Do the potential public-health benefits of such intervention outweigh the costs associated with implementation?
By Dwyer Gunn
(Photo: Spencer Platt/Getty Images)
Last week, the House Committee on Agriculture held a hearing reviewing the benefits, drawbacks, and feasibility of further restricting purchases made by recipients of the Supplemental Nutritional Assistance Program. The program already forbids recipients to use their SNAP benefits to purchase alcohol, tobacco, and hot foods (i.e. rotisserie chickens), among other things, but a number of policymakers and public-health experts have argued that the program should also restrict purchases of unhealthy foods — soft drinks, candy, and the like.
The hearing was prompted, at least in part, by a study conducted last year by the United States Department of Agriculture on how SNAP recipients spend their benefits. The study found that recipients of the Supplemental Nutritional Assistance Program spend approximately 40 cents of every dollar on “basic items like meat, fruits, vegetables, milk, eggs, and bread,” another 40 cents on items such as “cereal, prepared foods, other dairy products, rice, beans, and other cooking ingredients.” The remaining 20 cents of every dollar are spent on “sweetened drinks, desserts, salty snacks, candy, and sugar.”
Though the study participants’ spending habits registered as roughly consistent with that of their non-SNAP peers, it nonetheless provoked criticism of the food stamp program. One particularly scathing critique came from Marion Nestle, a public-health professor at New York University, who described SNAP to the New York Times as “a multibillion-dollar taxpayer subsidy of the soda industry.” The Times story went on to discuss the ongoing debate over whether SNAP recipients should be prohibited from using their benefits to buy unhealthy foods:
For years, dozens of cities, states and medical groups have urged changes to SNAP, or the Supplemental Nutrition Assistance Program, to help improve nutrition among the 43 million poorest Americans who receive food stamps. Specifically, they have called for restrictions so that food stamps cannot be used to buy junk food or sugary soft drinks.
But the food and beverage industries have spent millions opposing such measures, and the U.S.D.A. has denied every request, saying that selectively banning certain foods would be unfair to food stamp users and create too much red tape.
As the Times article indicates, this topic is surprisingly controversial. Some liberals argue in favor of restrictions — in 2013, a group of 18 U.S. mayors, almost all of them Democrats, wrote a letter to Congress urging it to consider testing limits to SNAP benefits — while others argue it’s unfair to single out SNAP recipients. Conversely, some conservatives favor restrictions on the grounds that government funds should not be subsidizing the purchase of soda or candy, while others are opposed to the regulation and market interference such restrictions would require.
There is, as Angela Rachidi, a research fellow at the American Enterprise Institute, a conservative think tank, pointed out in her testimony last week, some evidence to suggest that restrictions might, in fact, reduce the consumption of sugary beverages and foods.In a 2016 paper published in JAMA Internal Medicine, researchers described an experiment in which low-income adults (not SNAP recipients) were given several different types of food benefits: unrestricted food benefits (which could be used to purchase anything), restricted food benefits (which could not be used for the purchase of unhealthy foods), incentivized food benefits (which offered bonuses to participants who bought healthy foods), or benefits that were both restricted and incentivized. The researchers found that participants in the incentive-plus-restrictions category did, in fact, purchase slightly lower amounts of sugar-sweetened beverages or other sugary goods.
But not everyone is convinced that restricting benefits will actually change consumers buying habits. The average SNAP benefit is modest — about $4.50 per person, per day — so most users supplement their food purchases with their own incomes. So how might further restrictions on SNAP benefits affect recipients? Here’s Northwestern University professor Diane Schanzenbach’s prediction, from last week’s hearing:
What will happen if soft drink purchases are banned using SNAP benefits? Take a typical family that spends the average amount — $12 per month — on soft drinks, and supplements their SNAP spending with spending out of cash resources. Our best prediction is that there will be no consumption change as a result of the SNAP restriction; such a family can continue to purchase the same basket of goods, but they would have to make certain to pay for the soft drinks out of their own cash instead of their SNAP benefits. In other words, a ban will likely increase the administrative costs of the program to both the USDA and retailers, and increase the stigma faced by recipients when they use the benefits, but not have the benefit of inducing any behavioral changes.
As Schanzenbach notes, implementing SNAP restrictions on sweetened beverages or other sugary foods likely wouldn’t be a simple process. There are approximately 20,000 new food products introduced in this country every year — all of these would have to be evaluated by the USDA to determine eligibility. Nor is determining eligibility necessarily a straightforward proposition. Some granola bars, for example, have more sugar per serving than candy — should those foods be restricted? What about juice, specialty carbonated beverages, or flavored waters or sports drinks with small amounts of added sugar?
At this point, researchers don’t know if the potential public-health benefits of such a policy would outweigh the costs associated with implementation, and suggestions for a small pilot program testing such restrictions are not without merit. But it’s also worth noting that there are other ways to encourage healthier eating. The USDA’s recent Healthy Incentives Pilot program, for example, which gave SNAP recipients a 30-cent rebate for every dollar spent on fruits and vegetables, increased the consumption of those foods by 25 percent. Brian Wansink, the director of the Cornell University Food and Brand Lab, who also testified at the hearing, suggested a scheme in which SNAP recipients who voluntary chose to “self-restrict” would receive a higher level of benefits. And given that the data clearly indicates that non-SNAP households are also drinking too many sweetened beverages, and eating too many sugary foods, the government might also consider undertaking a large-scale public-education campaign, or placing a tax on sweetened beverages, two strategies that would benefit society more broadly.
Interestingly, given a political climate in which cuts to the safety net seem likely, the assembled experts all agreed on one thing: the effectiveness and and importance of the SNAP program. “I want to state clearly that SNAP is one of the more effective federal safety net programs in the U.S.,” Rachidi said. “A large body of research shows that it reduces poverty, improves food security among low-income households, and has positive effects on infant health and long-term benefits for children who receive it.”
