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SNAP proposal for tougher work requirements likely bad for public health


Public health experts said the Trump administration’s proposal on Thursday to expand work requirements for Supplemental Nutritional Assistance Programs beneficiaries would exacerbate food insecurity’s negative impact on health.

“From a health perspective, I am concerned that people who have medical conditions, who have food insecurity and have some social condition that prevents them from working would become more food insecure,” said Dr. Georges Benjamin, executive director of the American Public Health Association.

Current rules require able-bodied adults between the ages of 18 and 49 without dependents to document they have worked at least 20 hours a week or participated in a job training program to continue to receive benefits. Those unable to do so can receive up to three months of benefits every 36-month period.

But states have the option to waive those requirements in areas where the unemployment rate is either 10% or higher or is shown to have a lack of sufficient jobs, which is currently defined as an area where the unemployment rate is 20% above the national average.

The proposed rule released Thursday would limit the maximum time of a state’s waiver from two years to one, make it harder for a state to claim a statewide waiver, only allowing waivers in areas where the unemployment rate of the state or country was 7% or above.

Also proposed is an elimination of states’ ability to “bank” benefit exemptions. Current law allows states to grant exemptions from work requirements for up to 15% of their populations without a waiver. If an exemption is not used in a given year, states can accumulate exemptions for use at a later period.

According to a fact sheet released by the Department of Agriculture, up to 2.8 million SNAP beneficiaries are not working. The agency estimates the rule change would eliminate as many as 775,000 current beneficiaries from the program and reduce SNAP spending by $7.9 billion from 2020 to 2024.

“Americans are generous people who believe it is their responsibility to help their fellow citizens when they encounter a difficult stretch,” said Sonny Perdue, secretary of the USDA. “That is the commitment behind SNAP. But like other federal welfare programs, it was never intended to be a way of life.”

Benjamin, of the American Public Health Association, disagreed with Perdue’s claims, saying the proposed rule would disproportionately affect minority communities where unemployment remained relatively high despite being low nationally.

“While they tout the unemployment as a rationale for rationing this down, we’re concerned this could exacerbate the health disparities,” Benjamin said.

Benjamin shares concerns expressed by a number of healthcare providers and experts that threats of cuts to SNAP and other social assistance programs proposed by Republican lawmakers and the White House over the past two years would drive up healthcare costs and make it more difficult to help patients manage their health chronic conditions.

A 2015 study published in the Canadian Medical Association Journal found healthcare costs for food-insecure households were more than twice as high as households that were food secure.

A 2017 USDA study found lower food security was associated with a higher risk for developing or exacerbating a number of chronic health conditions, including hypertension, heart disease, stroke, cancer, asthma, diabetes, arthritis, chronic obstructive pulmonary disease and kidney disease.

“The idea that has always bothered me is that the SNAP discussion becomes a money discussion, but the basic health discussion in our country is about feeding people,” said Randy Oostra, CEO of northwest Ohio-based ProMedica back in April. The health system has been among several over the past decade at the forefront of raising awareness of the important role food security plays in promoting better health.