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The Vida Agency
An older daughter and her elder father smiling happily and embracing one another, with suppting text that says, "Al Immigrant can buy health insurance on Washington Healthplanfinder, even people who are undocumented.

Washington State Health Benefit Exchange

Multilingual Awareness Campaign

On November 1, 2023, Washington State Health Benefit Exchange (WAHBE) began offering health insurance enrollment to undocumented immigrants through Washington Healthplanfinder (HPF) for the first time. HPF is an online marketplace where individuals and families can find, compare, and enroll in a variety of health insurance plans. Based on income, some residents of Washington state are offered tax credits or financial help to pay for co-pays and premiums and can receive customer support online, by phone, or in-person through local organizations or insurance brokers.

WAHBE was only able to offer coverage to undocumented immigrants until 2023, due to changes in federal regulations. So it was crucial to meet this audience where they were, build trust, and reduce the obstacles to connecting with HPF. Some challenges included: distrust and fear of government, skepticism and complexities of healthcare and healthcare industry, language and literacy barriers, cultural barriers, and a lack of awareness.

Approach

To develop an informed strategy, we conducted research to understand the lived experience of immigrants previously unable to access insurance coverage through HPF. At the community’s suggestion, we also hosted feedback sessions with community-based organizations (CBOs). This helped us recognize the unique challenges, resources, and needs of connecting with these communities, as well as any gaps in existing resources.  

We identified the primary audience as non-citizens in Washington State newly eligible for coverage, who spoke Spanish, Chinese, Vietnamese, or Russian. 

Essential audience considerations were:

  1. Cost and a lack of literacy on the US healthcare system and insurance were the top two barriers.
  2. Some may not be familiar with the notion of “preventative care,” and/or cannot justify its cost when weighing against other necessities of life.
  3. All audiences don’t see health care access as a main solution to their health ailments/outcomes.
  4. Many are wary of Western medicine in general. 
  5. Many speak English less than “very well,” making access to healthcare much more difficult.

In order to establish primary geographic areas that reflected the audience demographics, we researched where they worked and lived, using available aggregate data. Individual data was not collected or used that could identify this population.

Analyzing the data helped us concentrate efforts and program dollars to reach them through the media they consume and messengers they trust. Our criteria focused on areas with a high population of priority immigrant communities where our campaign could have the greatest impact, and areas with newly eligible populations that have been historically neglected and/or left out.

Based on these considerations, our goals were: 

Goal 1: Build awareness and trust of HPF within immigrant communities across Washington State who had not previously engaged with the system.

Goal 2: Grow healthcare and health insurance literacy within immigrant communities across Washington State who had not engaged with the system.

Campaign

Our strategy was designed to engage audiences on multiple levels through community outreach, multicultural media, and digital outreach tactics, anchored in clear, culturally responsive, and consistent messaging across all communications and platforms. We built our approach around the defined goals, while considering the significant barriers HPF faces as well as its many strengths. Our outreach tactics included CBO partnerships and both earned and paid media campaigns.

CBO Partnerships 

We partnered with nine representative CBOs to be a trusted resource to spread the word about the availability of HPF. The partnership included fair compensation for their work, education on HPF, supportive materials, and ongoing support.

Advertising Campaigns

A series of paid ads were placed in target local and multicultural media outlets that were informed by our market research. Multicultural media platforms included Entravision, NW Asian Weekly, Yakima Herald, Seattle Medium, Converge, Russian Town Seattle, and La Raza. 

The ads drove to a landing page that provided easy access to information and resources with the Call to Action of: “Call the Customer Support Center”. Our tactics included: digital display ads, email marketing, video ads, radio, social media, and paid search. The promotional work was differentiated by the unique messaging and creative assets developed by our team and the primary audiences we were targeting.

To support our outreach tactics across CBOs and the digital campaign, we created a variety of materials, including trifold brochures, 1-page flyers, FAQ documents, posters, PowerPoint slides, short videos, and social media guidance. Materials were transcreated into a total of 26 languages to maximize accessibility across different communities.

Outcomes

Goal 1: Awareness and trust built.

During the open enrollment period, the landing page received 96,690 visitors and the campaign generated more than 13 million impressions, 59,202 clicks. Campaign-wide click-through-rates were also consistently above the industry benchmark. While we cannot directly correlate our ads with an increase in applicants or web traffic (due to privacy and other considerations), we can assume that they helped to increase enrollment. Based on analytics and traffic referral patterns, we believe it generated roughly 61% of the web traffic (total clicks/total website visitors). 

From the CBO partnerships, 16 counties were served, 175 events hosted, 46,000 people reached, and 37 languages represented. Social media amassed 11,000+ views, 985+ likes, and 194 shares. 

For earned media, we generated a series of interview segment opportunities for Washington Health Benefit Exchange spokespeople in The Seattle Medium, Converge Media, KING 5, and iheart Radio. These interviews had a combined reach of almost 1.9 million. 

Goal 2: Healthcare literacy increased.

Approximately 2,200 new customers accessed qualified health plans under the immigrant health coverage expansion. While we can’t say that our work directly led to these customers accessing new plans, it can be reasonably assumed that many customers learned about the plans based on our ads and materials.