State-Level Barriers to Federally Subsidized Food Assistance. The USDA-ERS survey found that 62% of food insecure households participated in at least one form of federal aid, while the Feeding America Study found that only 55% of Feeding America client households receive SNAP benefits. This is a noteworthy difference because the vast majority of Feeding America client households would be income eligible for SNAP.6,11 Additionally, the Food and Nutrition Service of the USDA found that of the estimated 51 million individuals eligible for SNAP benefits in an average month in fiscal year 2012, approximately 83% participated. Among eligible elderly adults, the participation rate was only 42%.33 Nearly 25% of FA clients with children report receiving WIC benefits. Because the FA survey did not ask about the presence of pregnant women or children under five who might be at risk nutritionally, FA was unable to determine an estimated percent of WIC eligible client households.6,11,33 There are several reasons why an individual or household may not participate in federal assistance programs through state-sponsored health departments: the belief that they or their family is not eligible, difficulty applying, applied but were found ineligible.34 Besides the difficulty of the first-time certification process for WIC or SNAP, there can also be difficulty in physically obtaining benefits. While SNAP benefits are available on an Electronic Benefits Transfer (EBT) card, WIC still uses vouchers and clients must pick up WIC vouchers at their local Department for Family and Child Services office. Moreover, in most states WIC recipients are required to attend health check-ups every 6-12 months, which is difficult for single or working parents.35 Moreover, EBT cards are accepted at more places, such as farmers markets, while WIC vouchers are not always accepted. In reality, some individuals and families may not be eligible to receive federal or state-only cash assistance called Temporary Assistance for Needy Families (TANF) or SNAP benefits. Following the 1996 Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA), also known as welfare reform, s t ates set restrictions for benefits related to immigration status, length in the United States, and criminal record.36 The PRWORA and later legislation set parameters for states’ use of federal and state funding and increased states’ authority in administering or restricting access to public benefit programs. This legislation and following provisions have created a complicated a...
