Forward Nadia Greenhalgh-Stanley, Ph.D. Assistant Professor of Economics Kent State University

Transcription

1 The S upplemental Nutrition A ssistance Program (SNAP) and the E lderly Forward Nadia Greenhalgh-Stanley, Ph.D. Assistant Professor of Economics Kent State University Article Katie Fitzpatrick, Ph.D. Assistant Professor of Economics Seattle University Volume II, Issue 4, 2015

2 The Oxford Dictionary defines Seniority as the fact or state of being older. This serial, digital magazine focuses on matters that affect those who are older. It will be a periodic examination of various issues related to aging and will address subjects that NFESH believes to be of vital importance in enhancing our understanding of the paradigm that is senior hunger in America. Senior hunger does not exist in a vacuum. A multitude of factors, policies and programs have direct impact on seniors particularly those who are vulnerable and threatened by hunger. Through this forum, we invite experts to examine and discuss a variety of them, because we believe doing so will enhance our understanding of the complex problem that is senior hunger and help us drive the changes necessary to ameliorate it once and for all. The Oxford Dictionary further defines Seniority as a privileged position earned by reason of longer service. We at NFESH have been privileged to work long on behalf of older Americans, and through our research and communications channels, such as this online magazine, we hope to continue to do so for many years. We would like to hear from you. Tell us what you think about this article. Tell us what other issues you would like to see us examine in the future. Be a part of the conversation. By working together we can end senior hunger.

3 The Supplemental Nutrition Assistance Program (SNAP) and the Elderly Forward Nadia Greenhalgh-Stanley, Ph.D. Assistant Professor of Economics Kent State University A growing number of seniors are at risk for food insecurity. This trend, coupled with the recent Great Recession, leaves many seniors struggling to have enough resources to pay for food and often leads to them choosing cheaper, less expensive food. Nutritious food is important for any population, but is essential for the elderly as there are direct links between proper nutrition and both health and health care use. The federal government runs several programs to decrease hunger among Americans, with the most important and widespread being the Supplemental Nutrition Assistance Program (SNAP), formerly known as Food Stamps. Unfortunately, the elderly have a low take-up rate of SNAP with only 35.1% of the eligible elderly participating. Among low-income elderly, the population most at risk for food insecurity, simple calculations from the Health and Retirement Study (HRS), a comprehensive longitudinal data set comprised of more than 26,000 elderly individuals, suggest that SNAP participants face multiple hardships: elderly SNAP participants are more likely to report multiple measures of food insecurity, worse health, and are more likely to report skipping meals and prescriptions due to financial constraints. A possible explanation for this is with the low participation rates, it is likely the worst off of the hungry elderly are participating in SNAP making their food sufficiency and health outcomes look relatively bad. However, it is not all bad news. Elderly SNAP recipients in the HRS are more likely to say their diabetes and heart disease are improving; they are also more likely to be on blood pressure medication, compared to those with high blood pressure that do not receive SNAP benefits. In addition, some research has found that subsidized meal- programs and SNAP are actually complementary programs and are frequently used together. Calculations from the HRS show that those elderly receiving both SNAP benefits and subsidized meals are more likely to report they are in very good or excellent health compared to those with SNAP benefits but who do not have subsidized meals. This evidence suggests we need to make more concentrated efforts to increase SNAP availability for the elderly. Doing so will decrease food insufficiency and improve the health and nutrition of the lowincome elderly population. If we are successful, it will likely have huge savings for Medicare as better nutrition will, in the long-term, lead to fewer health conditions, less need for health care, and lower health care costs. 2

