At our pediatric clinic, we recently saw a child whose mother lost her job during the pandemic working as a caterer. The mother struggled to put food on the table after the precipitous loss of income. After the family enrolled in SNAP, we could literally measure how that policy benefited our young patient. After teetering close to severe malnutrition, she returned to a healthy weight. Now, the mother is back to work and trying to grow her business again. But new change may once again place her family at risk of food insecurity and poor health.
In medicine, we are taught to follow the evidence and use research-based solutions for health. We know from decades of research that the Supplemental Nutrition Assistance Program, known as SNAP, is effective in reducing food insecurity and improving health for people of all ages. Given overwhelming evidence on the positive impacts of SNAP and its ability to rapidly respond to nutritional needs during times of crisis, Congress quickly passed legislation in March 2020 enabling states to provide boosted payments known as Emergency Allotments to help families manage financial hardships and promote health during the Covid-19 pandemic. Building on the evidence from a similar boost during the Great Recession, research showed that these allotments worked to stave off widespread hunger. The enhanced benefits helped millions of families, including those with young children, put food on the table and manage other basic household expenses, reducing the stresses of poverty.
But these allotments ended March 1, placing millions of children, including many of my patients, at risk of hunger and, long-term, poor health and development. Roughly 16 million households will experience a sharp cut in benefits as the government rolls back the temporary pandemic assistance. As Massachusetts Rep. Jim McGovern, a longtime anti-hunger advocate, often points out, hunger is a political condition: “we have the food, the resources, the infrastructure, everything but the political will to end hunger and combat diet-related diseases.”
A lack of political will means that SNAP benefits will be reduced on average by $90 each month for individuals and $250 or more for families. Working families with modest incomes will be disproportionately affected by this policy change. Our research at Children’s HealthWatch has found that when families experience abrupt SNAP reductions and cutoffs as a result of work and income fluctuations, they are more likely to experience food insecurity and other material hardships.
Serving roughly 41 million people, SNAP is the largest anti-hunger program in the United States and an evidence-based tool for improving child and caregiver health. As a Boston Medical Center pediatrician and co-director of a clinic treating children who meet the World Health Organization’s definition of malnutrition (M.S.), I see the benefits of SNAP daily among my patients. While I have powerful medicines and nutritional supplements at my disposal, there is no more potent tool than extra money to afford the foods I recommend to help their children grow, like eggs, whole milk, and cheese, whose prices are up more than 50% since 2022.
The first three years of life are critical for children’s growth and development. When families are unable to afford healthy food that provides key nutrition, it’s hard to catch up. Research shows that food insecurity during these early years can hurt a child’s development, mental health, and academic achievement.
The benefits of SNAP are clear and robust. With the ability to improve food security and physical and mental health among participants, SNAP has even been shown to reduce emergency room visits. Children’s HealthWatch found that compared with families likely eligible for SNAP but not participating, families who participated in SNAP were more likely to be able to afford their medical costs without trading off other basic needs. When the federal government boosted SNAP benefits to mitigate the effects of the Great Recession, the growth of Medicaid costs in Massachusetts actually slowed.
Even pre-pandemic, SNAP benefits were insufficient to afford a healthy diet. Now combined with food inflation, rolling back to an already-inadequate benefit amount is likely to lead to a harmful outcome.
We already know the consequences of ending supports too early. In 2013, Congress prematurely rolled back increased SNAP benefits in order to fund other programs focused on older children. Our research found that this rollback increased food insecurity among families with young children. Now, Congress has similarly ended the boosted benefits ahead of schedule in order to support other child nutrition programs. This political decision ignores the science and falsely purports that there is a limited budget to address hunger in our country. Much-needed investments in child nutrition should not come at the cost of other evidence-based anti-hunger programs.
But there is a way to get back on the path of the evidence, by permanently improving SNAP benefit levels in the upcoming federal Farm Bill. This omnibus piece of legislation, which includes SNAP authorization, is considered by Congress every five years and is up for revision again in 2023. There are three key ways we can follow the research to maximize SNAP’s potential to improve health and save on health care costs.
First, while recent improvements to the way in which SNAP is calculated increased benefits nationwide, research still consistently shows the current SNAP allotment does not reflect the real cost of a healthy diet. Switching the calculation to align the financial value of the benefit, with the true cost of a healthy diet, is key to ensuring benefits are aligned with evidence.
Second, adequately reflecting other costs of living in benefit calculations — including housing, utilities, and health care — would help offset some of the additional expenses families face and simultaneously recognize that people experience food insecurity alongside other hardships.
Third, eliminating exclusionary eligibility restrictions and reducing barriers to accessing SNAP will help families maintain resources necessary to feed their children while seeking to increase income and financially stabilize.
It is hard for us to watch our nation’s leaders ignore the overwhelming evidence that data tells them, and that our daily experience tells us. But there are new political frontiers to make the right choice and ensure that SNAP can get to the right dose to reach its biggest impact. It’s time to strengthen SNAP benefit levels, not weaken them. These changes are good medicine for families, reduce health care costs, good for public health, and for all of our communities.
Megan Sandel is co-director of the GROW clinic, co-lead principal investigator of Children’s HealthWatch at Boston Medical Center, and a professor of pediatrics at Boston University Chobanian and Avedisian School of Medicine and BU School of Public Health. Charlotte Bruce is a senior research and policy analyst at Children’s HealthWatch.