In a 2019 poll conducted by the opinion and market research company SSRS for The Pew Charitable Trusts, 7 in 10 Americans said that taking out a student loan is a reasonable choice given the benefits of a college degree, but 89 percent also expressed concern about people's ability to repay those debts. Research has provided insight into the characteristics of borrowers who have the most difficulty repaying their student loans, but less is known about why they struggle and about their personal experiences with the repayment process. This knowledge gap makes it difficult for policymakers to get a full picture of why some people successfully navigate the repayment system while others fall off track, or to readily identify which current policies might not be working as intended and what reforms are needed to better support borrowers. This report seeks to illuminate these issues by analyzing the responses provided during 16 focus groups, conducted by Pew in eight cities with more than 150 student loan borrowers, in late 2018 and early 2019. Findings suggest four actions that the U.S. Department of Education and Congress could take to facilitate successful repayment: (1) Ensure that information provided to borrowers is consistent, accurate, relevant, and timely; (2) Establish clear standards for servicing and provide oversight to ensure proper implementation; (3) Help off-track borrowers enroll in affordable plans; and (4) Examine the causes of balance growth within the federal student loan portfolio and potential steps to address them.