Food insecurity and the end of the public health emergency

Food insecurity and the end of the public health emergency

eEnrollments in social safety net programs during Covid-19 have been essential for low-income Americans who have been hit hard by the pandemic. But the stabilizing effect of these expansions will be in jeopardy when federalism Covid-19 is a public health emergencywhich was initially announced on January 31, 2020, may end By January 11, 2023.

Ending the public health emergency will end expansions of Medicaid and the Supplemental Nutrition Assistance Program (SNAP), the two leading programs in the country that provide individuals or families with low-income health insurance and the fight against hunger, respectively.

Households rarely suffer from food insecurity, poverty or poor health in isolation. Instead, hmm linked in a cycle High healthcare costs strain household budgets and lead to food insecurity, while food insecurity at the same time leads to stress and malnutrition, which leads to poor health.


Given the large gaps between wages and the cost of living for low-income families, families in general Participate in several Federal assistance programs to cover their expenses. In 2017, 89% of children received SNAP support also received Medicaid or Children’s Health Insurance Program (CHIP) support. During Covid-19, both programs have seen significant increases in enrollment.

When the public health emergency ends, many individuals and families will experience the cumulative effect of losing access to both Medicaid and SNAP or losing access to Medicaid and reducing SNAP benefits. Healthcare organizations must take an active role in supporting patients who are navigating the systems needed for them to access health services and achieve food security.


Double Loss of Medicaid Cover and SNAP Benefits

The end of PHE and the ad-related expansions will greatly affect the millions of Americans who are still struggling to get medical care and food costs.

Much has been written about “solution” Medicaid And the Explode, Explode. In short, when the public health emergency ends, the benefits and accessibility of the program will be affected in myriad ways:

Medicaid: Access will be restricted because states will discontinue ongoing coverage — under which Medicaid agencies are prohibited from deregistering participants unless they request it, out of state, or die — and will return to annual reviews to determine Medicaid eligibility. Medicaid and CHIP enrollment increased by 12 million between March 2020 and July 2021, which The increase was largely attributed to automatic renewals Keep people covered, rather than new entrants. An estimated 5 to 14 million people You can lose Medicaid coverage, depending on how states reschedule their Medicaid.

Explode, Explode: Benefits levels will be reduced after SNAP expires emergency allowances, which gives participants the maximum allowable benefit for their family size. On average, participants will lose An estimated $82 per month. SNAP access will also be restricted due to the reinstatement of time limits of three months for healthy adults without dependents, which has been shown to be Reduce enrollment Among eligible adults, exemptions for college students ended, simplifying eligibility requirements for college students and enabling An estimated 3 million additional low-income studentsTo qualify for the SNAP program.

Loss of Medicaid will affect access to other food assistance programs, increasing food insecurity. Medicaid coverage entitles an automatic income entitlement to free school meals (also known as direct testimony) and for WIC, the Supplemental Nutrition Assistance Program for Women, Infants and Children (also known as Additional Eligibility). as such More than three-quarters of WIC participants rely on additional eligibilityTermination of continuing coverage may result in loss of WIC coverage.

The links between food insecurity and access to health care in a pandemic

Interviews with representatives of Medicaid managed care organizations indicate that the pandemic has highlighted The extent of unmet social needs Confronting a sick population – needs that existed long before the onset of Covid-19. They noted that of all the social determinants of health, food security was the most pressing concern among those covered by Medicaid at the start of the pandemic.

Individuals who had experienced food insecurity prior to the pandemic were more likely to forgo health care, a trend that has continued during the pandemic, when overall rates of lost care were a constant concern. one studyFor example, it was found that adults who reported food insecurity were more likely to forgo medical care, while Another study It found that delays in pediatric visits due to Covid-19 were higher in homes where children He didn’t have enough to eat.

Evidence of hardship continues into 2022 for low-income families. Use data from the Household Pulse Survey Census In July and August In 2022, we found that 30% of Medicaid respondents sometimes or often reported not having enough food—officially known as food shortages—and that 52% reported using SNAP (see chart below). These results are expected, because people covered by Medicaid have lower incomes and are more likely to participate in SNAP. What these data confirm is that many individuals would be affected by the simultaneous decline in benefits from both programs.

Given the interdependence between health and food security and the inevitable reversal of expansions to Medicaid and SNAP when the public health emergency is over, actions by healthcare organizations, advocates, agencies and policy makers are absolutely essential.

Actions for healthcare organizations

  • Increase processing capacity Health-related social needs It is the right place to start. For example, health care organizations must maintain external Active Partnerships With community organizations to meet health-related social needs. This is especially important to quickly adapt to emergencies such as Covid-19. Donald Berwick, former director of Medicaid Centers and Medicare Services, and it has been suggested That healthcare organizations invest in teams dedicated to addressing social health-related needs, including food security.
  • Healthcare systems collect and store rich health data. Through actions such as integrating food insecurity Screening questions And the Referrals In electronic health record and health outcome tracking systems, health care systems can generate Implementation of science studies and case studies which provide evidence of workflows that promote enrollment in social safety net programmes.

Actions for Community Organizations and State Agencies

  • Medicaid Agencies Can Accredit Many best practicesincluding simplifying the process for associates, reducing the burden on frontline staff, conducting outreach to update contact information, and facilitating the transition to other coverage.
  • SNAP state agencies must request three-month grace period waivers from SNAP for healthy adults without dependents as soon as possible. 60 days notice It is given from the end of a public health emergency, because The USDA recommends Submit a waiver request 60 days before the execution date.
  • Medicaid agencies should embrace CMS Status Option To automatically renew Medicaid coverage for participants under age 65 who receive SNAP. Since nearly all SNAP participants are eligible for Medicaid, this will reduce administrative burdens for state and local agencies and will prevent participants from temporarily losing coverage during the redetermination process.
  • The 12 states That did not do so should expand Medicaid. Increases in Medicaid enrollment have been associated with the expansion of Medicaid under the Affordable Care Act With reduced food insecurity in California.
  • Community organizations and state agencies must have Resources are ready For families who have improved their income and are no longer eligible for SNAP or Medicaid but are still food insecure.

Actions for policy makers

There is much that policy makers can do to help reduce food insecurity after the public health emergency is lifted. They can simplify access to Medicaid and SNAP; SNAP benefits increase so they Cover the cost of a healthy diet; SNAP time limit removed from three months For healthy adults without dependents at the federal level; improve access to SNAP by low-income college students who are not eligible for benefits; and support SNAP management with automated disaster response and increased funding.

aWhen the public health emergency ends, the United States must be prepared to ensure that it does not jeopardize the health and nutritional needs of families across the country. Urgent action by health care systems, community organizations, and all levels of government will be necessary to stabilize health and food security among those most at risk. While vaccines and treatments reduce the life-altering risk of Covid-19, it is important not to lose sight of the imminent risk to health posed by the expiration of effective Medicaid and SNAP expansions.

Alison Maria Lakow is a nutrition and policy researcher at the Center for Food Research and Action in Washington, DC. Alison Bovell-Amon is director of policy and communications at the Children’s Health Observatory at Boston Medical Center, where Richard Sheward is director of system implementation strategies.

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