How Safety Net Programs Work Together To Improve Health
By Joseph Benitez, PhD
March 15, 2022
Joseph Benitez is a health services researcher, health economist and assistant professor in the Department of Health Management and Policy at the University of Kentucky. His research interests include the impacts of public policy changes on the medically underserved, Medicaid policy and the role of Medicaid as a safety net program. Joseph is a member of the 2022 Tradeoffs Research Council.
States run several different safety net programs to provide food, income support and health care to low-income people. Many people need help with all three areas and qualify for more than one program, but little is known about how different elements of the safety net interact. Does being in one program make it more likely someone will take advantage of another? Does receiving benefits in one make it harder to get help from another?
In a recent research summary in the NBER Reporter, researchers Lucie Schmidt, Lara Shore-Sheppard and Tara Watson pull together key findings from multiple studies they’ve done on the interactions among the Supplemental Nutritional Assistance Program (SNAP, formerly known as food stamps), Temporary Assistance for Needy Families (TANF, a cash assistance program), Supplemental Security Income and Social Security Disability Insurance (SSI and SSDI, income support for people with disabilities), Earned Income Tax Credit and Additional Child Tax Credit (EITC and AITC) and Medicaid.
One really cool way the authors assessed these overlapping programs was by creating a multi-program benefits calculator. This allowed them to estimate the total value of the benefits associated with the combined programs and investigate how they jointly affected the welfare of low-income households. Using this calculator across several studies, they found that households with more benefits have less financial insecurity and psychological distress.
For example, among non-immigrant, low-income single-parent families, $1,000 more cash and food benefits reduced food insecurity by 1.1 percentage points. Another study found $1.000 in additional benefits were also associated with lower psychological distress among single mothers, as were tax credits like the EITC and AITC. The authors also found that expansions in Medicaid were associated with higher take-up of SNAP benefits.
These findings have important implications for state policymakers and those administering these programs. First, households benefit more from the safety net when they can benefit from more programs. The authors argue streamlining or integrating enrollment processes could mitigate the strain imposed on low-income families to apply to all or choose between different programs. Doing this could allow for a more robust and responsive safety net capable of ensuring low-income families’ needs are met during difficult periods.
These studies also show that policy changes to one program can impact the use of others and that the entire safety net has measurable impacts on people’s health — an important consideration for policymakers aiming to improve health and well-being by acting on the social determinants of health.