Report Says Farm Bill Work Rules Will Worsen Food Insecurity

Food insecurity (ie, if a patient suffers from inadequate access to enough healthy food on a regular basis) is one of the markers of social determinants of health (SDOH), which are those nonmedical factors impacting an individual’s overall health and health outcomes that happen outside of a medical setting. Earlier this week, the American College of Physicians called for action on SDOH in order to improve patient care and health outcomes.

But a proposal in the farm bill that passed out of a Congressional committee Wednesday does the opposite and will worsen food insecurity, according to an analysis by a research and policy institute.

The bill’s plan to impose work requirements on those receiving food aid benefits, formerly known as food stamps, is incredibly harsh and will increase hardships for many of those already working, the Center on Budget and Policy Priorities (CBPP) said. In addition, it argued, the plan is not realistic and will be unable to reach its stated goals of acting as a work training program.

The farm bill was approved Wednesday in the House Agriculture Committee along party lines. Committee Chairman Mike Conaway, R-Texas, unveiled the proposal last week. Also that week, President Trump signed an executive order promoting the idea that government assistance programs should require work in exchange for benefits.

The farm bill proposal would require participants receiving aid from the Supplemental Nutrition Assistance Program (SNAP) to prove every month that they are working at least 20 hours a week, participating at least 20 hours a week in a work program, or a combination of the 2. The policy would apply to people aged 18 to 59 years who are not disabled or raising a child younger than 6 years.

The consequences for not meeting the requirements are severe. Individuals who don’t meet these requirements within a month would lose benefits for 1 year the first time and for 3 years for any subsequent occurrence.

Given the structure of low-wage work, CBPP said, it is likely that many workers would lose benefits if they couldn’t provide needed paperwork, if their employer cut their hours below 20 hours per week, or if they were temporarily out of work.

SNAP helps 1 in 8 Americans afford a basic diet, providing about $1.40 worth of food per meal.

The CBPP said the bill would force states to develop large inefficient bureaucracies while doing little to increase employment. In addition, results from work pilots established in the 2014 farm bill are not yet available, so there is no evidence upon which to base this policy.

The American Association of Retired Persons (AARP) agreed, saying in a letter to Conaway last week that the proposal puts older individuals at increased health risks. Like the CBPP, the AARP said that most individuals who receive SNAP are already working. Of those who are not, it is often because they have chronic health conditions, which prevent them from keeping a job.

“Over 1.7 million low-income older workers have a health difficulty,” wrote the AARP. Workers 50 years and older typically take longer than younger workers to find employment after being unemployed.

Denying an individual’s access to SNAP benefits for up to 3 years for not being able to comply with tougher work requirements could increase food insecurity and likely have negative health consequences, the AARP said.

The American Hospital Association last year published a guide about food insecurity and the role of hospitals, pointing out that adults who are food insecure are at a greater risk of developing chronic diseases and that children who are food insecure are at risk for developmental issues.

Studies have also found that adults who are food insecure have higher healthcare utilization costs.