Just months before the 2014 General Election, a coalition opposing Proposition 46 — a ballot initiative to quadruple California's cap on non-economic damages in medical malpractice cases — was facing voter apathy and unsympathetic reporters. The “No on 46” campaign committee sought a cost-effective way to target critical voting blocks.


APCO developed an online influencer outreach program to educate and activate leaders in targeted online communities. We created all content across the “No on 46” campaign’s social media properties, including amplifying offline paid and earned media tactics. We also drafted and pitched coalition guest posts for blogs.


Influencers regularly delivered campaign messages opposing Proposition 46 through their social networks. The campaign’s social media properties posted dozens of times weekly; voters, media and coalition members referenced them frequently. Proposition 46 was defeated by a 2-to-1 margin, making it the only ballot measure to lose in every county.

Results at a Glance

  • Generated 24 on-message blog posts across mom, patient advocacy, political and issue advocacy blogs
  • Acquired 94,000 followers on the “No on 46” Facebook page
  • Reached 4.3 million unique users the week leading up to Election Day through Facebook (7.5 million Californians voted)
  • Posted nearly 100 tweets per week targeting opinion leaders
  • Devised more than 50 sharable graphics, including the daily series “46 Reasons to Vote No on Prop 46”