety; pragmatic immigration; reproductive protections-each with timelines and pay-fors.
Build the pipeline: Integrate a receipt-based content system (e.g., Ditto), plus a local data dashboard to auto-generate county-level impacts.

Risks and guardrails

Data inaccuracies erode trust-deploy dual QA (policy + data), cite sources on-screen, and maintain a 2-hour rollback protocol.
Negative-message fatigue-keep a 60/40 fix-to-warning ratio.
Messenger scarcity-secure MOUs and micro-grants with clinics/faith orgs; provide brief media training.
Translation/tone misses-use certified translators and community review; live-listen via WhatsApp.
Legal exposure-pre-clear language, cite bill/section, archive documentation.

Next steps and measurement

Weeks 0–2: Ship receipt-first templates and quiet-tone style guide; publish NH cost-of-living one-pager; launch Spanish one-pagers + WhatsApp.
Weeks 2–6: Stand up Ditto-integrated receipt system; begin local data ingestion; start storybank with clinic/faith partners; A/B test evidence density and messenger.
Weeks 6–12: Scale county dashboards; expand rural radio/print and Spanish channels; release NH playbook v2 based on test results.
Month 4+: Optimize channel mix; extend to additional states and small-biz segments.

KPIs: Receipt credibility lift (+15% trust); explainer CTR ≥ 3.5% and time ≥ 40s; Spanish engagement (+25%) and 200+ hotline connects/month; time-to-publish local receipt < 48 hours in 80% of cases; NH persuasion lift on wallet issues (+3–5 pts).

Recommended Follow-up Questions Updated Jan 15, 2026

Which messengers are most and least credible to you for information about Medicaid changes? Consider: your primary care doctor, local clinic director, nurse, pharmacist, EMT, hospital CFO, state Medicaid agency, Congressional Budget Office (CBO), inspector general/GAO, local news reporters, national news outlets, patient advocates, small-business owners, religious leaders, union representatives, and elected officials from either party.

maxdiff Identify the most trusted validators to feature in ads and outreach, improving credibility and effectiveness.
Which evidence formats most increase your confidence in a claim about Medicaid impacts? Consider: bill section excerpts, CBO score tables, independent audits/IG reports, a household dollar-impact calculator, county/ZIP maps, before–after clinic metrics, case studies with receipts, and a citation-backed FAQ.

maxdiff Prioritize proof assets that actually move belief, guiding a receipt-first content toolkit.
What minimum monthly change in your household’s healthcare costs (for example, premiums, copays, prescriptions) would make Medicaid policy a top voting issue for you?

numeric Quantifies a dollar threshold to calibrate localized impact claims and resource allocation.
Please indicate your level of support or opposition for each Medicaid policy proposal, considering each independently: work requirements with exemptions for caregivers/disability; small premiums for adults above the poverty line; 12-month continuous eligibility for adults; continuous coverage for children; 12-month postpartum coverage; adding adult dental/vision; block grants or per‑capita caps to states; increased funding to stabilize rural hospitals; tighter eligibility verification; stronger...

matrix Maps policy alignments to select persuasive frames and contrasts in messaging.
How persuasive, if at all, are the following reasons sometimes given for tightening Medicaid rules: reducing fraud/waste; encouraging work and self-sufficiency; keeping the program financially sustainable; focusing resources on the most vulnerable; giving states more flexibility; aligning benefits with private insurance norms?

matrix Surfaces the most compelling opposition frames to pre-bunk or address directly.
If people in your state lose Medicaid coverage due to policy or administrative changes, who would you hold most responsible? Rank: Republicans in Congress, Democrats in Congress, your state legislature, your governor, the state Medicaid agency, federal agencies (HHS/CMS), private insurers/managed care companies, hospitals/clinics, the individuals affected.

rank Clarifies perceived accountability to target blame/credit and calls to action appropriately.

Questions focus on messenger trust, proof formats, action thresholds, policy stances, counter-frames, and accountability-critical gaps to operationalize a receipt-first, localized Medicaid messaging strategy.

Study Overview Updated Jan 15, 2026

News & Media

Source	Weight

Healthcare Messaging & Democratic Priorities in 2026

Lisa Ocana

Bria Velasquez

Angelica Mendez

Tyler Fernandez

Brenda Chandler

Glen Gurrola

Lisa Ocana

Bria Velasquez

Angelica Mendez

Tyler Fernandez

Brenda Chandler

Glen Gurrola

Sex / Gender

Race / Ethnicity

Locale (Top)

Occupations (Top)

Summary

Themes

Outliers

Overview

Key Segments

Shared Mindsets

Divergences

Overview

Quick Wins (next 2–4 weeks)

Initiatives (30–90 days)

KPIs to Track

Risks & Mitigations

Timeline

Healthcare Messaging & Democratic Priorities in 2026

Persona correlations and nuances

Recommendations

Risks and guardrails

Next steps and measurement

Distinct Market Research Groups

Marketing Reports Generated

Digital Twin Synthetic Personas

Questions Answered