Navigating Medicaid enrollment in New York
Understanding barriers for Medicaid recipients and navigators ahead of federal policy change
Year: 2025
Partner: Robin Hood Foundation, Blue Ridge Labs
Team: Blue Ridge Labs Founder Fellowship
Role: Service Designer, Research Lead
Sector: Nonprofit
Partner: Robin Hood Foundation, Blue Ridge Labs
Team: Blue Ridge Labs Founder Fellowship
Role: Service Designer, Research Lead
Sector: Nonprofit
Background
With sweeping federal Medicaid changes on the horizon, including new work requirements, eligibility restrictions, and increased administrative burdens, New York State’s navigator network faces a surge in demand at the same time their funding is under threat. Navigators are community-based assistors who help low-income New Yorkers enroll and stay enrolled in Medicaid and Marketplace coverage through the New York State of Health (NYSOH) platform. How might we identify the friction points in the enrollment experience and surface technology and policy opportunities to better support navigators and the communities they serve?
Approach
Conducted as part of the Robin Hood Foundation’s Blue Ridge Labs Founder Fellowship, this research took place between September and November 2025. We conducted roughly 20 semi-structured conversations with recipients, navigators, and organizations across the U.S. Medicaid and Marketplace ecosystem, alongside observational research at community health tabling events. Two co-design workshops with 18 NYC-based navigator and CBO staff helped validate findings and generate actionable ideas grounded in lived experience.
Discovery
Early phase to understand the NYSOH platform, navigator roles, and policy landscape.
How I contributed:
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Conducted interviews with Medicaid and Marketplace recipients and navigators
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Performed desk research on HR1 and federal and state policies shaping NYSOH service delivery
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Developed recipient and navigator personas grounded in interview findings
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Created a recipient journey map spanning awareness, enrollment, renewal, and transitions off coverage
Design
Synthesizing insights into workshop-tested opportunities and recommendations.
How I contributed:
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Facilitated two co-design workshops with 18 navigator and CBO staff to validate findings and generate platform and policy recommendations
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Organized insights across five challenge areas: the online application experience, official notices, NYSOH escalation paths, navigator visibility and tools, and recipient anxiety and trust
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Produced a research report with prioritized opportunities for New York State, nonprofits, and civic technology partners
What we accomplished
Produced a research report surfacing five primary challenge areas, each accompanied by concrete, navigator-informed opportunities for improving the NYSOH platform, communication design, escalation processes, and navigator tools. The research also made a policy-level case for increased navigator funding and elevated status within the enrollment ecosystem ahead of anticipated HR1 impacts.
Impact
The findings positioned navigators not just as enrollment helpers but as essential connectors between policy, technology, and the lived experience of recipients, and made clear that investing in navigator capacity would have measurable returns in enrollment retention, reduced coverage gaps, and stronger equity outcomes for communities facing linguistic, digital, and economic barriers.