Title 4 Recommendations

The following recommendations prioritize sustainable fiber-rich foods in nutrition programs.

  1. Create a task force whose mission is to strategically guide implementation and expansion of a nutrition incentives model into SNAP.
  2. Update eligible SNAP-authorized retailer definitions to include more accessible models like mobile markets and health food trucks.
  3. Permanently increase SNAP benefits.
  4. Prioritize a Child Nutrition Reauthorization before the next farm bill.
  5. Increase the value of the WIC cash value benefits for fiber-rich foods.
  6. Remove the option for States and agencies to require a prescription before using WIC dairy vouchers to buy plant-based substitutes like tofu and soy milk.
  7. Consolidate USDA authority over the agency’s nutrition standards and nutrition-education efforts.
  8. Increase overall funding for GusNIP.
  9. Remove Nutrition Incentive Grant match requirements under GusNIP.
  10. Increase proportion of GusNIP funds dedicated to Produce Prescription Programs.
  11. Create task force to research, scale, and integrate Produce Prescription models across food and health care sectors.

Supplemental Nutrition Assistance Program (SNAP)

Congress should permanently increase SNAP benefits. Most SNAP participants use up benefits before the end of the month and can hardly afford to spend what they’re given on nutritious foods.1 In fact, monthly SNAP benefits are estimated to only cover 42-60% of a diet matching the USDA MyPlate recommendations for families and individuals.2 Qualitative data shows that SNAP participants would buy more healthy foods if their benefits were higher.3

AFA also thinks SNAP should include an integrated model to incentivize the purchases of fresh fruits and vegetables. The Healthy Incentives Pilot does just this, giving SNAP users a 30% rebate on select purchases.4 The USDA’s evaluation of Massachusetts’ HIP shows that the program was popular among SNAP participants and increased their consumption of fresh fruits and vegetables by 26%.5 However, the program is considered by many policymakers to be too costly to implement on a national scale.

This is why Congress should establish a task force to strategically guide the implementation and expansion of a nutrition incentives model into SNAP, designed to complement but not replace other federal nutrition incentive programs.

AFA urges skeptical policymakers to consider the potential savings on public health care costs related to diet-related diseases.6 According to a recent GAO report, government spending to treat cardiovascular disease, cancer, and diabetes accounts for roughly $160 billion in health care costs. That’s 54% of the $383.6 billion total government spending on health care costs and more than the entire USDA budget.7 Increasing SNAP benefits and investing in SNAP-integrated nutrition incentivization could significantly offset health care costs for diet-related diseases.8 Policy makers could also consider scaling the model at a lower rebate percentage than HIP’s 30%.

Updating definitions of SNAP retailers could also go far toward increasing nutrition access to SNAP participants. Definitions of retailers eligible for SNAP authorization should explicitly include innovative purchasing and distribution models like mobile markets and health food trucks.

Special Supplemental Nutrition Program for Women, Infants and Children (WIC)

WIC is traditionally covered in Child Nutrition Reauthorizations (CNRs), the last of which was passed in 2010. Congress should prioritize a CNR before the next farm bill and in that CNR should:

  • Increase the value of the WIC cash value benefits for purchasing fiber-rich foods, and;
  • Remove State and agency discretion to require a prescription before using WIC dairy vouchers to buy plant-based substitutes, like tofu and soy milk.

Given that most Americans of color have difficulty digesting dairy compared to white Americans, requiring a prescription to buy soy instead of dairy milk with WIC vouchers is not only a barrier to eating fiber-rich, it’s an undue barrier that white WIC participants will experience less often than other racial and ethnic groups.9

Gus Schumacher Nutrition Incentive Program (GusNIP)

In the next farm bill, Congress should increase overall funding for GusNIP.

Congress should also advise USDA to permanently remove cost matching requirements for Nutrition Incentive Grant applicants, or at least adjust match requirements based on community health risks, project scale, and agency capacity. Though requiring Nutrition Incentive grantees to match funds encourages community-based partnerships while offsetting public costs, it also presents a barrier to under-resourced organizations who might otherwise establish these programs in areas at high risk of diet-related disease. 10

In tandem with increasing overall GusNIP funding, Congress should accelerate research, development, and scalability of the Produce Prescription model by:

  1. Increasing its share of allocated funds. (Currently, Produce Prescription Grants can only receive 10% of GusNIP funds.) 11
  2. Creating a USDA-HHS-led task force whose mission is to identify additional funding streams for Produce Prescription programs (like public health related grants or taxes) and provide strategic guidance toward scale and integration with public and private food and health care sectors, especially Medicare and Medicaid.
  1. https://www.sciencedaily.com/releases/2017/09/170907125642.htm
  2. https://www.jneb.org/article/S1499-4046(17)30762-5/fulltext
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6434592/
  4. https://www.fns.usda.gov/snap/hip
  5. https://www.fns.usda.gov/snap/hip/final-evaluation-report
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5980147/
  7. https://www.gao.gov/products/gao-21-593
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6836787/
  9. https://www.niddk.nih.gov/health-information/digestive-diseases/lactose-intolerance/definition-facts
  10. https://civileats.com/2020/05/14/op-ed-with-food-insecurity-on-the-rise-nutrition-incentives-should-be-more-equitable/
  11. https://www.chlpi.org/wp-content/uploads/2013/12/Produce-RX-March-2021.pdf