The Interaction Between SNAP and Medicaid
Over the course of this year, 500,000 to 1 million of Supplemental Nutrition Assistance Program (SNAP) recipients will be cut from their benefits. This drastic change is due to the decision in 23 states to bring back a three-month limit on food assistance benefits for unemployed adults who are not disabled or raising children. In the areas affected, even active job searchers will be disqualified. This policy sheds light on the underlying debate regarding the impact of taking food assistance away from the poor.
Rajan Sonik, a PhD student at Brandeis University, sheds light on that very question through his research on poverty alleviation and improved health outcomes. Most recently, he examined how an increase in SNAP benefits influences inpatient Medicaid costs and usage patterns. In order to observe that interaction, he looked at data from Massachusetts before and after the state increased SNAP benefits by 13.5% in 2009. Before the increase, inpatient Medicaid costs in Massachusetts increased by 0.55% per month. After 2009, cost growth fell by 73%. That drastic of a cost decrease is very relevant to policymakers immersed in the contentious debates over the efficacy of SNAP and the amount that should be given to families.
People with chronic illnesses who usually have heightened costs of care are both more likely to experience food insecurity and more vulnerable to its health effects. During the recession, hospital admissions and costs for those with chronic illnesses rose more sharply than they did within the overall Medicaid population, meaning that vulnerable group is particularly at risk during times of hardship. However, there is not much data on how that correlation relates to health care utilization among vulnerable populations. An alternative method to analyzing that relationship is by looking at the inverse of the core question of obesity reduction. In other words, Sonik examined the effects of alleviating food insecurity. For the average patient, the SNAP increase both reduced hospital admissions and decreased the length of stay in the hospital, particularly among those who had chronic illnesses also associated with high sensitivity to food-insecurity. His findings are consistent with the idea that patients with sickle cell disease, diabetes, malnutrition, cystic fibrosis, asthma, and inflammatory bowel disease are not only more susceptible to food insecurity, but also more responsive to its alleviation.
Sonik’s research indicates that the costs of a SNAP increase are partially offset by Medicaid savings, especially for beneficiaries with chronic illnesses. Due to the link between additional SNAP benefits and reduced hospital admissions, it appears that benefits allocated before the SNAP increase in Massachusetts were not sufficient to fully alleviate food insecurity and its associated health effects. A report released by the White House in December 15 confirmed SNAP’s effectiveness in promoting good health, education and food security outcomes, yet also found that current SNAP benefit amounts are inadequate for households. Despite this evidence, Congress has repeatedly proposed more budget cuts to the SNAP program . The economics behind SNAP is clearly complex. Yet, the decisions that are made now may significantly impact the health outcomes of our nation in ways that can’t be quantified in financial terms.
 Bolen, Ed, Dottie Rosenbaum, Stacy Dean, and Brynne Keith-Jennings. “More Than 500,000 Adults Will Lose SNAP Benefits in 2016 as Waivers Expire.” More Than 500,000 Adults Will Lose SNAP Benefits in 2016 as Waivers Expire. Center of Budget and Policy Priorities, 18 Mar. 2016. Web. 19 Mar. 2016.
 Sonik, Rajan Anthony. “Massachusetts Inpatient Medicaid Cost Response to Increased Supplemental Nutrition Assistance Program Benefits.” Am J Public Health American Journal of Public Health 106.3 (2016): 443-48. Web.
 “Long-Term Benefits of the Supplemental Nutrition Assistance Program.”www.whitehouse.gov. Executive Office of the President of the United States, Dec. 2015. Web. 19 Mar. 2016.