Many low-wage workers who rely on the Supplemental Nutrition Assistance Program were on an emotional roller coaster during the federal government shutdown about if and when their payments would arrive.
But new research shows that even when there isn't a shutdown, people have a difficult time accessing those federal benefits.
Researchers at Washington University and the University of North Carolina surveyed hundreds of workers with incomes below 250% of the federal poverty line — about $40,000 a year for an individual.
The resulting report quantified what many already know: Thanks to a confounding maze of administrative burdens, getting and staying enrolled in welfare programs can limit their reach and effectiveness among the groups that rely on them the most.
“The ability to afford food and access healthcare is essential,” the authors wrote in the research brief from Wash U’s Center for Social Development. “Yet our findings show that major public programs like SNAP and Medicaid, which serve tens of millions of people, are imposing substantial burdens on many Americans … and we find that these burdens are highest for those who need the program the most.”
Researchers divided such barriers into three categories: learning burdens, which include difficulties in understanding benefits and eligibility; compliance burdens, which include difficulties filing paperwork or attending caseworker meetings; and psychological burdens, which include the stress and shame of interacting with the benefits system.
The most common burdens were those associated with uncertainty about households’ eligibility for programs. That uncertainty affected close to one-third of SNAP and Medicaid recipients, the researchers found.
Around one-fourth of SNAP beneficiaries and one-fifth of Medicaid recipients reported issues providing documentation, and 10% of beneficiaries for both programs reported forms of discrimination.
Those who experienced such burdens were more likely to deal with the issues that benefits are meant to alleviate, said Stephen Roll, one of the study’s authors and the director of the Center for Social Development.
“Folks that reported the highest rates of burdens in trying to maintain their eligibility for sample also those at the highest risk of hunger,” he said. “And with Medicaid, we did, we did a similar analysis and actually found that the folks most likely to experience these burdens in enrolling in or staying on Medicaid tend to be those with the highest rates of chronic disease in the household.”
The burdens were not evenly distributed across demographics, the researchers found. Households that included a person with a disability reported consistent burdens across all categories. Those with relatively higher household incomes reported more learning burdens, perhaps because they were less likely to have experience navigating welfare systems. Those with higher educational attainment reported more psychological burdens.
Roll said it’s important to study the burdens on the working poor as a group.
"They’re doing what we want them to do,” he said. “But even despite that, they're still facing all these pretty diverse and complex barriers, so like accessing the benefits that they're entitled to under law to try to support their families.”
More people could experience such administrative burdens in the future as a work requirement for Medicaid recipients goes into effect in 2027. Advocates have expressed concerns that having to provide proof patients are working, looking for work or volunteering will result in tens of thousands of Missourians being kicked off the government program’s rolls.
The researchers recommended making applications shorter and easier to understand and using existing information in government systems to confirm eligibility without recipients having to continually provide documentation.
Governments using internet and mobile-based systems instead of mail and paper-based documentation would also make it easier for people to navigate benefits, Roll said.
