# Campaign Letter Template — Medicaid Expansion

A letter from a campaign to its base, for states that have not yet expanded Medicaid under the ACA. Adapt the bracketed details to your state, decision-maker, and current legislative session.

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**Subject line (pick one, lower-case, personal):**
- 500,000 of our neighbors don't have a doctor
- the cheapest thing [state] could do for working families
- [first name], one stat I can't get out of my head

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Hi [first name],

I'm [your name] with [organization]. I want to tell you about [first name of a real person, used with permission].

[Person] is [age], works [N] hours a week at [job — restaurant, retail, home health, gig], lives in [town/neighborhood], and makes too much to qualify for Medicaid under [state]'s current rules — and too little to afford a marketplace plan. So when [the medical thing that happened — chest pains, a sprained ankle that wouldn't heal, untreated diabetes, postpartum complications] happened, [person] [waited / went to the ER / went without care / set up a GoFundMe].

There are roughly **[N]** [people / adults / parents] in [state] in [person]'s position. They are disproportionately Black, Latino, rural, and working in essential jobs. They are the people who showed up through the pandemic and are now showing up to work sick because the alternative is no rent.

**Here is what most people don't know:** [state] could cover all of them tomorrow. Medicaid expansion under the Affordable Care Act is **90% federally funded**. The state cost is about **[$X] per year**, less than [a comparable line item in the state budget]. [State] is one of only [N] states that has not done it.

**Why hasn't [state] expanded?** Because [decision-makers — Governor, state Senate leadership, House speaker] have decided not to. That is a choice, not a fact. And choices change when the people most affected, and their neighbors, make a sustained ask.

**That's where you come in.** We are building a base of [N] residents in [district / county] who will:

1. **[Specific action — sign on as a constituent, attend the next legislative hearing, record a 60-second video story]** by [date].
2. **Show up to [event with date, time, place]** at the [state capitol / district office / hospital steps].
3. **Recruit two more neighbors** by sharing this letter.

If you have a Medicaid expansion story of your own — or someone close to you does — and you'd be willing to share it (we will never use a name without explicit consent), please **reply to this email**. The stories are how we win.

A few ways to get in deeper:

- **Reply with your story or a question.** Real people, real inboxes. We answer.
- **RSVP for [event]** at [link].
- **Host a kitchen-table meeting** with 5-8 neighbors. We'll bring the materials and (with notice) the food. Reply "kitchen" and I'll set it up.

We have one of the easiest, highest-leverage policy wins in [state] sitting right in front of us. The only reason it hasn't happened is because not enough of us have asked loudly enough yet. Let's fix that.

In care,

[Your full name]
[Title], [Organization]
[Phone number]

PS — The next [committee hearing / floor vote / town hall with the swing legislator] is **[date]** at **[time]** in **[room/place]**. If you can be there, hit reply. Showing up in person is worth a thousand emails.

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## Why this letter is structured this way

- **Start with one human.** Statistics persuade nobody who isn't already persuaded. A story does.
- **Then the number.** One stat, after the story, anchors the scale.
- **Surface the choice.** Medicaid expansion has not happened because someone decided not to. Name them.
- **Cost framing.** 90% federally funded changes the conversation in nearly every state where this is live.
- **Three asks.** Reply > RSVP > recruit. Reply is the relational ask.
- **Permission language for stories.** Never extract. Always explicit consent. Say so in the letter.

— Module 1, *Base Building From Scratch*