This roadmap provides a vision and plan for how to deliver modernized integrated eligibility and enrollment for health and human services using human-centered design, modular approaches to replacing legacy technology, change management, and iterative product processes.
This report details findings and lessons from a project to develop a calculator to help people anticipate how a change in earnings from employment would affect their net income and information on their estimated effective marginal tax rate.
U.S. Department of Health and Human Services (HHS)
This paper introduces the problem of semi-automatically building decision models from eligibility policies for social services, and presents an initial emerging approach to shorten the route from policy documents to executable, interpretable and standardised decision models using AI, NLP and Knowledge Graphs. There is enormous potential of AI to assist government agencies and policy experts in scaling the production of both human-readable and machine executable policy rules, while improving transparency, interpretability, traceability and accountability of the decision making.
The Policy Rules Database (PRD), developed by the Federal Reserve Bank of Atlanta and the National Center for Children in Poverty, consolidates complex rules for major U.S. federal and state benefit programs and tax policies into a standardized, easy-to-use format. This database allows researchers to model public assistance impacts, simulate policy changes, and analyze benefits cliffs across various household scenarios using common rules and language across different programming platforms.
The NYC Mayor’s Office for Economic Opportunity (NYC Opportunity) developed the NYC Benefits Platform, including ACCESS NYC, to help residents easily discover and check eligibility for over 80 social programs.
mRelief is a nonprofit that helps individuals in all 53 U.S. states and territories determine SNAP eligibility and apply using easy-to-use web and text tools. Their simplified, inclusive approach has supported over 2.7 million people and unlocked over $1 billion in benefits, focusing on minimizing barriers and adapting eligibility rules across states.
The team developed an application to simplify Medicaid and CHIP applications through LLM APIs while addressing limitations such as hallucinations and outdated information by implementing a selective input process for clean and current data.
We kicked off Rules as Code Demo Day with Alex Soble of 18F and Mike Gintz of 10x presenting their Eligibility APIs Initiative that explores whether APIs and rules as code might improve the efficiency and effectiveness with which federal public benefits programs communicate their policy to states. They demonstrated their original prototype, and how the open source code has now been extended into several initiatives.
