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Reducing Administrative Burdens and Improving Access to Public Benefits to Promote Health Equity

Statement of Problem

Administrative burdens are the costs and barriers faced by individuals or families in applying for, receiving, and using public benefits or services. These administrative burdens include learning costs, such as understanding that a program exists and that an individual is likely to be eligible, compliance costs, like completing the paperwork and virtual or in-person visits needed to enroll, and psychological costs, such as the stress, frustration and anxiety associated with accessing benefits.

Administrative burdens can harm health both directly through their effects on mental health and well-being, and indirectly by reducing access to health promoting benefit programs. For example, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is an evidence-based government nutrition benefit program that improves infant birth outcomes and child nutrition—yet about 50% of eligible families don’t receive these benefits. WIC’s low participation rate is in part due to administrative burdens associated with accessing and using this program, including the time it takes to fill out application paperwork and make an appointment, the requirement that families travel to WIC clinics in person for certification or recertification appointments, and burdens associated with identifying and purchasing WIC-eligible products in store.

Medicaid, which is a key source of health insurance for low-income children and children with medical complexity in the U.S., is another program where participation can be limited because of administrative burdens. In most states, caregivers of children who receive Medicaid must complete recertification paperwork at least once a year to ensure they can continue to receive these benefits. This can lead to unexpected and unnecessary loss of insurance coverage if families are not aware of recertification requirements, do not receive their recertification paperwork in the mail, or make any mistakes or clerical errors when completing this paperwork. Medicaid recertification can lead to adverse health outcomes if it delays children’s access to necessary health care. Continuity-of-coverage policies, which allow children to remain enrolled in Medicaid for several years, can both reduce administrative burdens and boost Medicaid enrollment and access to care.

Many of these administrative burdens could be mitigated or reduced by implementing policies aimed at making benefits easier to access. Our research aims to encourage states to implement these important policy changes.  


Next Steps

In our future work, we are interested in continuing to study both upstream and downstream approaches to reducing administrative burden. We plan to continue to examine the effectiveness of federal, state and local policies aimed at reducing administrative burdens to build an evidence base that encourages more widespread implementation of these policies. In addition, we are currently studying innovative care models focused on providing benefits enrollment support in clinical and community-based settings in order to help families navigate and overcome administrative burdens and access the government benefits and community resources they need to keep their children healthy.

This project page was last updated in March 2024.

Suggested Citation

Children's Hospital of Philadelphia, PolicyLab. Reducing Administrative Burdens and Improving Access to Public Benefits to Promote Health Equity [Online]. Available at: [Accessed: plug in date accessed here].