At last count, the Supplemental Nutrition Assistance Program (SNAP) delivered cash-like benefits for buying food to 42 million lower-income people per month, about 12 percent of the country’s residents. Started in 1964 as part of Lyndon Johnson’s Great Society effort, SNAP is the largest anti-hunger program in the U.S.

But what many lawmakers, journalists, and Americans fail to recognize is that SNAP is also a hugely successful public health operation. “SNAP has functioned to dramatically reduce food insecurity in this country,” said LDI Senior Fellow Christina Roberto, Professor of Medical Ethics and Health Policy at Penn’s Perelman School of Medicine. Improving food security contributes to health improvements, research shows.

Despite the program’s advantages, the One Big Beautiful Bill Act (OBBBA) passed by Congress this July reduces SNAP availability and, will likely increase food insecurity “by a substantial amount,” said LDI Senior Fellow Aaron Richterman, Assistant Professor of Infectious Disease at Perelman. Tens of thousands of recipients will likely die over the next 14 years, his work predicts.

Severe, albeit temporary, cuts have come sooner than expected with the government’s withholding of SNAP payments starting Nov. 1. Two federal judges ordered the administration to make the benefits available. But that didn’t occur by Nov. 1, causing long lines to form at food pantries and drive-throughs across the nation. It remains unclear how long it will take for SNAP payments to resume.

Once the shutdown ends, the OBBBA changes can go into effect. Here’s how those cuts may affect the health of Americans—and how some changes might minimize the damage.

Food insecurity’s deep effects on health

“Food insecurity is a lack of stable access to food. It’s characterized by worry about food. You don’t know where your next meal will come from,” explained Richterman. The experience of food insecurity affects people’s health via several pathways, starting with poor nutrition. “If people do not have enough to eat, eat mostly low-quality foods, and/or oscillate between having sufficient and insufficient nourishment depending on the time of month, that can affect their nutrition,” Richterman said.  

Lower levels of food security are linked to a higher risk of premature death and a shorter life expectancy, research shows.

Basic care can become a problem. “If you are having trouble accessing food for your family, then you might not be as focused on your health, which might mean you don’t take your medications or visit physicians,” said LDI Senior Fellow Sameed Khatana, Assistant Professor of Cardiology at Perelman. “The stress of not having enough resources, for example due to inadequate access to food, has been linked to cardiovascular disease and other conditions.”

Alternatively, relieving food insecurity via SNAP has been shown to boost the health of beneficiaries. Compared to non-funded peers, SNAP participants experience lower incidences of new HIV infections and higher self-reported health. The SNAP program has been associated with a slower increase in diabetes prevalence. Adults on SNAP also have lower healthcare spending and may live longer.

New work requirements for SNAP

Enacted on July 4 2025, the OBBBA reduces expenditures on SNAP by $187 billion through 2034, according to estimates from the Congressional Budget Office (CBO). The first cut, scheduled to start November 1, tightens up work requirements for able-bodied people without dependents. Pre-OBBBA, SNAP participants over 54 years old were exempt from the requirements; that age has now been raised to 65. Also, for the first time, parents with children 14 and older are subject to the restrictions.

Work requirements increase the administrative burden on applicants, making them fill out forms, produce documents, and appear at appointments during working hours. The change may be especially hard for parents of older children with chronic diseases. “Caring for a child with a chronic condition can require attending a lot of doctors’ appointments, bringing them to the hospital or clinic frequently. And so it can be difficult for their parents or caregivers to maintain consistent employment,” said LDI Senior Fellow Aditi Vasan, Assistant Professor of Pediatrics at Perelman.

The CBO estimates that work requirements will reduce the number of SNAP beneficiaries by 2.4 million, or nearly six percent, in an average month. “There is strong evidence that work requirements don’t achieve their stated goal of increasing labor force participation,” Richterman said. “Most SNAP beneficiaries work, and those who don’t often have a strong enough reason not to (like  caring for a sick family member) that a work requirement only leads to them losing the benefit. And even for people who are working, the additional red tape leads to a predictable and significant decrease in participation.” 

