June 24, 2022
A few weeks before 4-year-old Paul Peterson was scheduled to have surgery to close a hole in his stomach as part of his recovery from a stroke, he was dropped from Medicaid coverage. While his mother frantically worked to figure out what happened and get him re-enrolled, his surgery was delayed and he missed needed speech, occupational, and physical therapy appointments. Paul, like many others, lost coverage not because he wasn’t eligible but because of bureaucratic hurdles: burdensome paperwork, complex regulations, and changing deadlines.
Hurdles such as these are a type of administrative burden, that is – the time, money, effort, and other work needed for eligible people to access their benefits. Administrative burdens include compliance costs like completing paperwork, learning costs like navigating eligibility requirements, and psychological costs like overcoming stigma. Some administrative burdens are inevitable, but too often policymakers use them to purposely make it harder to access benefits.
In previous years, Paul and other children with complex medical needs or long-term disabilities in Idaho, where Paul lived, were automatically re-enrolled in Medicaid. This “ex parte” renewal helps ensure eligible enrollees don’t lose coverage. It reduces the administrative burden on both beneficiaries and state administrators. Despite significant evidence on the benefits of ex parte renewal, in 2019 the Trump administration deemed the process “inadequate” and threatened to pull Idaho’s federal funding unless it required additional documentation from recipients. That left about 2,700 children in Idaho – including Paul – with little or no warning that they would have to complete a new process in order to keep their coverage. Such regulations, implemented nationwide by the Trump administration, are part of the reason why over 700,000 more children were uninsured in 2019 than 2016.
Administrative burdens are everywhere in American life: when we fill out our taxes, apply for a driver’s license, vote, or have almost any interaction with the government. For some, these requirements are just an annoying chore. But for people living with chronic scarcity – for example, people with limited time to gather necessary paperwork, limited money to pay required fees, or limited resources to travel to in-person appointments – administrative burdens can be the difference between getting a benefit or not. Administrative burdens also disproportionately harm those who most need benefits.
For example, many families find the Free Application for Federal Student Aid (FAFSA) – a 100+ question form – to be too complex to complete, despite the financial benefits. A Department of Education report found that 23% of students who did not complete the FAFSA (non-filers) stated that they did not have enough information to complete it. While this “learning cost” affected all non-filers, the burden was not evenly distributed: 34% of Hispanic students and 27% of Black students, compared to only 18% of white students, and 43% of students whose parents did not have a high school degree reported they did not have enough information to file. ideas42 has done work to help students navigate these administrative burdens, which in turn increased FAFSA filing rates.
The Temporary Assistance for Needy Families (TANF) program, which provides financial assistance to families with low incomes, is similarly burdensome to access. Families must navigate drug tests, educational requirements, benefit time-limits, restrictions on cash usage, and more. These harsh “compliance costs” are part of the reason why only 21 of every 100 families living in poverty received TANF in 2020. Additionally, many of these burdens are rooted in intentionally racist policies that have historically, and continue to systemically, deny access to Black families. Today, states with larger Black populations have less generous and more restrictive TANF policies. As a result, Black children are less likely than white children to receive TANF benefits when their families fall into crisis. ideas42 research suggests that removing these administrative burdens would increase access and support for eligible families.
On the other hand, the enhanced Child Tax Credit (CTC), enacted as part of the American Rescue Plan, successfully reduced child poverty, in part, because it did not impose unnecessary administrative burdens. Most families automatically received the credit through monthly deposits into their accounts or by check. As a result, families experienced an unprecedented 30% reduction in child poverty rates in 2021 and racial disparities in poverty narrowed. This had important implications for families’ well-being. ideas42 collaborated with several organizations on research that found that the CTC reduced financial stress for all eligible families, particularly among Black and Hispanic families. Unfortunately, the expanded Child Tax Credit was not extended and families received their final monthly payment last year.
The Child Tax Credit is not a standalone example: the COVID-19 pandemic prompted policymakers across the country to reduce administrative burdens for critical social safety net programs. However, as the pandemic emergency has ended, these changes are expiring. This is unfortunate. While the changes may have been borne of necessity, reducing administrative burdens better served the American people and reduced disparities. Rather than rolling back the new streamlined systems, local, state, and federal governments should seek to make many of the changes permanent and look for additional ways to reduce administrative burdens.
We at the ideas42 Policy Lab are working to reduce administrative burdens so that all eligible people can easily access their benefits. This includes supporting policies like the extended Child Tax Credit, which puts money directly into families’ hands without unnecessary hurdles, and leveraging our research to provide recommendations to policymakers on how to reduce administrative burdens in safety net programs.