Built on Trust: How Data Sharing Can Better Support California’s Young Mothers

For many families navigating California’s network of public benefits programs—Medi-Cal, CalFresh, or the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)—the experience of accessing support often involves moving through multiple agencies with overlapping requirements and disconnected systems. A new mother enrolled in WIC may not realize she could also qualify for CalFresh or understand how enrolling could benefit her and her family. Even within Medi-Cal, mothers may not be aware of benefits or programs that could support their health, such as doula care or home visiting.  Referring them requires coordination between providers, health plans, and community organizations. 

In recent years, California’s benefits modernization efforts have focused on how state agency information can be used to better coordinate across programs and members of the perinatal care team. Sharing data across agencies and stakeholders, identifying individuals eligible for additional benefits or programs, including those with higher-risk pregnancies or postpartum periods, and proactively reaching out to them can be a powerful way to reduce administrative burden while connecting more families to needed support. Using administrative data to verify information is one of the key strategies used to support the implementation of federally-mandated work requirements. 

However, 2025 changed the context of cross-program data sharing, bringing unprecedented federal requests for state data, including public benefits data. The U.S. Department of Agriculture requested that states hand over personal data of food assistance recipients, such as names, Social Security numbers, addresses, and dates of birth, for tens of millions of people who applied for food assistance over the past five years, threatening to withhold federal funding from states that did not comply. The Centers for Medicare and Medicaid Services (CMS) has shared data with the Department of Homeland Security  and Immigration and Customs Enforcement (ICE) for immigration enforcement purposes, reversing prior policy. For many families, these changes made the question of who can access their personal information urgent and newly threatening. 

California and several other states have shifted their approach to data sharing across public benefits programs in response to federal actions that heightened concerns about how personal information might be used, including potential access by immigration or other federal enforcement agencies. In October 2025, Governor Gavin Newsom signed a new state law that rescinded an earlier measure that allowed broad sharing of Californians’ personal data to identify and enroll potentially eligible individuals in CalFresh food benefits. 

Across the country, 29 states introduced 79 bills or resolutions, 17 of which were enacted into law, in the 2025 legislative session addressing federal access to state administrative data. California and other states are now grappling with the question of how to share data across programs in ways that actually serve people, in line with their expectations about how that data will be shared. That requires asking those people what they want.

 

What Our Team Found

In 2025, the Family Benefits Lab conducted a qualitative study with 12 young mothers in California in two counties. Most of our participants were between the ages of 18 and 26, and the majority had given birth to their first child at age 22 or younger. The goal of this study was to better understand the experiences of mothers as they learned about and navigated state programs such as Medi-Cal, CalFresh, and WIC. We also interviewed 12 benefits administrators and program staff who regularly worked directly with young mothers to educate and connect them to public benefits programs. 

At the time of the interviews, conducted between summer and fall 2025, the federal administration increased its data requests to state programs for immigration enforcement purposes, during which the topic of benefits data sharing became more prominent. 

Amid this shifting context, we asked young mothers whether they felt comfortable having their information shared across programs through behind-the-scenes data linkages, and why or why not.

 

What We Heard From Mothers

1. Transparency about Data Sharing is Key

The clearest thing we heard was young mothers were not opposed to data sharing, and clearly saw the benefits of state agencies  sharing their information to better support them—a notable finding given the context of 2025. But mothers did wish to be notified or asked first, and they wanted to understand the purpose of the data sharing. This is consistent with broader findings from the Center for Democracy and Technology (CDT), which show that 79 percent of people believe government agencies should be required to inform individuals about the personal data they hold, why they collect it, and how it is used.

When the purpose was clearly explained and tied to a concrete health benefit, such as receiving care for themselves or their children, avoiding duplicate paperwork, or learning about programs they qualified for, mothers were generally open to having their information shared across programs. They were less comfortable with  their information being shared without their knowledge. 

In fact, mothers said that knowing the purpose of data sharing would ease their concerns, and make accessing public benefits more convenient. They understood that sharing information between programs would reduce the burden of researching and contacting providers themselves.

 

2. Specific Messengers May Be More Effective at Building Trust 

Mothers were consistent in their preference that trusted professionals facilitate the opt-in process, and repeatedly cited figures like  doctors, particularly OB/GYNs, as sources of information for data sharing, eligibility, and learning what to expect.

Trusted relationships mattered not just for communication, but for legitimacy. When information came from a clinician or another trusted provider, mothers were more likely to interpret data sharing as supportive of their health and well-being. 

Note: Our team did not ask specific questions about immigration enforcement as a potential concern. While immigration enforcement did arise in our conversations as something mothers were aware of in the community and in the news, young mothers did not cite it as a common concern related to data sharing. This could be unique to the particular mothers we spoke to, who all self-selected into our study and may have been less concerned about that specific issue. Other surveys and studies have asked about this specific topic, including CDT’s recent poll and report, and the Stanford RAPID survey. 

Family and friends were also cited as frequent and trusted sources for understanding what data was being shared, with whom, and explaining opt-in opportunities. This finding has been validated by other research. Many of our participants shared that they first learned about programs like WIC from their own mothers. This suggests that it’s important for state agencies to consider how to make sure friends, family, and community networks are receiving and sharing legitimate and accurate information with each other. 

