The current Republican draft of the 2018 Farm Bill is misguided, mean and fiscally unsound. Although titled as a Farm Bill – a key element this year is a radical reduction in food support for hungry families. Although the bill cuts funding for the Supplemental Nutritional Assistance Program, or SNAP (i.e. food stamps) program, it will actually increase federal spending and debt. Less food support means more hungry families. Hungry people get sick more frequently which drives up medical expenses for all of us.
Historically, the Farm Bill was a bipartisan effort that paired subsidies for farmers with food stamps for the poor. It bridged the urban/rural divide and was generally popular. This year, Republicans want to maintain the status quo on farm subsidies while putting up significant bureaucratic barriers for people seeking SNAP benefits. The new GOP approach creates new work requirements for those receiving SNAP. All parties agree that these new rules will push hundreds of thousands of households off the rolls by significantly increasing the hassle factor of registering for aid, and by breaking the link between SNAP and other safety net programs. This translates into nearly a quarter million poor kids losing access to free lunches at school.
There are already robust rules in place to encourage job-seeking for the able-bodied before they can receive SNAP benefits. If you are an adult without dependents, you already need to work to qualify for access. The new rules simply shrink the number of hungry parents and children who have access to the programs.
Hunger – or “food insecurity,” as it is also known—is a large challenge today. Daily hunger is a reality for about one in seven people in this country. I was shocked to read that half of community college students in Massachusetts were food insecure. Kids who are hungry or worried about where their next meal is coming from are not likely to study and excel in school. Without educational success, they will struggle to get ahead and are more likely to fall into a cycle of poverty.
However, there is a strong rationale for SNAP, even if one is not concerned about the moral or compassionate case for our rich society not permitting people to go hungry; Food insecurity inexorably leads to higher medical costs and lower productivity. The phenomenon is well-documented for children, chronically ill patients, and the elderly. Here are just a few examples:
- A study of hospital visits in California found that low-income patients with diabetes experienced a 27 percent jump in costly and debilitating admissions for hypoglycemia (low blood sugar) during the last week of the month as their food budgets ran out.
- An array of research has demonstrated that children with food insecurity are roughly 1.5 to 3 times as likely as their well-nourished peers to be hospitalized, and to suffer from asthma, anxiety, depression, poor oral health, poor general health and other maladies.
- Seniors who are food insecure have challenges similar to those of children. They are at greatly heightened risk for diabetes, congestive heart failure, depression and to limitations on activities of daily living.
Healthcare providers are becoming aware of the debilitating impact of hunger on their patients. Some are taking steps to directly address this “social determinant of health,” to improve outcomes and reduce medical costs.
In addition to being the right thing to do, with value-based payment models it can also yield a financial return on investment. For example, Geisinger Health has launched a fresh food “Farmacy” to distribute healthy food to Type 2 diabetics and their families. Geisinger has shown “significant improvements in blood sugars, HbA1c, cholesterol and blood pressure control” and claims that the program pays off financially.
Geisinger is far from the only hospital system with such a program; there are examples throughout the country. And despite the ill-conceived Farm Bill, there are signs of hope in Congress. The House Hunger Caucus, which fosters solutions to address hunger, includes several Republicans.
House leadership plans to reintroduce the Farm Bill in late June, after discussion on the immigration bill. It’s time for true patriots to put a pitchfork through the heart of the current draft. Congress should restore or expand access to SNAP before sending the bill for another vote.
There is also room for improvement in the agricultural subsidies portion of the bill to encourage the production of healthier foods…but that’s a topic for another article.