4 The Supplemental Nutrition Assistance Program (SNAP) and the Elderly Katie Fitzpatrick, Ph.D. Assistant Professor of Economics Seattle University The Supplemental Nutrition Assistance Program (SNAP, formerly the Food Stamp Program) is the largest and most important program in the nutritional safety net. The goal of SNAP is to reduce the prevalence of food insecurity and improve the nutrition of low-income individuals. According to the U.S. Department of Agriculture (USDA), in 2013, an average of 23.1 million households containing 47.6 million individuals received a total of $76.1 billion in benefits. Approximately 17% of SNAP households included an elderly adult and 9% of all SNAP participants (4.2 million participants) were elderly (USDA 2014). SNAP is a federal program administered by states. Eligibility is determined by household economic circumstances. Households with elderly adults defined as individuals age 60 and older have less stringent eligibility criteria than households without elderly adults: net household income (total income less shelter expenses, medical costs, and other deductions) must be at or below the federal poverty line and households must have less than $3,250 in financial assets. Once eligible, recipients periodically verify their continued eligibility, a process known as recertification. SNAP benefits are calculated by subtracting 30% of the household s net income from the maximum benefit for their household size. Households with an elderly individual tend to receive lower benefits than other households. In the 2012 fiscal year, households with an elderly member received an average benefit of $139 per month, compared to $302 per month for those without an elderly member (USDA 2014). These lower benefit levels are a result of smaller average household size for those with an elderly member 1.3 persons compared to 2.3 persons for those without an elderly member. Most households (93.6%) with an elderly household member do not have earned income (USDA 2014). Instead, income tends to be from Social Security (69.1%) and/or Supplemental Security Income (39.2%), a program for low-income persons. When elderly SNAP households do not have earned income, states can assign these households long recertification periods, a feature that should reduce the hassles of participation. Recertification periods for households with an elderly individual are typically either 12 months (41.8%) or 24 months (32.6%) but some have even recertification periods longer than 24 months (15.1%). As the name change suggests, SNAP has undergone dramatic changes recently. These changes provide states new flexibility over some aspects of eligibility and requirements of participants. In addition, there is a new emphasis on expanding access and reducing the burdens associated with participation. New research suggests that the difficult economy since the start of the Great Recession, greater program access, and fewer hassles with participation have jointly contributed to the current historically high caseload levels (Dickert-Conlin et al. 2014; Liebman and Ganong 2013; Ziliak, 2013). Despite these high caseloads, SNAP take-up rates among the eligible elderly remain stubbornly low. Only an estimated 35.1% of the eligible elderly participate in SNAP, compared to 75.6% of eligible non-elderly adults (Eslami et al. 2012). Researchers have posited a number of reasons for these low participation rates. Studies suggest that low elderly SNAP participation rates are due to lack of awareness about eligibility, (Daponte et al., 1999; Wolfe et al., 1996; Wu, 2009), stigma associated with 3

5 benefit receipt (Gabor et al. 2003), and low average benefit levels (Gabor et al. 2002; Wu, 2009). Others have suggested that the elderly may face higher costs in navigating the application process (Heflin and Mueser, 2010) or have less need for the program (Haider et al. 2003). Given the fixed incomes, poor health, and other needs of low-income elderly, low participation rates are worrisome due to the potential for SNAP to improve the well-being of participants (Gundersen et al., 2011; Yen et al., 2008; Ratcliffe et al., 2011). Although the elderly tend to have lower food insecurity rates than other demographic groups, between 2001 and 2005, 11.4% of the elderly faced some type of difficulty in affording an adequate diet (Ziliak et al. 2008). Moreover, food hardship appears to be increasing. From 2001 to 2011, the number of elderly at risk for hunger grew 88% (Ziliak and Gundersen 2013). In response to these facts, with federal encouragement, states are using their new flexibility to connect the eligible elderly with SNAP. One such method is Combined Application Projects (CAP). CAP policies allow those applying for or currently receiving Supplemental Security Income (SSI) to enroll in SNAP with a streamlined application process and reduced recertification requirements. Implemented in 18 states since 1997, states that implemented CAP policies have seen an increase in elderly SNAP participation rates (Fitzpatrick and Greenhalgh-Stanley 2013; Cunnyngham 2010). States are also seeking other ways to increase program access by simplifying the benefit calculation. For example, 14 states received federal approval for a Standard Medical Deduction policy which allows the elderly to deduct a standard amount for their medical expenses instead of determining actual medical expenses. Additionally, a handful of states implemented the Elderly/Disabled Simplified Application policy which reduces the application requirements for elderly households with no earned income. Elderly SNAP participation rates are increasing in states that have adopted these policies. Finally, federal and state agencies have partnered on demonstration projects to identify promising practices to increase SNAP participation among eligible non-recipients. Typically, these projects seek to reduce difficulties with the application process. For example, those receiving Medicare s Extra Help program, a subsidy for low-income individuals to purchase prescription drugs, can receive a streamlined application process due to sharing of applicant income and asset information across federal agencies. Another project allows staff at senior centers and food pantries to conduct the initial SNAP application interview rather than a worker at the local SNAP office. Evidence on these and other demonstration projects suggests that they increased SNAP participation among the targeted groups and may be promising approaches to be adopted more widely (Cody and Ohls, 2005). Thanks, in part, to these and other policies, elderly SNAP participation rates have recently increased. But, given the growing elderly population and the effects of the Great Recession on those at or near retirement, more is needed to assist seniors at risk for hunger. The 2014 Farm Bill, recently signed into law, continues efforts to connect the eligible elderly to the food safety net by allowing nonprofit food delivery services that serve the elderly to accept SNAP benefits as payment. These and other policies are needed to provide elderly individuals the resources they need to afford healthy and nutritious food and prevent the problem of senior hunger. 4

