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

Author(s): Children’s HealthWatch

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

As more than 350 healthcare providers across the state of Massachusetts, we write again out of deep concern 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 SNAP 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 an 18% reduction in the number of children participating in SNAP. This puts Massachusetts tied for the third highest percentage of children who have lost access to SNAP since July 2025 at 18% (with Texas), behind only Louisiana (23%) and Arizona (49%).

When children and their families lose SNAP, they are 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 8 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,

The Massachusetts Association of Community Health Workers

358 individual nurses, physicians, and social workers living and practicing across the Commonwealth:

 

Name City or Town of Residence
Erin Gadbois Abington
Beth Eagleson, MD Amherst
George Prodanas, BA Amherst
Megan Patton-Lopez, PhD, RDN Amherst
Jasmine Williams Andover
Carole Allen, MD, MBA, FAAP Arlington
Robert P. Marlin, MD, PhD, MPH Arlington
Roni Mansur, MS Arlington
Colleen Huysman, LICSW Arlington
Lisa Twente, MSW, LICSW Arlington
Hannah Barber Doucet, MD Arlington
Gretchen Dietrich, MD Arlington
Jason Tausek, LICSW Attleboro
Aldrige Awuku, MD Attleboro
Paulina Lange, MBA Belmont
Virginia Morrison, APRN Belmont
Lauren Fiechtner, MD, MPH Belmont
Christine Tardiff, MSW Beverly
Clare Cole, NP Beverly
Sulekho Egal, MD Billerica
Marissa Steinberg, MD, MPH Boston
Emily Kang, BA Boston
Gabriella Woeste, PA Boston
Meghna Nandi, MD Boston
Jennifer VanderWeele, MD Boston
Philip Severin, MD Boston
Madeline French, MBE Boston
Lauren Estess, MD Student Boston
Steven Young, MD Boston
Patricia Giunta, MD Boston
Bronwyn Stone, MD Boston
Olivia Moscicki, MD Boston
Mia Tornel, DO Boston
Victoria Oliva Rapoport, MD Boston
Julia Koehler, MD Boston
Sami Greenberg, LCSW Boston
Mollie Marr, MD, PhD Boston
Jeffrey Wojtowicz, PharmD Boston
Adeliza Olivero, MD Boston
Sari Sanchez Boston
Juliana Morris, MD Boston
Deanna Biddy Boston
Sylvie Tuchman, LICSW Boston
Lauren Glaser, LICSW Boston
Bevin Kenney, MD Boston
William Gleason Boston
Taylor Gonzalez, LICSW Boston
Kiley Schermerhorn Boston
Nicole Driscoll, BS Boston
Samantha Tulenko, MD, PhD Boston
Lindsay Partin, MD Boston
Amanda Sepulveda, BS Boston
Lashanda Skerritt, MD, PhD Boston
Alyssa Serafini, RD Boston
Danielle Brennan, LCSW Boston
Benjamin Maines, MD Boston
Connie Cai, MD Boston
Fathima Mohamed, MD, PhD Boston
Annie Banks, MSW Boston
Megan Harty, MD Boston
Fathia Karim, MD Boston
Avery Lytle, LCSW Boston
Rachel Thompson, MD Boston
Meghan Sullivan, MSW, LICSW Boston
Bethan Jones, LCSW Boston
Gabriela Tew, MSW, LICSW Boston
Katherine Gregory, MD Boston
Emily Feinberg, ScD, CPNP Boston
Netta Cudkevich, MD Boston
