This brief presents interim findings from the first cohort of participants in CashRx, a guaranteed income program administered by Bread for the City, which is a federally qualified health center that provides food, clothing, medical care, and legal and social services to low-income residents in Washington, DC. Financial strain is a key social determinant of health, shaping individuals’ access to stable housing, nutritious food, and consistent medical care. A growing body of research suggests that unrestricted cash assistance, like guaranteed income, can help reduce stress, improve material well-being, and support better health outcomes.

Why This Matters

The first cohort of CashRx participants demonstrates how flexible, dignity-centered cash assistance—combined with supportive services—can advance economic outlook and improve well-being among people facing chronic illness and financial instability. These findings underscore the potential of guaranteed income to address key social determinants of health, while also revealing the limits of monetary interventions without structural reform in housing, benefits, and labor policy. 

Key Findings

We observed the following key changes in participants’ social determinants of health and health outcomes over the course of the pilot:

• Physical and mental health outcomes improved. Two participants with diabetes saw clinically significant reductions in A1c levels, attributed to more reliable medication adherence and diet improvement. Every participant described reduced stress and anxiety and a restored “sense of security,” though some reported renewed anxiety as the pilot neared its conclusion.
• Cash helped participants work toward their health goals. Although the pilot program wasn’t originally designed to measure how goal setting influenced results, those participants who articulated clear health or personal goals demonstrated more significant improvements when the cash transfers provided support. In the first cohort, two participants living with diabetes both expressed goals to improve their diabetes management.
• Unrestricted cash is key. Participants used cash payments to cover rent and prevent housing loss, pay for food, and maintain access to essential medications. Participants reported fewer interruptions in food access and greater ability to purchase healthier foods.
• Cash did not eliminate structural barriers. Participants continued to face structural barriers—such as restrictive public benefits eligibility, poor housing conditions, and unstable employment—that unconditional cash could not fully resolve.
• Wraparound services are essential. The combination of financial support and Bread for the City’s medical, legal, and social services strengthened outcomes beyond what cash relief alone might have achieved.

How We Did It

Bread for the City’s Economic Security Team randomly selected 14 current medical patients to receive unconditional monthly payments for 24 months, distributed across three cohorts. Program amounts were tailored to each participant’s circumstances, with the first cohort of five participants receiving $1,100–$1,400 per month from November 2023 to November 2025. Quantitative and qualitative data were collected throughout the pilot, including clinical measures such as hemoglobin A1c values for participants with diabetes and interview-based reports of changes in food security, housing stability, and well-being. Findings are descriptive, not generalizable, and intended to inform future research on guaranteed income as a health intervention.