Analyzing the health impacts of federal legislation to modify the supplemental nutrition assistance program (SNAP)

Introduction: To reduce the federal deficit, Congress recently proposed changes to eligibility and benefit determination criteria for the Supplemental Nutrition Assistance Program (SNAP), the federal government's principal mechanism for alleviating hunger and improving nutrition for low-income households. We conducted a health impact assessment (HIA) to investigate the health implications of these proposed changes.

Methods: A policy analysis was conducted to understand the proposed changes. Quantitative analyses estimated the effects of the proposed changes on eligibility and benefits using the U.S. Department of Agriculture's microsimulation models. A systematic review of the literature was conducted to explore potential links between these changes and health, as well as the local economy. Stakeholders were engaged through a diverse advisory committee, a bipartisan group of Congressional staff, and other key informants. Semi-structured interviews were also conducted with SNAP administrators.

Results: The proposed changes to SNAP would affect benefit levels, eligibility for SNAP, access to federal programs such as the National School Meal Program, and create additional administrative burdens. These changes would reduce income for families with limited resources and increase difficult budgetary trade-offs in spending on food, medications, housing, and home heating or cooling. Reduced SNAP retail activity would also result in short-term effects on the local economy.

Conclusions: The proposed changes to SNAP could contribute to deficit reduction; however, they may place the health of low-income Americans at risk. HIAs offer a practical way of identifying potential health effects of proposed policies for which health implications might not otherwise be recognized or addressed.