Sebastiana Redford, MD, MS Boston
Jessica Goldberg, MD Boston
Autumn Tangney, MSPH Boston
Katelin Blackburn, MD Boston
Sara Stulac, MD Boston
Ndang Azang-Njaah, MD, MPH Boston
Augustine Kang, MD PhD Boston
Heather Hsu, MD, MPH Boston
Christina Su, MD Boston
Mary Grace Fries, MPH Boston
Ella Froggatt, MPA Boston
Navin Kariyawasam, MD Boston
Guadalupe Ramirez, MD Boston
Michael Fischer, MD Boston
Natalie DeLaCruz Boston
Katherine Daniel, MD, MS Boston
Irene Newman Jimenez, MS Boston
Susan Gonzalez, MD Boston
Stephen Klepfer, MD Boston
Kynnedie Maloz, MD Boston
Connie Cai, MD Boston
Lauren Ondrejka, MD Boston
Sahar Choudhry, MPH Boston
Rachel Allen, MD Boston
Tehnaz Boyle, MD, PhD Boston
Abby Temple, MD Boston
Christina Vollbrecht, MA, MS, RDN, LDN Boston
Arielle Spellun, MD Boston
Jessica Rosenblum, MD/MPH Student Boston
Jennifer Bugos, DNP Boston
Jessica Pierre Francois, MD Boston
Gabrielle LeMarier, MSW, LICSW Boston
Cecelia Plaehn, MD Boston
Alleigh Wettstein, MD Boston
Angela Kelly, LMHC Boston
Ella Froggatt, MPA Boston
Brooke Horowitch, MD Boston
Divya Makkapati, MD Boston
Samantha Nuccio, RN Boston
Alexandra Dubinsky, MD Boston
Cathleen Daley Boston
Joanna Cepeda Boston
Kelli Padilla, RN Boston
Courtney Keenan, NP Boston
Anna Rosenquist, MD Boston
Pamela Bellamy, LICSW Boston
Soukaina Adolphe, MD Boston
Sara Stulac, MD, MPH Boston
Katlynn McFarland, MD, MPH Boston
Katarina Watson, MD Boston
Cheryl McSweeney, MD, MPH Boston
Alejandro Aviña-Cadena, MD Boston
Christina Zuniga, CHW-C Boston
Ian Cohn, MD, PhD Boston
Mark Castera, MD Boston
Tasha Freed, MD Boston
Catalina Berenblum Tobi, MD Boston
Sarah McLaughlin, MD, MS Boston
Corinne Beaugard, PhD, LCSW Boston
Rohan Khazanchi, MD, MPH Boston
Mallika Sabharwal, MD Boston
Laurel Gabler, MD, DPhil Boston
Robert Vinci, MD Boston
Ashley Schiffmiller Braintree
Denise Cremins Braintree
Noelle Armstrong Bridgewater
Fedler Felix, CHW Brockton
Emma Takizawa, BS, MA Brookline
Patricia L Maher Maher, RNP Brookline
Aryana Mohtasham Gharagozloo, MD Brookline
Alexis Altman, LICSW Brookline
Kaye-Alese Green, MD, Esq Brookline
Priscilla Wang, MD, MPH Brookline
Karen Greenberg, MD Brookline
Carolyn Rosinsky, MD Brookline
Kaye-Alese Green, MD, Esq Brookline
Anima Shrestha, MD Brookline
Samantha White, MD Brookline
Deborah Frank, MD Brookline
Pooja Vikraman, MD Brookline
Jessica Landau-Taylor, MD Brookline
Nathaniel Mullin, MD, PhD Brookline
Charles Homer, MD, MPH Brookline
Uma Khemraj, MS Brookline
Sofia Warner, MD Brookline
Lea Sheward, MD Brookline
Stefano Rozental, MD Brookline
Emily Cross, MD Brookline
Emma Steinberg, MD Brookline
Jessica Calihan, MD Brookline
Elizabeth Yellen, MD Brookline
Emily Barnard, BA Brookline
Abigail Ortiz, MSW/MPH Brookline
Sahana Jayaraman, MD PhD Brookline
Grier Merwin, MD, MPH Cambridge
Christina Schmidt, MD Cambridge
Omar Wahid, MD Cambridge
Mara Murray Horwitz, MD MPH Cambridge
Dorothy Kelleher, PsyD Cambridge
