By ALISTER MARTIN and TARA MENON
If a friend were to ask you which state, Massachusetts or Texas, has a more streamlined federal benefits enrollment program, what would your guess be?
Having screened over 17,000 families and helped them obtain more than $1.8M in federal and state aid through our work in both Massachusetts and Texas, our experiences doing federal benefit enrollment have led us to a surprising conclusion: Texas is leading the way. While Massachusetts has room for improvement, this issue extends beyond a single state—many other states face similar challenges with complex and fragmented benefits systems.
At Link Health, where our work spans the bustling neighborhoods of Boston and Houston, this revelation has been both a surprise and a call to action. In many underserved communities, through partnerships with Federally Qualified Health Centers, our organization seeks to assist eligible people in the navigation and enrollment in benefit programs that address crucial needs like access to affordable internet, food access, healthcare support, and housing resources.
One of the main obstacles we’ve encountered is that people are often unaware of the benefits they qualify for or find the process overwhelming. In states like Massachusetts, separate applications are required for each benefit program, making it harder for families to get the help they need. Programs such as LIHEAP, which offers heating subsidies, Lifeline, which provides internet access for telehealth, and SNAP, which helps with food assistance, all come with different paperwork and requirements. This fragmentation creates unnecessary barriers.
This is not unique to Massachusetts. Across the U.S., many states have similarly disjointed systems, leaving millions of dollars in federal aid unclaimed. It’s estimated that around $140 billion in federal aid goes unclaimed each year due to these inefficiencies.
In contrast, we have found that Texas’s “Your Texas Benefits” platform is efficient and user-friendly. This centralized, comprehensive application process covers a wide range of state benefit programs, including SNAP, TANF, Medicaid, and CHIP, as well as other services like WIC, family violence support, adult education, and substance abuse prevention programs. This unified system allows users to apply for multiple programs through a single portal, streamlining the process considerably. Plus, this common application system allows groups like ours to efficiently connect patients with the help they need without the usual bureaucratic entanglements — it benefits us both.
Although Massachusetts made some progress with its limited common application for MassHealth and SNAP in 2021, it still doesn’t offer a fully unified system for all its programs. This means that many residents must continue navigating multiple applications and processes. During the recent Medicaid “unwinding,” people across the U.S. lost coverage because they couldn’t manage the renewal process. It’s estimated that between 8 million and 24 million people are at risk of losing Medicaid benefits nationwide(Center For Children and Families), not because they no longer qualify, but because of these application challenges.
The solution is clear: adopting unified, user-friendly platforms like Texas’s common application system would help reduce the barriers that prevent people from accessing essential support and services.
To try and address these disparities, our team at Link Health has leveraged artificial intelligence (AI) to transform how benefits are accessed in Massachusetts. We’ve collaborated with AI experts and students from the Northeastern AI for Impact Program to develop technological workarounds that mimic a unified application experience to tap into over $18,000 per year in various benefits. Yet, despite these advancements, these are merely Band-Aid solutions for a larger systemic issue. States must commit to building integrated systems from the ground up.
Encouragingly, Massachusetts has also recently mandated the development of a secure common application portal for needs-based benefits. This is a step in the right direction.
States like Massachusetts have long been recognized for their advancements in healthcare and social welfare. Now is the time to extend this progress to our benefits systems. Adopting common applications statewide would show a commitment to maximizing the impact of available aid and empowering citizens to take control of their financial well-being.
Let’s take the lesson from Texas to heart and push for changes that can improve thousands of lives, both in Massachusetts and across the U.S. It’s our collective responsibility to ensure that those in need can access the full range of resources without unnecessary barriers. America, we can do better.
Dr. Alister Martin is an emergency physician and the CEO of A Healthier Democracy. Tara Menon is a medical student at the Virginia Tech Carilion School of Medicine.