The Implications of Federal SNAP Spending Cuts on Individuals with Medicaid, Medicare and Other Health Coverage – KFF

Report on Food Insecurity, SNAP, and Health Coverage in the United States: Implications for Sustainable Development Goals

Introduction

In the United States, nearly 53 million people across all age groups reside in households experiencing food insecurity, defined as inadequate access to food due to financial or other resource constraints. The Supplemental Nutrition Assistance Program (SNAP), established in 1964, serves as a federal aid initiative aimed at alleviating food insecurity among low-income households by providing monthly benefits to assist with food purchases.

Proposed Federal Budget Cuts and Their Impact

Overview of the One Big Beautiful Bill Act

The GOP’s House and draft Senate budget reconciliation bill, known as the One Big Beautiful Bill Act, is progressing through Congress with provisions to reduce federal spending on SNAP by $287 billion over ten years. While these cuts aim to achieve budgetary savings, they risk increasing food insecurity and deteriorating health outcomes in the long term.

Health Program Spending Reductions

• The bill proposes over $1 trillion in cuts to federal health programs over the next decade.
• Specific reductions include $793 billion from Medicaid and $268 billion from the Affordable Care Act (ACA) Marketplaces.
• The Congressional Budget Office (CBO) projects an increase of 10.9 million uninsured individuals within ten years due to these cuts.

The combined reductions in SNAP and health program funding threaten to deprive many individuals, particularly Medicaid enrollees, of both food assistance and health coverage.

Distribution of SNAP Recipients and Food Insecurity by Health Coverage

Medicaid and SNAP Overlap

1. In 2022, 78% of SNAP recipients (approximately 30 million out of 38.3 million) were enrolled in Medicaid.
2. Among these, 23.3 million were covered solely by Medicaid, while 6.7 million were dual-eligible for both Medicaid and Medicare.
3. Medicaid covered 88% of children receiving SNAP benefits, equating to about 13 million children.

Medicare and Other Coverage

• 9.2 million Medicare beneficiaries received SNAP benefits in 2022, representing 24% of all SNAP recipients.
• Most Medicare beneficiaries on SNAP (18%, or 6.7 million) also had Medicaid coverage.
• Over 500,000 individuals with direct-purchase health insurance (primarily through ACA Marketplaces) received SNAP benefits.
• 2.4 million SNAP recipients were uninsured in 2022.

Implications for Sustainable Development Goals (SDGs)

The significant overlap between Medicaid and SNAP recipients highlights the interconnection between SDG 2 (Zero Hunger) and SDG 3 (Good Health and Well-being). Ensuring access to adequate nutrition and healthcare is critical for achieving these goals.

Potential Consequences of Proposed Eligibility Changes

Risk of Losing Both Food and Health Assistance

Proposed eligibility changes in SNAP and Medicaid may result in some individuals losing access to both adequate food and healthcare services. This risk is heightened by the substantial overlap in eligibility criteria for these programs across states, with 40% of Medicaid enrollees also receiving SNAP benefits compared to only 3% among non-Medicaid individuals.

Public Concern and Economic Impact

• Recent polling by KFF indicates widespread public concern about the consequences of Medicaid funding reductions.
• Half of low-income adults report difficulty affording necessities, including food.
• A CBO analysis estimates that households in the lowest income decile could experience a 4% reduction in resources by 2034 due to changes in Medicaid and SNAP, while the highest income decile may see a 2% increase due to tax cuts.

Food Insecurity Among Program Participants and Non-Participants

Prevalence of Food Insecurity by Coverage Type

1. In 2022, 52.8 million people lived in food-insecure households.
2. Food insecurity rates were 30% among Medicaid enrollees (22.4 million people), 13% among Medicare beneficiaries (8.7 million), 26% among the uninsured, and 12% among those with direct-purchase coverage including ACA Marketplaces.
3. 14.6 million children lived in food-insecure households.

Challenges Facing Vulnerable Households

• Many households experiencing food insecurity may face reductions or loss of SNAP benefits alongside increased healthcare costs due to proposed legislative changes.
• 22.4 million Medicaid enrollees, including 9.3 million children, experienced food insecurity in 2022.
• Nearly 2 million individuals with direct-purchase coverage lived in food-insecure households, with potential premium increases if enhanced premium tax credits expire.
• Approximately half of ACA Marketplace enrollees have incomes below 150% of the federal poverty level ($23,475 for an individual in 2025).

Food Insecurity Among SNAP Participants

Among the 38.3 million SNAP recipients in 2022, 37% (14 million) reported inadequate access to food due to financial constraints, indicating that even program participants face significant challenges.

Implications for SDGs

These findings underscore the urgency of addressing SDG 1 (No Poverty), SDG 2 (Zero Hunger), and SDG 3 (Good Health and Well-being) by protecting and enhancing social safety net programs that support vulnerable populations.