Michael H. Lewis Cambridge
Debra Rosenblum, MD Cambridge
Anastasia Yang, BA Cambridge
Jenna Quinn, MPH Cambridge
Katy O’Loughlin, MPH Cambridge
Maggie McGean, MD Cambridge
Jaimie DeScioli, MD Cambridge
Avik Chatterjee, MD, MPH Cambridge
Marie-France Hivert, MD Cambridge
Timothy Mikulski, MD Cambridge
Benjamin Delikat, MPH, MBA Cambridge
Mara Murray Horwitz, MD, MPH Cambridge
Bari Brodsky, MD Cambridge
Ligia Fragoso, MD Cambridge
Lauren Doctoroff, MD, MBA Cambridge
Emma Stevens, MD Cambridge
Cordelia Kwon, MPH Cambridge
Mindasari Daniar, RD, MPH Chelmsford
Zainab Basheer, MD Chelmsford
Juan Flores, LICSW Chelsea
Meghan Doherty, LICSW Colrain
David Lyczkowski, MD Concord
Samantha Rosman, MD, MPH Concord
Kim Merry, BA Danvers
Anastasia Maltseva, MD Dartmouth
Hannah Mecaskey Conley, LICSW, LABA, PhD Dedham
Jaclyn Lerner, RD Dedham
Caroline Coughlin, MD PhD Dedham
Megan Hempstead, MPH Dedham
Hannah Mecaskey Conley, LICSW, PhD Dedham
Anna Maria Siega-Riz, PhD East Longmeadow
Mal Petty Easthampton
Stephanie Prior, MD Falmouth
Christine Bryson, DO, MPH Florence
Tiffany Joseph, PhD Framingham
Jill Rosen, LICSW Framingham
Karenjeet Chahal, MD Gloucester
Anna Bottar, MD Grafton
Amanda Sanderson Greenfield
Marguerite Davis, MD Harvard
Hugh Silk, MD Harvard
Evelyn Borges, MD Haverhill
Veronica Pena-Vargas, MS, RN Haverhill
Monique Baxley, MPH Haverhill
Katrina Mitchell, LMHC Haverhill
Lisa Quinn, NP, PhD Holbrook
NIsha Fahey, DO, MS Holden
John DeLoge, MD, MPH Holliston
Micah Webster, MA Hopedale
E. John Lentini, DO Hull
David Woods, MD Hull
Katherine Luzuriaga, MD Ipswich
Cassandra Nytes, MD Lawrence
Alex Zapata, MD Lawrence
Rachel Mott Keis, MD Lexington
Linda Shipton, MD Lincoln
Debbie Callery Lowell
Rebecca Verhulst, RN Lunenburg
Natasha Shah, MD Lynnfield
Meghna Tummala, MD Malden
Kirby Tang, LICSW Malden
Elizabeth Alt, MD, MPH Manchester
Adrian Couture, LICSW Marblehead
Amy Newbery, RN Marlborough
Jeffri Navarro, MA, MS, MS Marlborough
Kathleen Tobin, RN Marshfield
Shannon Bennett, MSW, LCSW Medford
Shayla Parker, MPH Medford
Jenna Faltas, MPH Medford
Steven Bucchianeri, PharmD Medford
Wilfred McCalla, MSW Medford
Andrea Gordon, MD Melrose
Caroline Komanecky, MD Methuen
Nicole Quispe Methuen
Mahbod Kazemarab, MPH Middleboro
Gina D’Ottavio, MD Milford
Megan Nolan, MSN, MBA, RN Milton
Sarah Wright, MSW, LICSW Nantucket
Sheila Owen, LICSW Nantucket
Jesica Pagano-Therrien, PhD, RN, CNP Natick
Courtney Fosberg Brillant, MEd Natick
Rachel Soroka, LICSW Natick
Elise Gottesman, LICSW Needham
Ezra Cohen, MD Needham
Eldric Abreu New Bedford
Annah Powers, LMHC Newbury
SARAH PRIMEAU, MSW, MPH Newburyport
Rebekah Rollston, MD, MPH Newton
Laura Scharf, MD Newton
Michelle Master, MD Newton
Ariella Slovin, MD Newton
Margot Tang, MD, MPH Newton
Priya Garg, MD Newton
Sarah Bagley, MD Newton
Elise Tremblay, MD, MPH Newton
Arvin Garg, MD Newton
Jodi Wenger, MD Newton
Chava Chapman, MPH Newton