6 References Cody, Scott and James Ohls Evaluation of the USDA Elderly Nutrition Demonstrations. Contractor and Cooperator Report No July Cunnyngham, Karen State Trends in Supplemental Nutrition Assistance Program Eligibility and Participation among Elderly Individuals, Economic Research Service, USDA. Food and Nutrition Assistance Research Program Contractor and Cooperator Report No Washington, D.C. Daponte, Beth Osborne; Seth Sanders and Lowell Taylor Why Do Low-Income Households Not Use Food Stamps? Evidence from an Experiment. The Journal of Human Resources, 34(3), Dickert-Conlin, Stacy, Katie Fitzpatrick, and Laura Tiehen The Downs and Ups of the SNAP Caseload: What Matters? Mimeo. Eslami, Esa, Joshua Leftin, and Mark Strayer Supplemental Nutrition Assistance Program Participation Rates: Fiscal Year Food and Nutrition Service, U.S. Department of Agriculture, Washington, D.C. Fitzpatrick, Katie and Nadia Greenhalgh-Stanley Food Stamps, Food Sufficiency, and Diet- Related Disease Among the Elderly. Mimeo. Gabor, Vivan, Brooke Hardison, Christopher Botsko, and Susan Bartlett. Food Stamp Program Access Study: Local Office Policies and Practices, (Washington D.C.: USDA Economic Research Service) E-Fan , December Gundersen, Craig; Brent Kreider and John Pepper The Economics of Food Insecurity in the United States. Applied Economic Perspectives and Policy, 33(3), Haider, Steven J.; Alison Jacknowitz and Robert F. Schoeni Food Stamps and the Elderly: Why Is Participation So Low. Journal of Human Resources, 38, Heflin, Colleen and Peter Mueser Assessing the Impact of a Modernized Application Process on Florida s Food Stamp Caseload, University of Kentucky Center for Poverty Research Discussion Paper Series. Ganong, Peter and Jeffrey B. Liebman The Decline, Rebound, and Further Rise in Snap Enrollment: Disentangling Business Cycle Fluctuations and Policy Changes, NBER Working Paper Series. Cambridge, MA: National Bureau of Economic Research. Ratcliffe, Caroline; Signe-Mary McKernan and Sisi Zhang How Much Does the Supplemental Nutrition Assistance Program Reduce Food Insecurity? American Journal of Agricultural Economics, 93(4), U.S. Department of Agriculture, Food and Nutrition Service (USDA), Office of Policy Support, Characteristics of Supplemental Nutrition Assistance Program Households: Fiscal Year 2012, by Kelsey Farson Gray and Esa Eslami. Alexandria, VA: Wolfe, Wendy S.; Christine M. Olson; Anne Kendall and Edward A. Frongillo Jr Understanding Food Insecurity in the Elderly: A Conceptual Framework. Journal of Nutrition Education, 28(2), Wu, April Why Do So Few Elderly Use Food Stamps, The Harris School of Public Policy Working Paper Series. Chicago: The University of Chicago. Yen, Steven T.; Margaret Andrews; Zhuo Chen and David B. Eastwood Food Stamp Program Participation and Food Insecurity: An Instrumental Variables Approach. American Journal of Agricultural Economics, 90(1), Ziliak, James P.; Craig Gundersen and Margaret Haist The Causes, Consequences, and Future of Senior Hunger in America, University of Kentucky Center for Poverty Research Special Report to the Meals on Wheels Association of 5

7 America Foundation, University of Kentucky, Center for Poverty Research. Ziliak, James P. and Craig Gundersen The State of Senior Hunger in America 2011: An Annual Report, National Foundation to End Senior Hunger. Ziliak, James P Why Are So Many Americans on Food Stamps? The Role of the Economy, Policy, and Demographics, Institute for Research on Poverty (IRP) Discussion Paper. Madison, WI: IRP. References (continued) 6

8 Contributor Biographies Nadia Greenhalgh-Stanley, Ph.D. Nadia Greenhalgh-Stanley graduated summa cum laude with a B.A. in economics from Wittenberg University and a M.A. and Ph.D. in economics from Syracuse University. She currently is an Assistant Professor of Economics in the Department of Economics at Kent State University, where she teaches urban economics, economics of healthcare, and principles of microeconomics. Her research interests are in urban economics and public finance. More specifically she focuses on the effects of changes in social insurance programs on elderly housing decisions, living arrangements, and home equity investments. Her work has been published in the Journal of Law and Economics, Journal of Urban Economics, and Public Finance Review. Her research has been funded by the Social Security Administration, Institute for Poverty on Research at the University of Wisconsin, U.S. Department of Agriculture, and the MacArthur Foundation. Katie Fitzpatrick, Ph.D. Katie Fitzpatrick is an Assistant Professor of Economics at Seattle University. Her primary research interests are in low-income tax and transfer programs. Much of her recent work focuses on understanding what has contributed to the recent rise in Supplemental Nutrition Assistance Program (SNAP, formerly the Food Stamp Program) caseloads, the causes and consequences of food insecurity, and how owning a bank account affects other financial decisions. Prior to coming to Seattle University, she worked as an Economist at the U.S. Department of Agriculture s Economic Research Service where she focused on food assistance policy. She previously worked at the Health Policy Institute, the Urban-Brookings Tax Policy Center, and the Brookings Institution. Katie received a B.A. from Stanford University in 1999, a Masters of Public Policy from Georgetown University in 2004, and a Ph.D. in Economics from Syracuse University in