Administrative Easing: Rule Reduction and Medicaid Enrollment

Abstract Administrative burden is widely recognized as a barrier to program enrollment , denying legal entitlements to many potentially eligible individuals . Building on recent research in behavioral public administration , this article examines the effect of voluntary state reductions in administrative burden (administrative easing) on Medicaid enrollment rates using differential implementation of the Affordable Care Act . Using a novel data set that includes state‐level data on simplified enrollment and renewal procedures for Medicaid from 2008 to 2017 , the authors examine how change in Medicaid enrollment is conditioned by the adoption of rule‐reduction procedures . Findings show that reductions in the administrative burden required to sign up for Medicaid were associated with increased enrollments . Real‐time eligibility and reductions in enrollment burden were particularly impactful at increasing enrollment for both children and adults separate from increases in Medicaid income eligibility thresholds . The results suggest that efforts to ease the cognitive burden of enrolling in entitlement programs can improve take‐up .