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Tougher SNAP rules worry providers
Healthcare providers do more to fight hunger, but efforts could be hindered by funding cuts

Friday, April 13, 2018
Modern Healthcare
by Steven Ross Johnson

Providers are condemning the farm bill draft released Thursday, saying proposed changes to food stamps would leave millions hungry and result in much higher future healthcare costs.

A House Republican provision included in the bill would toughen work requirements for the Supplemental Nutritional Assistance Program, requiring those signing up to be employed or attend job training for at least 20 hours a week. Beneficiaries who don't meet those requirements would lose benefits for up to year for the first violation and up to three years for a second.

"We believe breaking this poverty cycle is very important," House Agriculture Committee Chairman Rep. Michael Conaway (R-Texas)said in a briefing with reporters on Thursday.

Providers too, believe it's important to address hunger.

Dr. Jay Shannon, CEO of Cook County Health and Hospital Systems in Chicago favored approaches that encourage beneficiaries to find work and lift them out of poverty. Since 2015 Cook County Health has collaborated with local food charities to periodically distribute fresh produce to patients who visit their outpatient health clinics. But he felt the SNAP changes are just meant to drop the costs of the program.

"I don't disagree with the motivation to grow the economy and grow the economic potential for individuals such that they don't need to depend on supplemental nutrition or Medicaid," Shannon said. "But it's harder to join the workforce if you're unhealthy, and it's harder to be in good health if you're hungry."

Food insecurity has been associated with a higher likelihood of developing hypertension, heart disease, hepatitis, stroke, cancer, asthma, diabetes, arthritis, chronic obstructive pulmonary disease and kidney disease. It's also one of several social determinants of health that a growing number of healthcare organizations, along with the CMS, have sought to address.

More than 40 million Americans receive food stamps. The program has been linked with improved health outcomes among low-income households. On average, adults participating in SNAP have around $1,400 less in medical care costs a year when compared to low-income adult non-beneficiaries, according to the left-leaning think tank Center on Budget and Policy Priorities.

Under current program rules, able-bodied adults with no dependents between the ages of 18 and 49 must work or engage in job training for 20 hours a week within three months after receiving benefits. The new proposal would enforce work requirements on adults up to age 59, and include parents of children over the age of 6. They would have to begin work or job training within one month of receiving benefits. The new rules would go into effect by 2021, increasing the workweek requirement to 25 hours in 2026.

"While immediate savings may seem beneficial now, they will evaporate quickly when the nation gets the bill for poor health and nutrition, John Auerbach, president and CEO for Trust for America's Health, said in a written statement.

The proposed changes to SNAP's work requirements are the latest effort this week by Republicans to cut the supplemental program. On Tuesday President Donald Trump signed an executive order to have federal agencies review welfare programs in order to establish or toughen work requirements.

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