The American Paperwork Burden Index: Which States Bury Residents in the Most Admin

Government paperwork is an unavoidable part of life, but how much of it you face depends largely on where you live. While some states have modernised everyday services, others still leave residents navigating lengthy forms, multiple agencies and outdated processes, turning simple administrative tasks into time-consuming headaches.

To find out where bureaucracy creates the biggest burden, we analysed five government and research datasets covering healthcare, occupational licensing, digital government performance, tax filing, vehicle administration and home buying.

We combined the findings into a single Paperwork Burden Score (0–100) for all 50 states, revealing where red tape is at its worst, which states have done the most to streamline everyday processes, and why strong digital government rankings don't always translate into less paperwork for residents.

Key findings

• The average state scores 36.7 out of 100 on the Paperwork Burden Index, with a 37.6-point gap separating the heaviest state from the lightest
• New York carries the heaviest paperwork burden in the country at 53.6, the only state to score at the maximum on both tax paperwork and vehicle burden
• Washington carries the lightest burden of any state at 16.0, helped by no wage income tax return and no vehicle safety inspections since 2020
• Indiana records the highest procedural disenrollment rate in the country: 43% of Medicaid cases are closed over paperwork issues rather than a finding of ineligibility, even as only 11% of cases auto-renew.
• Texas is a paradox: 47th-lightest on paper (no income tax, no safety inspection), yet its Medicaid system auto-renews only 9% of cases, the lowest ex parte rate in the country.
• Medicaid callers in Oklahoma wait an average of 73 minutes on hold; in Hawaii, the wait is 61 minutes and 39% of callers hang up before reaching anyone
• Hawaii ranks 4th overall on the back of the heaviest occupational licensing regime in the US: 972 days of required education and experience and $506 in average fees
• Vermont is the only state where zero recording jurisdictions accept electronic property filings: every deed is still filed on paper with a town clerk
• A strong digital reputation is no guarantee of a light burden: California holds an A grade for digital government yet ranks 5th heaviest overall, while Alaska takes over 45 days to process 57% of Medicaid applications, more than five times the ~10% national average.

The Five Heaviest Paperwork States

1. New York: Overall score – 53.6/100

• Received the maximum score for tax paperwork, due to its graduated state income tax and additional local income taxes in New York City and Yonkers.
• Also received the maximum score for vehicle administration, with mandatory annual safety and emissions inspections statewide.
• Only 26% of Medicaid renewals are completed automatically (ex parte), well below the best-performing states.

Why it ranks first: New York is the only state to receive the maximum score in both the tax and vehicle administration categories. Combined with its relatively low rate of automatic Medicaid renewals, these factors make it the clear outlier and give it the highest overall Paperwork Burden Score in the country.

2. New Mexico: Overall score – 52.9/100

• Recorded one of the heaviest occupational licensing burdens in the country, with 66 of 102 occupations requiring a licence and an average wait of 495 calendar days to obtain one.
• Received a C grade for digital government, the lowest rating of any state, indicating public services remain significantly less streamlined than elsewhere in the country.
• Only 54% of Medicaid renewals are completed automatically (ex parte), while 20% of cases are closed for procedural reasons rather than eligibility.

Why it ranks second: New Mexico combines one of the nation's most restrictive occupational licensing systems with weak digital government performance and relatively low levels of automatic Medicaid renewals. Together, these factors give it the second-highest overall Paperwork Burden Score in the country.

3. Delaware: Overall score – 51.7/100

• Recorded one of the nation's heaviest occupational licensing burdens, with an average of 495 calendar days required to obtain a licence.
• Despite ranking highly overall, its home-buying process is relatively light for a top-five state, helped by the highest electronic property recording coverage in the country (100%). New Mexico, not Delaware, records the lowest overall home-buying burden among the top five.
• One in three (33%) calls to the state's Medicaid helpline are abandoned before being answered, one of the highest rates in the country.

Why it ranks third: Delaware shows that paperwork burdens are not always spread evenly across government services. While it performs strongly on home-buying processes, its lengthy occupational licensing requirements and poor Medicaid service accessibility are enough to give it the third-highest overall Paperwork Burden Score in the country.

4. Hawaii: Overall score – 49.8/100

• Recorded the nation's heaviest occupational licensing burden, requiring an average of 972 days of education and experience to obtain a licence, more than double the national median, alongside average licensing fees of $506.
• Residents face the longest Medicaid call wait times in the country at 61 minutes, while 39% of callers abandon the queue before reaching an advisor.
• Despite these challenges, Hawaii received an A- for digital government, putting it in the top tier nationally. Its paperwork problem clearly isn't a technology problem.

Why it ranks fourth: Hawaii shows that strong digital services do not always translate into less paperwork. While its online government performance scores highly, lengthy occupational licensing requirements and significant delays in accessing Medicaid support contribute to the fourth-highest overall Paperwork Burden Score in the country.

