Food Stamps and Health

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It’s hardly surprising that the nation’s news media haven’t sent forth a flood of stories about how Congress has cut billions from the food stamp program to help states pay for Medicaid and teachers’ salaries—a kind of robbing-Peter-to-pay-Paul exchange.

What stories have appeared played the issue very matter-of-factly, delivering the news that food stamps will eventually be cut in 2014—down by $59 a month for a family of four*—and portraying the cut as a necessary trade-off among social programs, since the country can’t afford everything. “To save some social programs, they’ll have to sacrifice others,” is what one Politico story said in its lede. WTVG-TV in Toledo told viewers: “The recent Senate bill gives states money to keep teachers, police, and firefighters on the payroll, but in turn takes funding away from the food program.” The Columbus Dispatch put it this way: “To advocates for the poor, it’s an impossible choice.”

The stories quoted food advocates, who said the cuts would be devastating. The Dispatch story went further and did a decent enough numbers piece—how much federal money would be needed to save Ohio teacher jobs; how a home care program for seniors would escape the axe.

Missing, though, was a good dose of food-stamp politics that get to the crux of the country’s priorities. Wasn’t there $12 billion somewhere else in the federal budget? Food stamps vs. tanks, for example? “[Congress] should have the decency to chisel some less-humane program than food stamps,” The New York Times editorialized. But that debate never really happened in a public way. “It’s easier to cut benefits for poor people than find more effective ways to pay for things,” James Weill, president of the Food Research and Action Center, told me.

Why were food stamps less important than art teachers or nursing homes? Where was the lobbying story? Teachers unions pulled out all stops to save their members’ jobs, but promised they’d work to restore the food stamp dollars, although some advocates believe that’s unlikely. Providers benefiting from Medicaid dollars also made sure that the dollars would keep flowing. The American Health Care Association, the trade group for the for-profit nursing homes, ran radio ads in Washington urging Congress to protect seniors and children—and, not incidentally, the coffers of its members.

But the link between food stamps and health was the biggest omission. The cuts take effect in 2014, the same year that the main event for health reform debuts—the requirement that everyone must have health insurance or pay a penalty. There will be subsidies for some people, but they may be too low to afford a decent policy. Families may have to balance the need to buy food against taking a financial hit for not buying insurance.

Then there’s the issue of how food contributes to health. The lack of nutritious food and the poverty that goes along with it are called the social determinants of health, and studies show that they are much more important to good health than the kind of health system a country has. Having a way to pay for care is important, but keeping people healthy in the first place is more important.

There was a lot of rhetoric flying around last year about preventive care—free mammograms and colonoscopies for seniors, money for wellness programs; incentives for businesses to make employees lose weight; preventing illness before it becomes costly to treat. These priorities made it into the final legislation. But what about money people need to buy food to stay healthy? That’s where food stamps come in. If families have too little money to buy expensive fruits and vegetables, they will make do, eating ramen noodles or fast foods—anything that provides calories to fill them up. Cheap food does not always equal healthy food.

“Let’s have some smart decisions,” Rep. Tim Walz, a Democrat from Minnesota, told Politico. “And by us having to make a hard decision on something that would have been considered untouchable, like food stamps, this is a part of it. It presents itself as more common sense.”

It would be great to see some media investigation of just how much sense this all makes.

Correction: This article originally reported that, by 2014, food stamps would be reduced to $59 for a family of four. In fact, they will be reduced by $59, not to $59. The relevant sentence has been changed. CJR regrets the error.

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Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for CJR's Covering the Health Care Fight. She also blogs for Health News Review and the Center for Health Journalism. Follow her on Twitter @Trudy_Lieberman.