Originally published on TIME.

While SNAP and other federal food-aid programs have changed substantially since the ’60s, they still leave millions of Americans struggling to get enough to eat. A single person making more than $1,064 a month after taxes does not qualify for any SNAP funds at all, and those who do qualify often can’t feed their families on the amount provided, which maxes out at $2.60 per meal. Food-­justice advocates also point to other factors—like the dearth of good grocery stores, outreach to vulnerable communities and reliable public transit in low-income areas—as contributing to the problem. Troy Bike Rescue, where Anderson is trying to set up another fridge, is a 31-stop bus ride and transfer from the nearest supermarket. In Garner, N.C., 52-year-old SNAP recipient Karrie Nelson says her current $200 monthly food-stamp ­allotment—almost twice as much as usual, thanks to the pandemic-relief ­increases—is less problematic than the fact that she can’t afford a car and public transit is insufficient. She estimates that she spends $450 per month on rideshare apps to commute to and from her job at a local grocery store, where she makes $12 an hour. “I can’t save because I’m spending half my paycheck getting­ back and forth to work,” she says.

That’s not an isolated problem, says Dr. Megan Sandel, who works with ­malnourished children and extremely low-income families as a co-director of the Grow Clinic at Boston Medical Center. Sandel says that by setting income ceilings low, not factoring in a recipient’s obligatory expenses like transportation, and reducing benefits every time somebody gets a modest pay bump, SNAP and other welfare programs often punish beneficiaries for building assets. If Nelson gets a raise that helps her buy a car, she may lose SNAP, forcing her to choose between gas and food.

These and other policy failures “play out on the bodies of babies,” Sandel says. Kids whose caregivers lose SNAP benefits are at greater risk of poor health, studies show. At the Grow Clinic, Sandel sees hundreds of malnourished children per year, including 2-year-olds who still fit into clothes meant for 1-year-olds and toddlers whose hair doesn’t grow, because of a combination of not getting enough nutrient-­dense food and not getting enough food, period. Since March 2020, her clinic’s caseload has jumped 40%.