We thank Guido, Maier, and Martin for highlighting the critical importance of the Supplemental Nutrition Assistance Program (SNAP) for supporting food security and improving health. We applaud efforts within health systems, such as those of the Link Health program they noted, to ensure eligible households are enrolled in SNAP and benefit from the food purchasing assistance provided by the program. We would like to expand on the authors’ statements regarding the harms of policy changes that reduce SNAP funding, limit eligibility, and create additional barriers to program participation, including the recent One Big Beautiful Bill Act (OBBBA).
Participating in SNAP reduces the risk of food insecurity by about 30% (Ratcliffe et al., 2011) and leads to improvements in numerous health outcomes (Schanzenbach, 2023). Every $1 spent on benefits generates approximately $1.50–$1.80 in economic activity, though some estimate higher returns on investment (United States Department of Agriculture, 2019; Center on Poverty and Social Policy, 2025). Despite SNAP’s effectiveness, its funding will be reduced by nearly $200 billion over the next decade under OBBBA—the largest cuts in the program’s history—leading to approximately 4 million people losing benefits in a typical month (Congressional Budget Office, 2025). Our own research shows that food insufficiency, difficulty affording other expenses such as rent and utilities, and poor health outcomes increase when SNAP benefits are reduced or terminated (Austin et al., 2025; Ettinger de Cuba et al., 2019). OBBBA cuts to SNAP are anticipated to disproportionately harm children, seniors, veterans, people with disabilities, immigrant households, and rural communities, and to exacerbate racial and ethnic health inequities.
In addition to historic cuts to SNAP funding, a key policy change under OBBBA is that SNAP work requirements will be applied to significantly more adults. Adults ages 55–64 years; parents and caregivers of children ages 14 years and older; youth ages 18–24 years exiting foster care; veterans; and people experiencing homelessness will now have to provide documentation proving they worked or participated in a work program for at least 80 hours per month to receive SNAP benefits for more than three months. Meeting work requirements will be particularly difficult for youth aging out of foster care who have histories of complex trauma and instability, people without safe and stable housing, and low-wage and hourly workers who have volatile work schedules and high levels of job displacement. The complexity of successfully navigating systems to document work or applicable exemptions (e.g., disability) will increase the risk that eligible individuals unfairly lose benefits and will add new administrative burdens on already strained state SNAP agencies.
Importantly, there is no evidence that SNAP work requirements increase employment (Gray et al., 2023), but ample evidence that they decrease SNAP participation (Ku et al., 2019) and worsen health outcomes (Feng, 2022). Similar evidence exists in Medicaid, with Medicaid work requirements shown to have no impact on employment while resulting in substantial losses of coverage and increases in financial hardship and delayed care due to cost (Sommers et al., 2020).
OBBBA will also significantly shift SNAP benefit and administrative costs from the federal government to states. If states cannot cover these increased costs, they may be forced to limit SNAP eligibility, reduce benefit amounts, or redirect funding from other vital services—such as health and education programs—leading to higher levels of food insufficiency and poverty and worse health outcomes.
Given the overwhelming evidence demonstrating the value of SNAP, action is needed to protect this critical public health intervention. Continued data collection (Shafer and Ettinger de Cuba, 2025) and research documenting the impacts of SNAP policy changes, along with clear communication of these impacts to policymakers and the public, will be essential. Programmatic efforts to help those subject to SNAP work requirements navigate the reporting process will also be critical. Cutting SNAP will leave millions hungry and increase demands on food banks, hospitals, and other organizations that lack the reach and resources necessary to sustainably support food access for all.