Ordinarily, state Republican Rep. Dean Kaufert, who introduced the measure in Wisconsin, says he wouldn't support this kind of government intrusion into personal responsibility. But with growing concerns about the cost of the diabetes and obesity epidemics to states, this seems like a logical opportunity to try to reverse that trend. The United States spends $190 billion every year on obesity-related diseases, according to the Harvard School of Public Health, and Kaufert believes there's significant potential for dollars to be saved and lives to be improved with his proposal.
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Studies show that low-income Americans, the population that receives food stamps through the Supplemental Nutrition Assistance Program (SNAP), are more likely to have a poor diet and therefore are at a bigger risk for obesity and its associated medical conditions. Kaufert argues that the state would likely end up covering their medical expenses for these conditions too.
“People are just not eating healthy with taxpayer dollars. These food stamps are supposed to go toward making sure there’s nutritious food in the cupboards for families that are struggling. That was the original intent,” he says. “I don’t want to be big government, big nanny state, but the difference is that these are tax dollars.”
Officials at the South Carolina Department of Health & Environmental Control (DHEC) were thinking the same thing when they introduced a similar proposal this spring. With her department fighting obesity on multiple fronts, DHEC Director Catherine Templeton says it doesn’t make sense for government dollars to essentially subsidize unhealthy behavior.
“When I got here, I wanted to measure three things: what kills the most people, what makes the most people sick, and what, if prevented, would save the state the most money. The answer to all three was obesity,” she says. “I’m not [New York City] Mayor Bloomberg. I don’t want to tell people what they can and cannot do or spend money on or eat. But if you’re going to receive a federal dollar, you ought to buy nutritional things.”
Now they have to convince the U.S. Department of Agriculture (USDA) -- which jointly administers SNAP with the states -- to sign off on the idea. States have to apply for waivers to make changes to their food-stamp programs, and the USDA has so far denied every waiver that sought to do what South Carolina and Wisconsin are proposing.
In finalizing their waivers, South Carolina and Wisconsin are trying to learn from the USDA's denials of those earlier applications, which were deemed too broad or punitive.
Wisconsin's Kaufert -- who plans to enact the plan statewide -- hopes to win approval by creating guidelines rather than outright banning the purchase of certain foods. He's proposed that the state set dollar amounts that must be spent on healthy foods, leaving less money for people to spend on junk food.
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South Carolina, though, is seeking to start with a pilot program. Templeton has suggested using the state’s approved food list for the Women, Infants and Children (WIC) food assistance program -- another state-federal venture that does place restrictions on what foods can and can't be purchased with taxpayer dollars. Whole-grain bread, fruit juices and vegetables are some of the approved items.
Because the USDA has already allowed WIC to adopt an approved-foods list, Templeton says letting states like South Carolina and Wisconsin do the same with SNAP should be a no-brainer.
"Why can't the USDA adopt the WIC framework for everyone?" she says. "It's hypocritical to say it doesn't work. Clearly, it works or they wouldn't do it."
As they develop their plans, part of the problem is that states currently have no way of knowing exactly how many SNAP dollars are going toward unhealthy food. A 2012 Yale study estimated that $2 billion of the $75 billion SNAP money paid for sugary beverages -- a small portion, but that's only one example of the unhealthy foods that people can buy with food stamps.
A bill introduced in the U.S. House could change that. Pennsylvania Rep. Thomas Marino, a Republican, authored the SNAP Transparency Act of 2013, which he submitted at the end of April. It would require the USDA to set up a system to track retail purchases with SNAP dollars. The bill was referred to the House Agriculture Committee and hasn’t gone anywhere since, but its introduction was welcomed by Kaufert and Templeton.
“It’s frustrating that we don’t track it. That would be helpful,” Kaufert says. “We’re just trying to make sure taxpayer dollars are being spent wisely. I don’t think that’s too much to ask.”
Checking Up on Health News
- The Florida legislature failed to expand Medicaid before its session ended, despite the endorsement of Gov. Rick Scott. The Tampa Bay Times tries to quantify the "price" of that decision.
- National Journal draws some interesting parallels between the rollout of Medicare Part D in 2006 and the implementation of the Affordable Care Act (ACA).
- The Sacramento Bee exposed a Nevada mental health hospital for busing patients out of state. Several state workers have been fired, and a federal investigation is underway.
- Stateline asked whether the ACA's health insurance marketplaces would increase competition as promised and came to some interesting conclusions.
- The 'personhood' movement saw some setbacks last year, but Iowa legislators are reviving it there, the Des Moines Register reports.
