The Effect of Work Requirements in SNAP in Virginia
Study Details
Study Description
Brief Summary
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.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
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.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| No Intervention: Control Group No change to work requirements or recertification period |
|
| Active Comparator: Intervention Group 1 Standard 6-month recertification period, additional 6-month work requirement exemption |
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.
Other Names:
|
| Active Comparator: Intervention Group 2 Standard 6-month recertification period, additional 12-month work requirement exemption |
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.
Other Names:
|
| Active Comparator: Intervention Group 3 Standard 6-month recertification period, additional 12-month work requirement exemption |
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.
Other Names:
|
| Active Comparator: Intervention Group 4 12-month recertification period (6-month extension), additional 6-month work requirement exemption |
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.
Other Names:
|
Outcome Measures
Primary Outcome Measures
- SNAP enrollment [Up to 24 months after randomization]
Collected administratively (DSS records)
- Employment status [Up to 24 months after randomization]
Collected administratively (VEC records)
- UI covered earnings [Up to 24 months after randomization]
Collected administratively (VEC records)
- Non-UI covered earnings [Up to 24 months after randomization]
Collected administratively (federal tax records)
Secondary Outcome Measures
- Number of jobs held [Up to 24 months after randomization]
Collected administratively (DSS records)
- Medicaid participation [Up to 24 months after randomization]
Collected administratively (DSS records)
- Hospitalizations [Up to 24 months after randomization]
Collected administratively (Virginia Health Information)
- Credit scores [Up to 24 months after randomization]
Collected administratively (credit bureaus)
- Evictions [Up to 24 months after randomization]
Collected administratively (court records)
- Crime (records of charges, convictions) [Up to 24 months after randomization]
Collected administratively (court records)
- Food insecurity [Survey to be administered approximately 1 year after randomization begins]
Collected by survey
- Self-reported health [Survey to be administered approximately 1 year after randomization begins]
Collected by survey
- Depression score [Survey to be administered approximately 1 year after randomization begins]
Collected by survey
- Non-work community engagement activities [Survey to be administered approximately 1 year after randomization begins]
Collected by survey
- Forced moves, housing instability [Survey to be administered approximately 1 year after randomization begins]
Collected by survey
- Reasons for exiting SNAP [Survey to be administered approximately 1 year after randomization begins]
Collected by survey
- Barriers to employment [Survey to be administered approximately 1 year after randomization begins]
Collected by survey
- Hours worked per week [Survey to be administered approximately 1 year after randomization begins]
Collected by survey
- Difficulty paying medical bills [Survey to be administered approximately 1 year after randomization begins]
Collected by survey
- Uninsurance [Survey to be administered approximately 1 year after randomization begins]
Collected by survey
Eligibility Criteria
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)
Contacts and Locations
Locations
No locations specified.Sponsors and Collaborators
- Harvard Medical School (HMS and HSDM)
- Abdul Latif Jameel Poverty Action Lab
- National Institute on Minority Health and Health Disparities (NIMHD)
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- IRB19-0859
- 5R01MD014970-02