Methodology to Gather Medicaid Enrollment Stories
This research builds on a series of one-on-one interviews Immigration Research Initiative (IRI) conducted and published as “Immigrants’ Experience with Medicaid Enrollment: Challenges and Recommendations.” The goal of both of these projects was to understand the challenges that immigrants experience when enrolling for Medicaid and to lift up the voices of those directly impacted. The survey helps provide context for those interviews, giving us a better understanding of the prevalence of these barriers, enriching the stories with a wider range of experiences of immigrants across the United States, and combining individual stories with statistical analysis.
In an attempt to gather a national sample, IRI conducted a survey that was shared widely by partner organizations that support and work with us. The help of these organizations has proven essential to this data collection, establishing a chain of trust between IRI and the survey respondents who might otherwise be wary of responding. IRI has gained the trust of the organizations through our past work with them and our reputation in the field, and the organizations have gained the trust of their members and constituents. They can assure participants that IRI is a reliable research group, that the survey is safe, and that their Medicaid status will not be affected in any way and spread the message that this research could be helpful for policy change.
To address language access needs, we worked with partner organizations to identify their language needs and worked with a translation company, Tomedes, to provide the informational flyer and survey in the languages requested by our partners at direct service and community-based organizations. The survey was conducted in English, Spanish, traditional Chinese and simplified Chinese.
We set a goal of 250 survey responses. After asking partners to share the survey with their communities, people started responding astonishingly quickly and IRI received an influx of responses in one day that exceeded our goal and left us with 412 responses. The high level of participation led us to close the survey sooner than we had expected.
Before analyzing our survey, we had to clean up and eliminate 153 responses of the total due to duplicates and responses that did not seem to be real. This left us with a total of 259 responses to analyze, which still exceeded our goal.
After analyzing the survey responses, we noticed that we got a large number of responses from Asian Americans. Our analysis found that 48 percent of survey respondents identified as Asian/Pacific Islander compared to 25 percent White/Caucasian, 10 percent Black/African American, 9 percent Hispanic/Latinx, and 5 percent American Indian/Alaskan Native. We attribute this strong response from Asian Americans to our partnership with community-based organizations and the availability of the survey in both Cantonese and Mandarin.
We hoped to gather a more representative sample, but the limited number of responses we planned to accept, paired with a very quick and large response from those who did get the survey, meant there was a skew toward those that came in the door first.
To conduct the survey, we used SurveyMonkey. To help us analyze the responses and organize our findings, we used Airtable to categorize the short answer and open-ended questions.
In recognition of the time respondents spent filling out the forms, we compensated survey participants with $10 e-VISA giftcards.
We want to thank all the participants who took the time to be part of this research, our partner organizations who helped with outreach and Tomedes for their translation services.