5. California: Overall score – 48.3/100

• Received an A grade for digital government, placing it among the country's strongest performers for online public services.
• Recorded a substantial occupational licensing burden, with an average of 837 days of education and experience required across 75 of 102 licensed occupations, one of the broadest licensing footprints in the country.
• Only 43% of Medicaid renewals are completed automatically (ex parte), while 23% of callers abandon the Medicaid helpline before reaching an advisor.

Why it ranks fifth: California demonstrates that a strong digital government alone is not enough to reduce paperwork. Despite its high-performing online services, extensive occupational licensing requirements and average Medicaid administrative performance contribute to the fifth-highest overall Paperwork Burden Score in the country.

The Five Lightest Paperwork States

Washington, Tennessee, New Hampshire, Minnesota and Mississippi rank as the states with the lowest overall paperwork burden, each scoring below 25 on the index. Rather than excelling in one area, these states avoid the combination of policies that drive paperwork higher elsewhere.

Common characteristics include:

• No compounding burden: None combines a graduated state income tax, extensive occupational licensing requirements and weak Medicaid administration.
• Fewer administrative hurdles: Residents generally face fewer barriers when completing everyday government tasks.
• Stronger-performing systems: Several of these states benefit from streamlined tax systems, lower licensing requirements or more efficient public services.

Washington (16.0), the lowest-scoring state, stands out in particular:

• No general state income tax on wages, eliminating the need for most residents to file a state income tax return.
• No annual vehicle safety inspections, following the end of the state's emissions inspection programme in 2020.
• 83% of Medicaid renewals are completed automatically (ex parte), the second-highest rate in the country.

A Digital Government Doesn’t Always Mean Less Paperwork

One of the biggest surprises from the analysis is that high digital government scores don't always translate into less paperwork. While some states use technology to genuinely simplify public services, others have modernised their online services without reducing the administrative burden on residents.

States broadly fall into four groups:

1. Digital and simple
Strong online services paired with low paperwork burdens.
Examples: Washington, Tennessee, Minnesota and New Hampshire.

2. Heavy bureaucracy
High paperwork burdens combined with weaker digital government.
Examples: New York, New Mexico, Florida and Alaska.

3. Digital, but still paperwork-heavy
Modern online services, but residents still face significant administrative hurdles.
Examples: California (5th) and Hawaii (4th).

4. Broadly aligned
Digital government performance and paperwork burden are broadly in line with one another.
Examples: Colorado, Iowa, Montana and West Virginia.

The takeaway: a modern-looking state government website is not evidence that the underlying processes have actually gotten simpler. Some of the states with the best digital reputations in the country still rank among the heaviest for the paperwork residents actually have to produce.

Paper Requirements vs. Delivered Performance

A state's paperwork burden isn't just about how many rules exist. It's also about how efficiently those rules are administered.

For example, New York has the highest paperwork burden in the index, yet processes 100% of Medicaid applications within 24 hours, the fastest turnaround in the country. Texas tells the opposite story. It has one of the lightest regulatory burdens on paper, but records the lowest rate of automatic Medicaid renewals, at just 9%.

This is why a state can appear simple on paper but still create frustrating experiences for residents, or have more requirements while delivering services quickly. Our index measures both.

What’s Driving the Paperwork Burden?

The index combines six areas of government administration:

• Healthcare and government services (28%)
• Occupational licensing (22%)
• Digital government (18%)
• Tax paperwork (15%)
• Vehicle and DMV administration (12%)
• Home buying (5%)

Healthcare and occupational licensing make up half of the overall score, meaning states with slow Medicaid systems or extensive licensing requirements tend to rank highest overall. Home buying has the smallest impact, although Vermont stands out as the only state with 0% electronic deed recording, meaning every property deed must still be filed on paper.

What the Findings Show

The results suggest that paperwork burden isn't simply a question of big government versus small government. Instead, it's about how administrative barriers build on one another.

States rank highest when multiple burdens overlap, such as complex licensing rules, slower public services and inefficient digital systems. States with the lowest scores don't necessarily have fewer regulations. Instead, they avoid these layers of bureaucracy, making everyday interactions with the government simpler and faster.

This research shows that paperwork burden isn't about the number of rules a state has, it's about how those rules interact. You can have high taxes and a smooth experience, or low taxes and endless bureaucracy. What really matters is whether government systems work together. We weren't trying to rank states as good or bad, only to identify where everyday administrative friction is highest. The findings show that friction has much less to do with politics or population size than with how well different public services are connected.

Jackson Barrett, Director of Product at Xodo

Methodology

The Paperwork Burden Index scores all 50 states on a 0–100 scale using six weighted categories: healthcare (28%), occupational licensing (22%), digital government (18%), tax paperwork (15%), vehicle and DMV administration (12%), and home buying (5%).

Each score is based on objective government data, statutory requirements or official records, with all metrics standardised using min-max scaling. Washington, D.C. and U.S. territories were excluded due to data availability.

The analysis draws on data from the Centers for Medicare & Medicaid Services (CMS), the Institute for Justice, the Center for Digital Government, the Tax Foundation, state DMV agencies, and the Property Records Industry Association (PRIA). Testing alternative weightings produced very similar results, confirming the rankings are robust.