Changing patterns of SNAP take‐up and participation and the role of out‐of‐pocket medical expenses among older adults

Abstract

We use longitudinal data from the nationally representative Health and Retirement Study from 2002 to 2016 to document how Supplemental Nutrition Assistance Program (SNAP) participation and estimated take‐up changed over time for older adults and the role that out‐of‐pocket medical expenses has played in these changing patterns. We rely upon the state adoption of Medicaid expansion of the Affordable Care Act as a source of identifying variation and do not find evidence that Medicaid expansion changed estimated SNAP take‐up or participation. These findings suggest that out‐of‐pocket medical expenses are unlikely to be a major driver of SNAP take‐up decisions for the nondisabled population under age 65.

Introduction to senior hunger special issue

“…Heflin, Li, et al (2023) postulate that some of the low take‐up of SNAP might be due to an implicit health and food trade‐off that financially vulnerable seniors may face. Seniors (and those households with disabled members) are exempt from the gross income test for SNAP eligibility, but do face the net income test (i.e., gross income less allowed deductions), which must be below the federal poverty guideline for the household size.…”

“…That said, when the authors conduct a decomposition of changes in SNAP participation over time into the observable "endowment" effect and the returns on those endowments, very little of the participation gaps between seniors residing with grandchildren and those without can be explained by the living arrangements per se. Heflin, Li, et al (2023) postulate that some of the low take-up of SNAP might be due to an implicit health and food trade-off that financially vulnerable seniors may face. Seniors (and those households with disabled members) are exempt from the gross income test for SNAP eligibility, but do face the net income test (i.e., gross income less allowed deductions), which must be below the federal poverty guideline for the household size.…”