Case StudyAdvocacy

From voter voices to a statewide strategy.

How Change Research helped the American Heart Association build a data-driven case for Medicaid expansion in Mississippi.

66%support for Medicaid expansion
2 phasesMixed-methods research
Chart of Mississippi voter attitudes toward Medicaid expansion
The Challenge

Mississippi is one of a handful of states that has not expanded Medicaid, leaving hundreds of thousands of residents in the coverage gap. The American Heart Association had a clear policy goal but needed a sharper read on where Mississippi voters actually stood, what specifically moved them, and how to talk about expansion in a state where the politics remain contested.

Public polling offered a rough picture but nothing granular enough to drive communications strategy. The organization needed research that could capture the texture of real voter concerns, then quantify which of those concerns, and which messages, would build durable statewide support.

The Approach

Change Research partnered with the American Heart Association on a two-phase mixed-methods project to map Mississippi voter attitudes on Medicaid expansion. The work was designed so each phase fed the next: open-ended voter voice first, representative statewide measurement second.

In December 2024, Change Research ran Voices Chats with 44 Mississippi registered voters. Voices Chats is a text-based qualitative research tool that engages voters in real SMS conversations, capturing the kind of nuance and candor traditional focus groups often miss, especially from voters in rural areas and lower-income communities who can be harder to reach through conventional recruitment. The conversations surfaced recurring concerns about affordability, gaps in rural access, and the real-world tradeoffs voters weigh when thinking about coverage.

Those qualitative insights then shaped a representative statewide poll of 1,000 likely Mississippi voters in January 2025. The quantitative phase confirmed broad support for Medicaid expansion and tested specific messaging frames, identifying rural hospital funding, household affordability, and federal cost-sharing as the strongest persuasion arguments across partisan, racial, and geographic lines.

The Results

A research-backed strategy for building durable statewide support.

2 phasesMixed-methods research
66%Support for Medicaid expansion
1,000Likely voters polled
StatewideMississippi sample

The research gave the American Heart Association a clear, defensible picture of where Mississippi voters stand on Medicaid expansion and, more importantly, which messages actually move them. Majority support held across political, demographic, and geographic lines, and the tested messaging framework gave the organization a playbook for talking about expansion with audiences that have historically been hardest to persuade. The findings informed the organization’s statewide communications strategy and its ongoing advocacy for closing Mississippi’s coverage gap.

Success

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