In an Oct. 17 Penn LDI virtual seminar on national food policy, three top experts mapped an evidence-based path from rhetoric to results, urging mandatory sodium reduction, simple front-of-package warnings, and revenue-raising soda taxes at the same time they warned that SNAP cost shifts and new restrictions could deepen hunger and stigma unless paired with stronger benefits, fresh food incentives, and school meal investments that push menus toward minimally processed foods for the nation’s children.

Moderated by LDI Executive Director Rachel M. Werner, MD, PhD, the event featured researchers with long experience in the topic area: Aviva Musicus, ScD, Science Director of the Center for Science in the Public Interest; Christina Roberto, PhD, Associate Professor at the Perelman School of Medicine and Director of the Penn Psychology of Eating and Consumer Health Lab (PEACH Lab); and Lynn Silver, MD, MPH, Director of the Prevention Policy Group at the Public Health Institute.

Moderator Werner emphasized how complex the food policy issue is. “There are many ways in which policy can shape what people consume, including nutrition assistance through programs like SNAP, tax policies affecting food pricing and access, and regulations targeting nutritional quality and marketing of food products. Adding to the complication, food and nutrition policies are developed and implemented at multiple levels of government and influenced by a diverse set of actors, including federal agencies like Health and Human Services (HHS), industry stakeholders, public health advocates, and consumers themselves.”

The discussion spanned an array of food policy topics from federal dietary guidelines, soda taxes, and ultra-processed school lunches to food labeling, industry deregulation, and food-chemical safety. But the overall emphasis was on the dramatic changes now occurring in the Supplemental Nutrition Assistance Program (SNAP).

Cutbacks and Deregulation

Backgrounding the Penn event were the many changes the Trump Administration has made to federal food and nutrition policy. It shifted toward deregulation and cost-cutting. The U.S. Department of Agriculture (USDA) rolled back key school meal rules, easing limits on sodium, flavored milk, and whole grains. SNAP rules tightened as states gained more power to restrict certain purchases, while overall federal oversight by the Food and Drug Administration (FDA) eased. Although the 2018 Farm Bill kept nutrition funding largely intact, the administration pushed to reduce federal costs and shift more financial responsibility to states. Local food procurement programs also faced cuts.

In early September, Health and Human Services Secretary Robert F. Kennedy Jr. issued the “Make Our Children Healthy Again Strategy” report detailing more than 120 federal initiatives across research, policy, and public engagement theoretically aimed at realigning government systems toward ending childhood chronic disease.

Roberto expressed surprise. “I remember when the Biden Administration put out a health, hunger, and nutrition report and when I read it, I was crestfallen because it wasn’t pushing the envelope,” she said. “But when I picked up this MAHA report, the narrative and language and list of goals were solid. It’s not like I think this stuff is going to happen, but I have to say it is a list of things that I would have made. It included big changes that we almost never see in this conversation about government food programs, school lunches, and minimally processed foods. I don’t buy into Kennedy’s vision on vaccines, but I do buy a lot into his vision of removing ultra-processed foods.”

Big Food at Mar-a-Lago

Silver was less impressed. “It’s really great that Kennedy is talking about healthy food in a way that hasn’t been discussed before,” she said. “But when Big Food heads to Mar-a-Lago and pulls out their checkbooks, what’s actually going to happen?”

Musicus focused on the contradiction that the Kennedy MAHA blueprint of goals is out of sync with the administration’s broader policies.

“We’re generally seeing a disconnect between what the federal government says and what they actually do,” she said. “This administration has said that ‘we need to address chronic disease. We need to fix our broken food system. We need to make America healthy.’ But what we’re seeing them do in real time is dismantle public health infrastructure and fire tens of thousands of federal workers who are in charge of keeping us safe and healthy. We also saw Congress defund SNAP and Medicaid, and all these actions are poised to make America sicker and hungrier. That’s the backdrop against which we’re talking about the government’s list of strategies to end childhood chronic disease — there’s a lot of cognitive dissonance here.”

No Mention of Sodium

“There were also things missing in the report that surprised me because they are so important to preventing childhood chronic diseases,” Musicus continued. “There is no mention of sodium. Added sugar is mentioned only once. The report is also missing policy action to address alcohol and tobacco use, which we know are responsible for a lot of chronic disease in this country and their use often starts in adolescence. Also absent were strategies to address health inequities or social determinants of health, which we know matter a lot for health.”

