Report: Better customer experience can smooth states’ rollout of new federal benefit requirements

Time is ticking for states to keep up with the federal governments’ changes to eligibility requirements to public benefit services like Medicaid and the Supplemental Nutrition Assistance Program. As states wait for official guidance to be established, many leaders are considering how to prepare their eligibility and enrollment systems for such changes. 

Since President Donald Trump signed the Big Beautiful Bill, or H.R. 1, in July, states have been subject to new and evolving rules for administering Medicaid and SNAP benefits. Differences in eligibility and payment rules, for example, are pushing states to consider how they can update their public benefit systems to comply with the changes. 

But the tight deadlines to do so and a lack of clear guidance thus far has created a challenge for state leaders. Officials are concerned that implementing any changes to their eligibility and enrollment systems now will have to be redone in the future but also that waiting until final rules are released will be a burden on their constrained resources and capacity, according to a report released this month from the Beeck Center for Social Impact and Innovation based on interviews with seven state officials. 

One state, for instance, “is cautiously making changes to its system in case any H.R. 1 requirements are rescinded by Congress or overturned by a court,” according to the report. 

A separate report from the nonprofit Civilla points to how states can lean on customer experience practices to help streamline the rollout of new Medicaid and SNAP provisions for agencies and residents. 

Beyond backend improvements like expanding interagency data sharing or implementing automation tools to streamline eligibility verification processes, states can leverage a human-centered approach to system changes to reduce their administrative burden, said Lena Selzer, chief operating officer and cofounder of Civilla. 

“Even with the best technical implementation for work requirements … millions of people are still going to need to take action on their cases in order to maintain coverage, and that means governments are going to need to bring real intention to how they communicate with residents [like] informing them of what changes are coming down the pike,” Selzer said.

Under H.R. 1, for instance, SNAP now includes work requirements for certain adults ages 18 to 64 years old, increasing the age of eligibility from 54 years old. The bill will also impact cost sharing between states and the federal government for SNAP over the next few years, with states having to increase their contributions based on their payment error rates. 

For Medicaid, states are expected to implement work requirements for the program by Dec. 31, 2026, but the Centers for Medicare and Medicaid Services is not slated to issue a final rule on the matter until June. 

In the meantime, states must consider how to relay those changing policies through clear and accessible messaging to residents through notices or on benefits applications themselves, Selzer said. 

“If they don’t do that, people will be calling, they’ll be visiting offices, they’ll be falling off their benefits and reapplying,” she explained. This issue creates “a real important opportunity for states to think about the customer experience and the customer relationship from the outset [and] to make sure that they're providing clarity to help residents who are eligible maintain their coverage, but also to relieve the burden from frontline staff,” Selzer said. 

Text reminders are a valuable tool for states to engage with residents about updates to their public benefits coverage, she said. 

“Communicating a new and complex policy like Medicaid work requirements is not a one-time task,” the report states. “Residents will need timely reminders to take action.” 

States can send automated text communications to remind beneficiaries to renew their coverage, for example, during times when their eligibility or enrollment may change, like a person’s birthday, Selzer said. Text notices can be particularly helpful to prompt beneficiaries to report their work hours under the new work requirement rules, according to the report. 

Text messages should include plain language by avoiding jargon typically used in formal policies like “premium” or “qualifying activities” and instead frame the message as a prompt to, for example, submit a required document before a deadline. 

To further streamline the process, the report recommends that text messages include links to the appropriate application and enrollment portals to reduce confusion or additional burden on residents to complete necessary tasks. 

States should also consider how to incorporate new eligibility questions into existing benefit application forms, Selzer said. 

For Medicaid work requirements, for example, states should consider adding questions to determine if a person is exempt from the rule at the start of an application to help residents work through the form more efficiently, according to the report. Such questions should also be grouped together in one section of the form, rather than scattered throughout the application, to prevent confusion. 

Applications should also include conditional logic-based questions, signaling to users which questions they must answer based on their response to previous prompts, to help avoid residents over-reporting or spending time to fill out unnecessary sections, according to the report. 

To expedite the data verification process for residents and agencies, states can ask for users’ consent to leverage other administrative records to confirm wage and identification data with a simple checkbox on the form, the report states. Officials can also consider forgoing requirements that people create an account to access benefit applications or portals in general, as this feature can create a barrier for some users, according to the report. 

Improving customer experience of public benefit programs, particularly at a time when tens of millions of people are at risk of losing their coverage under the proposed rule changes, can help states keep people enrolled in benefits and prevent them from losing coverage just because they struggled to navigate the new systems, Selzer said.