Sharon Nerboso, RN, BSN Norfolk
Christopher Garofalo, MD North Attleborough
Kathleen Holdsworth, MHA, BSN, RN North Grafton
Jessica Rosenberg, MPH Northampton
Maria Del Vecchio, MS Northborough
Sydney Hartman-Munick, MD Northborough
Mary Beth Miotto, MD, MPH Northborough
Jori Berger-Greenstein, PhD Northborough
Dawn Gomez Northbridge
Janet Limke, MD Norwood
Karla Mendoza Abarca, PhD Norwood
Amy Costa, MD Norwood
Bonnie Gorman, RN, MS Quincy
Lillian Gomes Quincy
Brennan Dagle, MD Quincy
Caryn Altman, MPH Quincy
Karan Barry, RN, MSN Quincy
Gaenslie Lamour Procope, MBA Randolph
Ellie Richards, PhD Reading
Kristen MacGlashing, MSW, LICSW Reading
Leigh Simmons, MD Revere
Brett Mitchell, MD, MPH Roxbury
Olivia Studley, NP Salem
Josh Levine, LICSW Salem
Lauren Cleveland, MS, MPH Salem
Jordyn Seri Salisbury
Christine Valdes Valdes, MD Saugus
Casandra Leslie, LICSW Saugus
Christina Lazdowsky, NP Sharon
Kira Bona, MD, MPH Sherborn
Mahima Poreddy, MD Shrewsbury
David Larrabee, MD Shrewsbury
Louise Amat, MD Somerville
Logan Beyer, MD/PhD Student Somerville
Gregory Barrett, LMHC Somerville
Marilyn Augustyn Augustyn, MD Somerville
Emma Anderson, MPH Somerville
Caroline Palleschi, LICSW Somerville
Samuel Feuer, BA Somerville
Olivia Winn, BS Somerville
Catherine Hetu, CPNP Somerville
Anna Goldman, MD, MPA, MPH Somerville
Olivia Chatfield, BA Somerville
Marilyn Augustyn, MD Somerville
Dory Ziperstein, LICSW, MPH Somerville
Shannon Watts, MSc Somerville
Aaron Bornstein, MD South Easton
Amreen Shaikh South Hadley
Briana Poole South Shore
Barbara Olendzki, RD, MPH, LDN Sterling
Sunny Kung, MD Stoneham
Susan Kessler, LICSW Stoneham
Anthony Mell, MD Stoughton
Nancy Porter, MBBS Stow
Jennifer Fishbein, MD Sudbury
Mariana Chilton, PhD, MPH Sunderland
Erin Heiskell, MD Swampscott
Kristine Latour Kennedy, MSW, LICSW Swampscott
Lisia Morales, MA Tewksbury
Tara Hammes, RDN Wakefield
Madhav Sharma, MD, FACP Walpole
Karen Kelly, MD Waltham
Kara Huselton, LICSW Waltham
Anderson Lamberto-Wilson, LCSW Watertown
Tiffany Lewallen, LICSW Watertown
Regina LaRocque, MD, MPH Wellesley
Susan Robinson, LICSW Wellesley
Lauren Ameden, MD Wellesley
Julie Herlihy, MD, MPH Wellesley
Elisabeth DiPietro, MD Weston
Christina Meade, MD Westwood
Iris Montijo, CPNP Westwood
Sarah Canale, MD Winchester
Fiona Danaher, MD, MPH Winchester
Sarah Canale, MD Winchester
Catherine Celler, MD Winchester
Kellie Farrell, BS Woburn
Leah Evans Wong, MD Worcester
Diane Blake, MD Worcester
Leah Evans Wong, MD Worcester
Claire Branley, PhD Worcester
Taylor Rich, DHS, MPH Worcester
Clyde Talley, Rev. Worcester
Marlon Velasquez, PMP Worcester
Ariana Perry, MD Worcester
Katherine Faulkner, MD Student Worcester
Stephanie Doan-Soares, DrPH, MPH Worcester
Olivia Schneider, MD Worcester
Willa Kahn, MD Worcester
Jeannette Brook, MD Student Worcester
Christopher Driscoll, MD Worcester
Jason Denoncourt, MD Worcester

 

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