Methodology

Data Source and Analysis

This analysis utilizes data from the U.S. Census Bureau’s 2023 Survey of Income and Program Participation (SIPP), a nationally representative household survey capturing social program participation, income, and labor force data for the non-institutionalized U.S. population.

Coverage Classification

• Health insurance coverage was identified based on possession for at least six months during 2022.
• Individuals were categorized into a single insurance coverage type using the hierarchy: Medicare, Medicaid, Direct Purchase (ACA), Employer-Sponsored Insurance (ESI), Other, Uninsured.
• Dual Medicare and Medicaid enrollees were included in both categories unless otherwise specified.

SNAP and Food Security Measures

• SNAP coverage was defined as receiving benefits for at least one month during 2022.
• Food security was assessed at the household level using the USDA Six-Item Short Form Food Security Survey Module, covering experiences such as:
• Food purchased often or sometimes not lasting due to lack of money.
• Inability to afford balanced meals.
• Cutting or skipping meals because of insufficient food resources.
• Eating less than felt necessary or going hungry due to lack of money for food.

Conclusion

The proposed federal budget cuts to SNAP and health programs pose significant risks to food security and health coverage for millions of Americans, particularly low-income and vulnerable populations. These developments threaten progress toward multiple Sustainable Development Goals, including SDG 1 (No Poverty), SDG 2 (Zero Hunger), and SDG 3 (Good Health and Well-being). Policymakers should carefully consider these implications to ensure that efforts to reduce federal spending do not undermine essential social support systems that promote equitable health and nutrition outcomes.

1. Sustainable Development Goals (SDGs) Addressed or Connected

1. SDG 2: Zero Hunger
   • The article focuses extensively on food insecurity in the United States and the impact of SNAP (Supplemental Nutrition Assistance Program) on alleviating hunger.
2. SDG 3: Good Health and Well-being
   • It discusses health outcomes related to food insecurity and the effects of cuts to Medicaid and health programs on health coverage and health status.
3. SDG 1: No Poverty
   • The article highlights the financial struggles of low-income households, the role of federal assistance programs, and the potential increase in poverty due to budget cuts.

2. Specific Targets Under Those SDGs Identified

1. SDG 2: Zero Hunger
   • Target 2.1: By 2030, end hunger and ensure access by all people to safe, nutritious, and sufficient food all year round.
   • Target 2.2: By 2030, end all forms of malnutrition, including achieving targets set internationally on stunted and wasted children under 5 years of age.
2. SDG 3: Good Health and Well-being
   • Target 3.8: Achieve universal health coverage, including financial risk protection and access to quality essential health-care services.
   • Target 3.4: Reduce premature mortality from non-communicable diseases through prevention and treatment.
3. SDG 1: No Poverty
   • Target 1.2: By 2030, reduce at least by half the proportion of men, women, and children living in poverty in all its dimensions according to national definitions.
   • Target 1.3: Implement nationally appropriate social protection systems and measures for all.

3. Indicators Mentioned or Implied to Measure Progress

1. Indicators for SDG 2 (Zero Hunger)
   • Prevalence of food insecurity in households (measured by the USDA Six-Item Short Form of the Food Security Survey Module).
   • Number of people receiving SNAP benefits.
   • Percentage of children living in food-insecure households.
2. Indicators for SDG 3 (Good Health and Well-being)
   • Number of uninsured individuals (projected increase due to budget cuts).
   • Health outcomes related to food insecurity such as rates of chronic conditions, health care utilization, and medication adherence.
   • Coverage rates under Medicaid and Medicare among SNAP recipients.
3. Indicators for SDG 1 (No Poverty)
   • Household income levels, especially those below federal poverty thresholds.
   • Resource changes in lowest income deciles due to policy changes.
   • Rates of difficulty affording necessities including food among low-income adults.

4. Table of SDGs, Targets, and Indicators

SDGs	Targets	Indicators
SDG 2: Zero Hunger	2.1 End hunger and ensure access to safe, nutritious food. 2.2 End all forms of malnutrition.	Prevalence of food insecurity (USDA Six-Item Short Form). Number of SNAP beneficiaries. Percentage of children in food-insecure households.
SDG 3: Good Health and Well-being	3.8 Achieve universal health coverage. 3.4 Reduce premature mortality from non-communicable diseases.	Number of uninsured individuals. Health outcomes linked to food insecurity (chronic conditions, health care utilization, medication adherence). Medicaid and Medicare coverage rates among SNAP recipients.
SDG 1: No Poverty	1.2 Reduce poverty by half. 1.3 Implement social protection systems.	Household income below poverty thresholds. Resource changes in lowest income deciles. Difficulty affording necessities including food.

Source: kff.org