Millions of Americans rely on public assistance programs such as the Supplemental Nutrition Assistance Program (SNAP) and Medicaid to meet basic needs for food and health care. Yet a new study from the Brown School at Washington University in St. Louis finds that the very systems designed to help are often the hardest to navigate — especially for the people who need them most.
Researchers at the Brown School find that low-wage workers face high levels of administrative burden — the time and effort involved in applying for and maintaining benefits.
The Center for Social Development policy report, “The Experience of Administrative Burdens in SNAP and Medicaid: New Evidence from a Nationally Representative Survey of Low-Wage Workers,” identifies which households face the steepest challenges and offers suggestions for policymakers to improve equitable access.
“Our research shows that people with the least financial flexibility are spending the most time and energy trying to access essential programs,” said Stephen Roll, an assistant professor at the Brown School and research director at the Center for Social Development. “Simplifying these processes isn’t just about efficiency — it’s about fairness and ensuring that families can meet their basic needs.”
Roll and his co-authors found that workers with annual household incomes between $30,000 and $50,000 experience the highest learning burdens when navigating SNAP and Medicaid. These families often fall near income-eligibility thresholds, forcing them to interpret complex and sometimes conflicting rules about income, assets and deductions — such as SNAP’s Excess Shelter Costs deduction.
“These programs are lifelines, but we find that the people most likely to face barriers to access these programs are those who could stand to benefit the most from them,” Roll said. “The people who face difficulties accessing SNAP payments are at higher risk of going hungry in the next month, while those struggling to access SNAP have higher rates of chronic diseases and report more difficulties paying for essential medical care.”
The authors argue that if equitable access to food, nutrition and health care is a policy priority, then reducing the costs and effort required of people seeking these benefits should also be a priority. They note that several states, led by both Democrats and Republicans, are working to reduce the administrative burden by streamlining and simplifying applications, using existing information to confirm continued eligibility and making mobile apps more user-friendly.
At the same time, the recent passage of the One Big Beautiful Bill, which imposed additional complex eligibility requirements on families receiving Medicaid, may result in these problems getting worse over time.
“Families who can’t navigate the new, and often confusing, federal rules around Medicaid eligibility are at risk of losing essential and life-saving health care, which makes it more urgent than ever for states to do what they can in order to reduce these burdens for their residents,” Roll said.
Co-authors on the study are Mathieu Despard, at the University of North Carolina at Chapel Hill, and Yung Chun, a research assistant professor at the Brown School and director of data insight at the Center for Social Development.