A few mothers also mentioned receiving information about public benefits from their school counselors, in both high schools and public colleges. Given schools’ access and ongoing relationships to student mothers, these institutions could serve as effective referral pathways for public benefits programs by equipping staff with the appropriate resources and information, and helping to manage follow-up.

 

3. Unknown Incoming Calls or Texts Are Increasingly Untrusted

More young mothers expressed frustration with the amount of spam phone calls or text messages they regularly received, and wanted their doctor or another trusted person to provide a heads-up that a message may be coming about enrolling in benefits to avoid ignoring or deleting it automatically. 

Being notified and/or asked for consent, and intentionally explaining how their information will be used, could potentially change mothers’ perception from that of surveillance or spam, to one of support and effective delivery of government services. Additionally, text messages including the mother’s name, along with contact information for a call center can improve the perception of legitimacy and increase response rates.

Overall, we heard that mothers value efficiency, and understand the importance of maintaining their participation in programs like CalFresh and WIC. However, they also want to fully understand how their data is being used, know what outreach to expect so it’s not immediately disregarded, and retain the autonomy to make decisions about opting in to enrollment.

 

What We Heard From Staff

Our team spoke with 12 benefits program and community organization staff that directly engage with young mothers in California. These included roles such as nutrition counselors, lactation counselors, project managers, social workers, and nonprofit administration staff. They told us about the importance of being able to close referral loops and share data across multiple public benefits to connect mothers to these benefits more effectively. Without a system for providers or other referral sources to share information directly, staff have to reach out to mothers to verify eligibility independently for their different programs, and may lose contact during follow-up for additional information, while also potentially creating a duplicative experience for mothers. Developing cross-program relationships and exchanging information may be steadily improving under the California Advancing and Innovating Medi-Cal program, but remains challenging. 

Providing more flexibility in communication and data-sharing methods could ease the barriers to benefits enrollment for young mothers. We heard that it’s best not to presuppose what method of communication mothers prefer: Some may prefer (or require) in-person support, while others prefer a paper application (particularly if they lack access to a smartphone or laptop) or the convenience of virtual communication methods. Staff mentioned that it might be easier to provide screenshots of supporting documentation, rather than other file formats, if they convey the same information, making the provision of this documentation more accessible. 

Staff validated that trusted sources, such as family, friends, community connections, are more successful in both communicating to mothers about benefits, and facilitating data sharing within applicable legal frameworks. To build trust, representatives from these agencies can partner with community organizations or schools for outreach about benefits and to troubleshoot questions (one of our team’s previous findings was that many families have complex households and specific questions unique to their living situations). The framing of staff positions can also be important messaging, as one staff person said that families responded better to “case managers” than “social workers.”

Sharing data to more seamlessly enroll families in public benefits is not a new topic, but instead has been a long-lasting policy goal. However, as the landscape of federal policy shifts in unforeseen ways, and continues to change rapidly each month, state program leaders must assess how such data can move between state agencies efficiently while maintaining the trust and safety of program beneficiaries. They must also determine how to appropriately notify and obtain consent from individuals. This trust is key to their continued participation in programs that are critical to family health and economic security. 

 

Next Steps and Further Research

Because our study was limited to 12 mothers and 12 benefits staff, our findings are not necessarily conclusive about mothers’ preferences. Instead, we offer initial insights that merit more research. Other institutions are conducting similar important research, such as Stanford’s RAPID survey team, on the implications and perceptions of young families on data sharing for immigration enforcement. One of their findings from late 2025 is that over half of parents (52 percent) shared that they had declining trust in institutions. This perception could easily disrupt their choice to participate in public benefits programs. 

Further issues to explore could include:

• Surveys at a larger scale, and/or more qualitative studies to understand the privacy perceptions of communities facing higher risk of immigration enforcement. This could be accomplished through additional interviews of community-based organization staff serving these communities to understand these issues at scale without putting individual families at risk. 
• More design and usability research to develop appropriate, easy-to-understand informed consent language for data sharing, and test this approach with trusted messengers in health clinics, WIC clinics, or other community settings. 
• Exploring how state agencies might employ principles of data minimization to better protect individuals’ data and build trust around the specific purposes for which data is being used. This is increasingly important given the landscape of 2025. 

 

The Family Benefits Lab is continuing our partnership with California, working with the Department of Health Care Services (DHCS) to better understand the ways that Medicaid managed care plans (MCPs) can use members’ benefits program eligibility and participation status to more seamlessly increase enrollment in multiple programs and support perinatal health. We’re also exploring ways that important Medi-Cal benefits, like doula care, can be more effectively shared with members.

Our research with MCPs and providers serving Medi-Cal members in the CMS-funded Transforming Maternal Health (TMaH) Model test region focuses on supporting MCPs with county-level data sharing for the limited purpose of understanding enrollment gaps and facilitating cross-referrals between programs. 

To learn more about the Family Benefits Lab’s work, please contact FBLBeeck@georgetown.edu. 

Thank you to the Center for Democracy and Technology for providing feedback on this report.