Administered by the U.S. Department of Agriculture, SNAP is the largest federal food assistance program in the United States. It provides monthly benefits on an electronic benefits transfer (EBT) card, which recipients use like a debit card to buy food at grocery stores, farmers markets, and other authorized retailers.

According to the USDA Economic Research Service, 41.7 million people — or 12.3 percent of the U.S. population — receive SNAP food assistance benefits. Thirty-nine percent of those are children; 42 percent are adults ages 18-59; and 19 percent are adults 60 and older.

SNAP is designed to reduce hunger and improve nutrition for low-income individuals and families. Eligibility is based on household income, expenses, and size. It abids by a mantra long championed by the Centers for Disease Control and Prevention (CDC): “People with healthy eating patterns live longer and are at lower risk for serious health problems such as heart disease, type 2 diabetes, and obesity.”

Shifting Financial Burden to States

“It is very clear that the SNAP program has tremendous health and society benefits,” said Roberto. “There are two changes in the (One Big Beautiful Bill Act) that impact that: First, the federal government and the states have pretty much shared the administrative costs of SNAP 50/50 but now the states have to pay 75%, and that puts a real financial burden on them. Second, the federal government has borne 100% of the benefit payments made to recipients but now the states will have to pick up part of those benefit payments according to their state’s ‘payment error rate.’”

(The payment error rate is an arcane calculation derived from a USDA audit determining the share of SNAP benefits a state overpays or underpays each year. The average rate throughout the states is around 8% to 12%.)

“If your payment error rate is between 6% and 8% suddenly your state has to cover 5% of benefit payments,” continued Roberto. “If the rate is 10%, the state has to cover 10% of benefit payments. And if it’s over 10%, the state will pay 15% of benefit payments. To fully understand what this means, consider California, which is sitting at about a 15% error rate. They are going to have to pony up about $2 billion to cover their new share of the benefit payments. So, there is concern that some states may consider shutting their SNAP programs. Or they may make it much harder to enroll in SNAP. This is going to really reduce the number of people who will be getting this really incredible government safety net program.”

State Waivers for SNAP Restrictions

Along with its reductions in financial support for the program, the Trump Administration approved waivers in 12 states allowing them to prohibit the use of SNAP benefits to purchase sugary soda or candy. It encourages the rest of the states to seek the same waivers.

Silver explained that she “supported the proposals to not allow SNAP dollars to be used for sugary drinks. Right now, the federal government spends far more subsidizing Pepsi and Coke through SNAP dollars than we do in the whole National Public Health and Prevention Fund (PPHF).” (Part of the Affordable Care Act, the PPHF is a mandated funding mechanism to provide expanded and sustained national investment in prevention and public health programs.)

Musicus noted that she was concerned that there have been no studies of what happens when you restrict soda and candy from SNAP purchases. “Ideally, we would use evidence-based policy to see what the science says and then advocate for policies with a strong evidence base,” she said. “These waivers now being put into place are not going through studies and evaluations. Are such restrictions going to increase stigma around SNAP participants? Are people going to drop off SNAP because they don’t feel good going into a grocery store? Is it going to affect purchasing at all? All of these are questions that require research.”

$10 Billion for Coke and Pepsi

Roberto said, “I don’t need evidence on this one. Every year about $10 billion is going from the federal government essentially to Coke and Pepsi. That same government has said soda is bad and unhealthy and we need to restrict it from SNAP. I ask what doors does that open for other policies? Now we have a precedent and maybe we can do more with it. That’s the big reason I favor the restriction.”

As the session wrapped up, Werner asked the three panelists to share the single recommendation they would give HHS Secretary Kennedy to best advance the goal of making America healthier.

Silver: “Adopt an overarching strategy that is a global commitment to push our food supply to fresh and minimally processed foods, using every lever we have — subsidies, taxes, procurement, education, or labeling. Let’s harness our very powerful government and private forces to promote and make economically viable, beautiful, delicious, healthy, fresh foods that people want to eat in ways that they can afford.”

Musicus: “Think in terms of low-hanging fruit that we could jump on right now with fiscal policies. If you decrease the price of a food, we know that people will buy more of it. If you increase the cost, people are going to buy less of it. We should make healthy food so much more affordable and unhealthy food so much less affordable. The strategy may not be that easy, but it’s easier than systemic change.”

Roberto: “Fundamentally change the school lunch program because it touches the majority of kids in the country. Really focus on getting minimally processed, healthy, nutritious, good-tasting food into schools along with the infrastructure and money needed to achieve that. Really reduce the exposure to ultra-processed junk foods that is coming through our schools. That will help shape healthier habits for an entire generation.”

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