How Effective Service Delivery Can Build Trust in Government

Our work in Minnesota shows that when people have a better customer service experience accessing public benefits, their feelings about government change

For decades, trust in government institutions has been fading. A recent survey found that only 22% of Americans trust the government to do the right thing most or all of the time. This is in stark contrast to the 1960s, when around 77% of people trusted the government. 

We know that when people don’t trust the government, they may withdraw or disengage from positive civic behaviors, like voting. And we’ve seen recently what low trust in government can lead to as we’re faced with pressing problems that require collective action—when public health agencies advised vaccinations and social distancing during the COVID-19 pandemic, a significant chunk of the population greeted these measures with skepticism. 

Improving trust in government will be a multifaceted project, but we know some ways to make it happen. One solution is giving people a better experience at the point they most commonly interact with government—when accessing public benefits and services. Just 23% of people find government services easy to navigate, highlighting the huge potential the government has in this area to rebuild trust. 

Here’s one example: renewing benefits like Medicaid can be an onerous process. There are a lot of forms, confusing language, and required documents that might be hard to track down. If someone misses a deadline, they could have a lapse of coverage and be unable to fill prescriptions or visit their doctor. A taxing process with massive consequences for mistakes is a bad customer service experience. 

A better benefits experience

What if government automatically renewed Medicaid benefits for people, using information already on file? More and more state governments are trying to get better at this, and automatic renewal rates have increased from about 25% of Medicaid users to about 50% since the end of the pandemic. Does this make a difference in people’s perceptions of government? A recent research project we worked on with the Better Government Lab sought to understand if such simplifications increase trust in government. We found that when people have a better customer service experience accessing public benefits, they also have more positive feelings about government. 

With our help, the state of Minnesota recently expanded their automatic benefits renewals for some Medicaid clients. To understand if this made a difference to attitudes, we surveyed those who went through the automatic renewal process versus the standard one (where they had to fill out and return a set of forms, often helping staff fill in the gaps about their income or assets) to see how much they trust the government to do the right thing.  

We asked all of these clients how their trust varied with the level of government (e.g., counties, state, federal), how easy or difficult completing their renewal was, their overall opinions of Medicaid, and how supportive they would be of expanding automatic healthcare renewals. We found that clients who had their health insurance automatically renewed had more trust in all levels of government, compared to the clients who had to complete the more burdensome renewal. 

As expected, these clients reported they had an easier time renewing their health care than standard paper renewal clients. They also had more favorable opinions of Medicaid and were more supportive of expanding automatic renewals. The survey took place several months after the automatic renewal, suggesting that improvements at critical touch points have a lasting impact on people’s perceptions. 

Because it wasn’t random who received the more streamlined renewal process, we can’t say for certain that automatic renewals caused clients to have higher trust in their government. It would have been unethical to randomly allow some people to experience this improved process and some people not. The clients who did not receive the streamlined process don’t look observably different based on demographic data we collected but likely had more complicated financial situations that made their healthcare difficult to automatically renew, and this may also impact their other experiences with government. Even so, the results still show how better customer service can be correlated with higher trust in government.

Using these lessons to improve trust

We believe there are two key lessons here that government agencies can move forward with based on our research:

  • Automatically renewing coverage for a client (using data available from trusted interfaces) increases trust that government is acting in their best interest. Clients who had their healthcare automatically renewed had higher trust in the Minnesota Department of Human Services (DHS), which, in partnership with counties and tribes, administers programs like Medicaid. We found 75% of clients with the streamlined experience trusted DHS to often or always do the right thing for people like them, in contrast to 66% of clients who had to complete the standard renewal process. 
  • Local service delivery is the place where trust can be built or broken. Among the Medicaid recipients we surveyed, trust was highest in counties and tribes, followed by DHS, the state, and the federal government. This is consistent with other polling. We found 70% of the clients trusted their local county or tribe to often or always do the right thing for people like them. In contrast, just 48% of clients trusted the federal government at the same levels. 

While we have a long way to go, we believe that building trust can lead to improved governance and more effective policy implementation. Better service delivery is one step on the path to get there.

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