The Effect of Work Requirements in SNAP in Virginia
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Work requirement exemption months.
- Who it may be relevant to
- Registry conditions: Health Disparities, Food Security. Basic parameters: 18 years — 49 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- United States
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Disparities in Medicaid and SNAP Participation: the Effects of Work Requirements and the COVID-19 Pandemic
Overview
More than a dozen states have proposed or plan to implement work requirements in Medicaid, and similar requirements already exist nationally in the Supplemental Nutritional Assistance Program (SNAP), yet evidence on the effects of these policies is limited. In cooperation with the state of Virginia, the investigators plan to conduct a randomized controlled trial studying the impacts of work requirements in public programs on insurance coverage, SNAP participation, employment, and health, with a particular focus on changes in racial/ethnic and geographic disparities in these outcomes. The COVID-19 epidemic and concurrent economic downturn creates additional urgency around these issues, and the investigators will use a combination of national administrative data and a new population survey to assess disparities in employment, health care, and food insecurity during this crisis.
Detailed description
Work requirements are becoming increasingly common in major public assistance programs, with federal requirements for most adults to work in order to participate in the Supplemental Nutritional Assistance Program (SNAP, previously known as food stamps), and more than a dozen states proposing similar requirements in Medicaid. Proponents of work requirements contend that these policies increase beneficiary engagement in work and community activities that may lead to higher incomes and better health. On the other hand, opponents of work requirements suggest that many low-resource households will lose much-needed benefits, without commensurate improvements in employment. The investigators propose a randomized controlled trial of work requirements in Virginia, leveraging state support for exempting a portion of Medicaid expansion enrollees from the state's proposed work requirements. The investigators are also working with the state to explore the impact of work requirements in SNAP. They will study the impacts of each policy on health insurance coverage, access to care, employment, food insecurity, and health outcomes using a mix of administrative data and a new beneficiary survey. Our analysis will oversample several populations of interest, including racial/ethnic minorities and low-income rural residents. In doing so, investigators will identify the overall policy impacts of these policies, and will also assess who is most affected by each component to determine the impact of these policy changes on racial, ethnic, socioeconomic, and geographic disparities. Meanwhile, the COVID-19 epidemic and concurrent economic downturn create additional urgency around the issues of employment and participation in social programs. Using a combination of national administrative data and a new population survey, this study will also provide a timely assessment of disparities in employment, health care, and food insecurity during the current public health and economic crises.
Interventions
- Other Work requirement exemption months
Cross-randomized intervention will test effect of additional exemption months before work requirements in SNAP become binding and extensions of the standard SNAP recertification period.
Primary outcome measures
- SNAP enrollment [Time frame: Up to 24 months after randomization]
- Employment status [Time frame: Up to 24 months after randomization]
- UI covered earnings [Time frame: Up to 24 months after randomization]
- Non-UI covered earnings [Time frame: Up to 24 months after randomization]
Secondary outcome measures (12)
- Number of jobs held [Time frame: Up to 24 months after randomization]
- Medicaid participation [Time frame: Up to 24 months after randomization]
- Hospitalizations [Time frame: Up to 24 months after randomization]
- Credit scores [Time frame: Up to 24 months after randomization]
- Evictions [Time frame: Up to 24 months after randomization]
- Crime (records of charges, convictions) [Time frame: Up to 24 months after randomization]
- Food insecurity [Time frame: Survey to be administered approximately 1 year after randomization begins]
- Self-reported health [Time frame: Survey to be administered approximately 1 year after randomization begins]
- Depression score [Time frame: Survey to be administered approximately 1 year after randomization begins]
- Non-work community engagement activities [Time frame: Survey to be administered approximately 1 year after randomization begins]
- Forced moves, housing instability [Time frame: Survey to be administered approximately 1 year after randomization begins]
- Reasons for exiting SNAP [Time frame: Survey to be administered approximately 1 year after randomization begins]
Eligibility criteria
Inclusion criteria
- Eligible for Virginia's SNAP program as an "able-bodied adult without dependents" (ABAWD) and thus subject to work requirements (this eligibility is age restricted to 18-49)
Exclusion criteria
- Categorical exemption from work requirements for any reason (e.g., has a disability, has dependents, resides in a geographic area where work requirements have been waived due to elevated employment)
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: Yes
Study design
- Allocation
- Randomized
- Model
- Factorial
- Masking
- Open label
- Primary purpose
- Health services research
Study locations
United States · 1 center
- Virginia Department of Social Services (Home Office) — Glen Allen
Identifiers
NCT: NCT04888832 · IRB19-0859 · 5R01MD014970-02