SNAP changes looming amid mixed data on program’s success
On April 1, a final rule that changes some of the Supplemental Nutrition Assistance Program, or SNAP, eligibility requirements takes effect, according to reporting by USA Today.
According to the U.S. Department of Agriculture website, SNAP supplements the food budget of needy families so they can buy healthy food and help these families move towards self-sufficiency. Its rules also “reflect the importance of work and responsibility.”
The Trump administration said the final rule brings SNAP back to that original intent of helping provide food to Americans going through short-term crises.
“We need to encourage people by giving them a helping hand but not allowing it to become an indefinitely giving hand,” USDA Secretary Sonny Perdue, said in a statement.
However, the American Academy of Family Physicians was among those who expressed concern the final rule would have a detrimental health effect.
“We are concerned about the proposed rule and its potential to negatively impact the health and well-being of vulnerable Americans and increase health care utilization and costs,” Michael Munger, MD, a former president of AAFP, wrote in a letter to the USDA during the public comment period regarding the rule.
The USDA states that SNAP’s new rule “shifts the default [for participants] toward work preparation or work,” that each individual wishing to participate in the program should be assessed as “work-capable,” that waivers should be specific to one area within a state (as opposed to the entire state) and identifies areas where residents can find jobs within a “reasonable distance” that does not force them to move.
The new rule also limits SNAP eligibility criteria for “able-bodied adults” aged 18 to 49 years without dependents. Long-standing SNAP eligibility criteria limits these individuals to receive 3 months of SNAP benefits in a 3-year period, unless they are working at least 80 hours each month or volunteering, according to the U.S. Department of Agriculture website. Long-standing SNAP rules allow states to request that waive this time restriction for individuals living in areas with poor economic conditions. Previously, counties with an unemployment rate of 2.5% were included in waived areas. However, the new rule requires counties to have an unemployment rate of at least 6% in order to qualify as a waived area.
“In the midst of the strongest economy in a generation, we need everyone who can work, to work,” Purdue said in the statement. “This rule lays the groundwork for the expectation that able-bodied Americans re-enter the workforce where there are currently more job openings than people to fill them.”
J. Wyatt Koma, independent researcher, felt the final rule counters SNAP objectives.
“Taking SNAP away from a share of these recipients could likely increase food insecurity, which is associated with poor health outcomes, higher health care costs and poverty,” he told Healio Primary Care.
Munger’s letter stated that people who “face persistent hunger are at risk for experiencing many deleterious health impacts [including] increased prevalence and severity of diet-related diseases, such as obesity, type 2 diabetes, heart disease, stroke and some cancers.” He also wrote that the rule could force some SNAP participants with limited financial resources to stretch budgets by limiting or abandoning their medication regimens, forgoing the diets their health conditions require, and delaying or avoiding preventive or needed medical care.
SNAP’s mixed legacy
Recently published studies suggest SNAP has bestowed positive and negative behaviors among its participants. A 2018 study showed older SNAP participants with diabetes improved their adherence to their treatment regimens. However, later that year, another group of researchers found that SNAP participants aged at least 20 years did not meet most recommendations for a healthy diet.
Koma and colleagues’ recently published findings in the American Journal of Preventive Medicine add to the conflicting evidence of SNAP’s impact. They found that from 2003 to 2014, the probability of SNAP participants aged 2 to 19 years old drinking soda dropped from 57.6% to 33.7% and fruit drinks dropped from 30.6% to 24.8%. But consumption of sports or energy drinks rose from 2.6% to 8.4%.
Caroline M. Apovian, MD, FACP, director of the Boston Medical Center’s Nutrition and Weight Management Center who is not affiliated with the study, told Healio Primary Care that the results “suggest that the public health efforts to decrease sugar-sweetened consumption among U.S. children and adolescents have been successful for the most part.”
“This success in education is tempered by the fact that current levels of sugar-sweetened beverage consumption remain high,” she added.
Apovian suggested other SNAP policy approaches that could improve its participants’ health.
“Restricting the purchase of sugar-sweetened beverages in SNAP could be a way to effectively reduce the consumption of drinks that have no nutritional value, especially in those who would not have disposable income to purchase sugar-sweetened beverages on their own,” she said, adding that such limits may improve the consumption of milk and water.
Koma provided a possible way to reverse unhealthy beverage consumption trends that does not involve changing SNAP.
“Clinicians can act as a primary resource by letting parents know about how healthy beverages, such as fruit drinks, are for their children,” he said, adding that some of Purdue’s comments related to the new rule may be off the mark.
“A primary purpose of the SNAP program is to reduce food insecurity in the United States, and research shows that it has been successful at doing so. At the end of the day, to my knowledge, there is no evidence that SNAP discourages work.” – by Janel Miller
AAFP. Letter regarding Supplemental Nutrition Assistance Program (SNAP): Requirements for able-bodied adults without dependents. https://www.aafp.org/dam/AAFP/documents/advocacy/prevention/strategy/LT-USDA-SNAPWorkRule-04102019.pdf. Accessed Dec. 20, 2019.
Stanglin D. 700,000 people could lose food stamps under Trump administration’s new SNAP rules. https://www.usatoday.com/story/news/nation/2019/12/04/food-stamps-trump-administration-tightens-snap-work-requirements/2608297001/. Accessed Dec. 23, 2019.
USDA. SNAP. https://www.fns.usda.gov/snap/supplemental-nutrition-assistance-program. Accessed Jan. 6, 2020.
USDA. USDA Restores original intent of SNAP: A second chance, not a way of life. https://www.usda.gov/media/press-releases/2019/12/04/usda-restores-original-intent-snap-second-chance-not-way-life. Accessed Dec. 17, 2019.
USDA. Regulatory reform at a glance final rule: employment for work-capable adults. https://fns-prod.azureedge.net/sites/default/files/resource-files/ABAWD-fact-sheet-2019.pdf. Accessed Nov. 26, 2019.
Disclosures: Apovian reports numerous industry ties. Koma reports no relevant financial disclosures. Munger was AAFP board chair at the time of his remarks.