Letter to Healey Administration and Massachusetts Legislature on DTA Investment and Protecting SNAP Access

Dear Governor Healey, Lieutenant Governor Driscoll, House Speaker Mariano, and Senate President Spilka:

As healthcare providers across the state of Massachusetts, we are deeply concerned that tens of thousands of children and families are at risk of experiencing greater food insecurity unless the Commonwealth acts swiftly to improve access to the Supplemental Nutrition Assistance Program (SNAP). We urge the Administration and Legislature to invest in Department of Transitional Assistance (DTA) staffing and administrative capacity and to reduce unnecessary verification requirements that create barriers to enrollment and retention, ensuring eligible families can access and maintain the nutrition assistance they need to be healthy.

Like a Prescription, SNAP Protects Health

SNAP, our nation’s largest evidence-based nutrition program, reduces food insecurity and is a crucial foundation for child health. Approximately 900,000 Massachusetts residents use SNAP to purchase the foods they need to feed themselves and their families, averaging to $314 per household, or roughly $10 per household per day.

Participating in SNAP protects children and their families from the harmful, costly health consequences of food insecurity. Research shows that children living in food insecure households are more likely to be hospitalized, to have low birthweight, to develop asthma and anemia, to experience developmental delays, and to fall behind in school. With 80% of brain development occurring within the first three years of life, infants and toddlers are particularly sensitive to the effects of food insecurity–which do not present months or years later, but just after a few days and weeks.

Household food insecurity is also linked with parental depression, anxiety, and increased stress, which in turn impacts child health and development. Among adults, food insecurity is associated with a higher risk of poor health and worsened chronic disease management.

Oftentimes, families experiencing food insecurity are forced to make impossible budget tradeoffs, like skipping prescription medications, delaying medical care, or forgoing other basic necessities in order to afford food. These circumstances can create a cycle of unmet needs, which further contributes to worse health. When patients show up to our clinics with health complications that can arise from food insecurity, like worsened hypertension or diabetes, the level of care needed to treat and stabilize the patient is high. The cost of increased staffing, more advanced medical interventions, and potential hospital stays are considered “avoidable” healthcare costs because they are preventable if food insecurity is wholly addressed before the symptoms of disease progress. Avoidable costs add up: researchers have estimated the avoidable healthcare costs related to food insecurity in the United States to total $237 billion annually. In Massachusetts alone, this cost was $2.4 billion in 2018 – an estimate that has likely ballooned due to increased costs and inflation. This cost does not just affect patients experiencing food insecurity, but all of us. Healthcare is inherently a system of pooled risk, with the cost of care needed to care for sicker patients passed onto all patients via increased health insurance premiums and increased cost at point of service.

As healthcare providers, we take an oath to do no harm and to care for and protect our patients. However, healthcare alone cannot treat the harmful effects of food insecurity. We need to work in partnership with strong and accessible nutrition assistance programs, including SNAP, to ensure all children and families in Massachusetts are able to meet their needs for enough nutritious food to grow and protect health.

Policy Drivers of SNAP Access Issues

In July 2025, Congress passed H.R 1, ushering in the largest cuts to SNAP in the history of the program. Starting in fall 2027, Massachusetts will likely be required to cover a share of SNAP benefits costs for at least two federal fiscal years. In Massachusetts, these changes are expected to cost hundreds of millions of dollars annually. States’ financial obligations will be tied to their SNAP payment error rate (PER), creating strong pressure to rapidly reduce errors.

H.R 1 also expanded SNAP work reporting requirements to many participants who were previously exempt. Data shows that the majority of SNAP participants who can work already do. Research shows these requirements do not increase employment, but rather increase paperwork and administrative complexity for both participants and state agencies.

As a result, caseworkers will spend more time processing applications, verifying eligibility, and managing reporting requirements, while SNAP participants will face additional documentation burdens to maintain benefits. These added burdens increase the risk that eligible families will lose access to needed food assistance.

SNAP Access Crisis in Massachusetts

SNAP access barriers have contributed to a 16% reduction in SNAP caseload in Massachusetts. From July 2025 to May 2026, the number of Massachusetts children receiving SNAP declined by nearly 62,000, an 18% decrease. This loss puts children and their families at greater risk of experiencing food insecurity, posing serious risk for harmful, costly health complications, both now and later in life. Losing SNAP can also cause families to lose automatic eligibility for other child food assistance programs, such as the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and free school meals, reducing access to supports that protect child health and development and contribute to better educational and long-term economic outcomes.

The SNAP caseload decline is not driven by reduced need, but by growing barriers to accessing assistance. Caseloads per worker have increased substantially, leaving fewer staff available to help families navigate the program. At the same time, new administrative requirements under H.R. 1 are increasing the workload for both participants and caseworkers. As a result, many SNAP participants are unable to reach a caseworker for assistance. In 2026, at least 75% of calls trying to reach a worker each month did were automatically disconnected.

Increased Investment is Necessary to Address This Crisis

While there are multiple opportunities to solve this crisis, we urge you to adopt changes that will address the most systemic barriers to accessing SNAP, including:

• Significant investment is needed in DTA to increase staff capacity. Better equipping DTA caseworkers to adequately manage the SNAP caseload will result in both improved customer service and accuracy, helping reduce the state’s PER while maintaining SNAP access for families. This strategy was identified by the Governor’s Anti Hunger Task Force and outlined in a March 2026 Report by Governor Healey, Lieutenant Governor Driscoll, Secretary Mahaniah, and Commissioner Cole. We recognize and appreciate the hiring of 76 additional caseworkers in January 2026. Looking at the trends nearly 6 months after these added staff, we know further investment in the Department is needed to better serve all eligible SNAP families.
• Limit over verification of SNAP participants. Increasing unnecessary verification processes beyond what is mandated will only increase administrative burdens for SNAP participants and caseworkers. SNAP has an exceptionally low fraud rate due to its high level of program integrity. DTA already implements rigorous application and eligibility review processes, and SNAP has several measures to assess household eligibility accurately. Households already must reapply for benefits regularly and must report income changes that would affect their eligibility during each reapplication process. Adding additional barriers only increases the likelihood of eligible families losing access to the program.

As healthcare workers who provide care across the state, we alone cannot address the harms of food insecurity. We need strong, accessible nutrition assistance programs, such as SNAP, to ensure all residents can access the food they need to thrive. While SNAP is a federal program, its implementation is guided by state policy choices. We ask to act with urgency and a sense of shared responsibility to solve this access crisis, which will only become more severe if not addressed.

Respectfully,

200 healthcare workers living and practicing across the Commonwealth