SNAP costs shifted to states

In a significant change to SNAP, the federal government will shift some costs of the program to individual states. “The states and the federal government have always shared the costs of administering SNAP 50-50, but starting in FY2027, the states will pay 75% and the U.S. government 25%,” said Roberto. In addition, beginning in FY2028 (with many qualifications), the federal government will no longer pay 100% of SNAP benefits. “States are going to have to pay a certain percentage of those benefits based on the SNAP payment error rate,” Roberto added.

How states will react is uncertain. Some “will maintain current benefits and eligibility; others will modify benefits or eligibility or leave the program altogether,” concluded an August report from the CBO.

The combined effects of work requirements and other ways of reducing enrollment are predicted to increase premature mortality in the U.S. Using a figure of 3.2 million beneficiaries losing benefits, Khatana and Nicholas Illenberger from NYU estimated that  93,000 Americans would die early between now and 2039 because of SNAP cuts.

SNAP benefits will get smaller

A common complaint among SNAP recipients is that they do not receive enough money to cover their meals, according to a 2024 Pediatrics article coauthored by Vasan. “About half of SNAP households experience food insecurity at some time in the year,” Richterman said.

For this reason, many LDI experts consulted believe SNAP benefits should be raised, not reduced. However, changes to the way benefits are calculated in the Thrifty Food Plan are estimated to lower payments beginning in 2027. “By 2034, the policy change is estimated to reduce the average monthly benefit by $14,” noted the CBO. 

The U.S. no longer measures food insecurity

The true impact of SNAP cuts will not be known because in September, the Trump administration announced that it is terminating the Household Food Security Report, which, for 30 years, has tracked household food insecurity in the U.S. This high-quality survey “is second to none among our peer countries,” Richterman said. “Understanding the prevalence of food insecurity allows you to know what kinds of policies are going to be useful to prevent that. Not measuring the problem is not going to make it go away—it will just make us blind to the situation.”

It is unlikely that a private sector organization could create replacement figures. “You’re talking about tens of thousands of people being surveyed on a rolling basis. It’s the kind of thing that’s best implemented by government agencies,” Richterman said.

Can charities fill the gap?

“A lot of food banks and food pantries are trying to do what they can to prepare for the increased demand that is going to happen with SNAP cuts, said Vasan, “but they cannot provide the long-term population support that comes from programs like SNAP. A commonly cited statistic, according to the New York Times, is that food pantries supply one meal for every nine covered by SNAP.

“It is extremely sad that a country as wealthy as the U.S. relies so much on a charitable food system to supply the nourishment and food that people need,” Roberto said.

Reducing bureaucratic burdens

“If state and local governments and health systems can make it easier for people to navigate administrative requirements, that would make a big difference in mitigating the degree to which the new SNAP policies lead to loss of benefits,” said Vasan. An example is adjunctive eligibility, where qualifying  for one program like Medicaid automatically enrolls a person in another like SNAP without completing another application. In Pennsylvania, for instance, a website called Compass allows people to enroll in several social programs at once.   

In addition, “states could use data they already have from families who file tax returns to enroll or re-enroll families who participate in SNAP,” Vasan said.

Health systems can also act as navigators. “In clinical settings at CHOP, we ask families if they’re worried about having enough food and ask them if they’d like to be connected to food resources such as food banks or food pantries,” Vasan said. She believes that more clinicians are screening for food insecurity because they recognize its health impacts. “The support part is really critical—you want a clear plan for connecting folks who screen positive with available and appropriate resources,” she said.  

A short-sighted strategy?

Not recognizing the positive effects of SNAP on the health of Americans comes at a price. “By failing to take the health benefits of SNAP into calculation, policymakers are not including the health-related costs that will come with cutting the program, perhaps by adding to states’ Medicaid expenditures,” Richterman said.

---

Author

---