The voices of Urban Institute's researchers and staff
October 8, 2014

Food and medical benefits don’t reach many eligible families in need

October 8, 2014

Evidence shows that public benefits for food and medical needs can lift families out of poverty and support their ability to get and keep jobs, but only if assistance gets to those in need. In five states alone—Colorado, Idaho, Illinois, North Carolina, and South Carolina—over 1.1 million people eligible for food and medical assistance were not receiving these benefits in 2011.

My coauthors—Victoria Lynch, Laura Wheaton, and Erika Huber—and I recently measured the percentage of eligible non-elderly people who actually received both food and medical assistance in five states in 2011 (the most recent data available at the time of this research). These five states are part of the Work Support Strategies project, which aims to improve the well-being of low-income families by helping more people get and keep the benefits for which they are eligible. We estimated joint participation in Supplemental Nutrition Assistance Program (SNAP, formerly food stamps) and Medicaid/Children’s Health Insurance Program (CHIP), two programs available only to individuals with low incomes. Ours are the first estimates of the joint participation rate that we are aware of.

The chart below shows the range of findings for each state based on two methods. The lower estimate (for example, 61 percent for Colorado) is the share of all nonelderly eligible people who participate in both programs. The higher estimate (71 percent in Colorado) only includes as eligible those who are uninsured or already have Medicaid/CHIP, because they are more likely to participate than those who already have other insurance coverage.

JointPar

While some individuals may actively choose not to participate in SNAP and CHIP, many are unaware that they are eligible, find it too hard to navigate program bureaucracies (especially redundant requirements across programs), or even find it hard to apply while holding down a job. The figures above suggest there is room for improvement.

The five states in our study are taking action on this problem through Work Support Strategies. In this multi-year initiative, states are designing and testing ways to deliver these benefits more effectively and efficiently.

Recognizing the potential barriers to benefit receipt in their own eligibility systems, these states (and Rhode Island, data not shown) are increasing coordination of eligibility processes and policies across programs, simplifying and more efficiently using technology in eligibility systems, and reducing bureaucratic barriers to receipt.

With the implementation of health reform and Medicaid expansion in many states, joint eligibility for food and medical assistance is growing, especially for adults. As our country tries to address the hardships of low-income families through these benefit programs, we need to make sure that eligible people are able to participate with the least burden for individuals and states. The efforts of the states in the Work Support Strategies initiative are an important place to look for answers as we try to assist low-income families in need.

SHARE THIS PAGE

As an organization, the Urban Institute does not take positions on issues. Experts are independent and empowered to share their evidence-based views and recommendations shaped by research.