More than 70 million people in the United States have a disability, and many face higher healthcare costs than people without disabilities costs for health care, housing, transportation, and other essential needs.

Those added expenses can make affording enough food especially difficult: households that include a person with a disability are two to three times more likely to experience food insecurity than households without a disabled member.

A new Center on Budget and Policy Priorities report examines the critical role of the Supplemental Nutrition Assistance Program (SNAP), which provided food assistance to an estimated 19.5 million people with disabilities in 2023. The report also identifies significant gaps in access—from restrictive definitions of disability and burdensome documentation requirements to expanded work requirements that could cause eligible people to lose their benefits.

In this Q&A, Johns Hopkins School of Nursing faculty and report co-authors Laura Samuel, PhD, RN, FAAN, and Bonnielin Swenor, PhD, MPH, discuss why people with disabilities face such high rates of food insecurity, how SNAP policies can deepen or reduce those inequities, and what policymakers can do to ensure the program reaches the people who need it.

Your analysis estimates that 19.5 million SNAP participants have a disability, compared with roughly 4 million identified in SNAP administrative data. What explains that gap, and why does it matter?

The estimates differ because the two data sources identify disability differently. SNAP administrative data generally identifies people who receive government disability benefits or have exemptions from work requirements. That approach misses many people with disabilities, particularly older adults who are not subject to those requirements.

Our estimate uses national survey data that captures whether people have difficulty performing daily activities and functions. It suggests that nearly half of SNAP participants have disabilities, far more than administrative data indicates. This gap shows that SNAP’s critical role in meeting the food needs of people with disabilities has been significantly overlooked.

What does this discrepancy tell us about how federal programs define disability? Who becomes invisible when those definitions are too narrow?

Applying for federal disability benefits is complex, burdensome, and often inequitable. When federal programs define disability based on benefit receipt, many disabled people become invisible, including those awaiting a Supplemental Security Income or Social Security Disability Insurance determination and those unable to navigate the difficult application process.

The report finds that households including someone with a disability need substantially more income to achieve the same standard of living as other households. What additional costs are these families absorbing, and how does that contribute to food insecurity?

Disabled people often bear a “disability tax,” including higher costs for accessible housing, specialized foods, health care, and transportation. These expenses add up quickly and leave households with less money for food.

Beyond helping households afford more food, what role does SNAP play for people with disabilities?

SNAP can reduce both food insecurity and poverty. This has important health implications because food insecurity is associated with poor mental health and chronic conditions such as high blood pressure and diabetes. Food-insecure adults are also more likely to be hospitalized or visit the emergency department. Growing evidence shows that SNAP can help people manage diet-sensitive conditions and reduce costly, preventable hospital care.

Why might work requirement exemptions fail to protect people with significant health or functional limitations?

Recent expansions may leave people unsure whether the rules apply to them or how to secure an exemption. Qualifying typically requires documentation of disability benefits or a medical exemption form signed by a health care provider. Disability determinations may take months or years, and many low-income adults lack a regular provider who can document their limitations. Eligible people may therefore lose benefits before receiving an exemption.

Research has found no clear evidence that work requirements increase employment, and most adult SNAP participants already work. Instead, these policies reduce SNAP participation, worsen health outcomes, and increase debt and reliance on food pantries.

SNAP work requirements now include more adults ages 55 to 64, among whom health-related barriers to employment are increasingly common. What concerns you most?

Work requirements historically applied only to adults under 50. They expanded to adults ages 50 to 54 in 2023 and to those ages 55 to 64 in 2026. Because middle-aged adults are more likely than younger adults to have functional limitations and chronic conditions, they may have greater difficulty meeting the requirements.

This is especially concerning because SNAP can help people manage diet-sensitive chronic conditions. Those with poor health and the greatest need for SNAP will likely face the greatest difficulty maintaining their benefits.

What are the health consequences when someone with a disability loses SNAP or experiences an interruption in benefits?

Studies show that SNAP enrollment and increased benefits reduce food insecurity, improve management of conditions such as diabetes, and reduce the need for costly hospital care. Losing benefits will likely worsen chronic conditions because people cannot afford the food needed to stay healthy.

Food-insecure adults also struggle to afford medications, copays, and other necessities. Losing SNAP forces people to spend more of their limited budgets on food, often choosing between less healthy options and forgoing medications or health care.

What policy or administrative changes would help SNAP better reflect the realities of living with a disability?

Policymakers should stop SNAP funding cuts scheduled for October 2027. These cuts will require states to cover part of SNAP’s costs, potentially creating more administrative hurdles or causing some states to discontinue their programs.

Instead, states should be incentivized to simplify applications and ensure they are accessible to disabled people. SNAP could also automate the identification of eligible deductions, including medical expenses, which are often higher for disabled people. Finally, SNAP should broaden its definition of disability and account for the higher costs disabled people face.