The One Big Beautiful Bill is already reshaping federal nutrition policy. As Congress prepares to debate the next Farm Bill, the Supplemental Nutrition Assistance Program (SNAP) faces sweeping changes that could cut billions from the program, reduce access for millions of households, and deepen food insecurity.

Laura Samuel, PhD, RN, FAAN, associate professor at the Johns Hopkins School of Nursing, has studied SNAP, food insecurity, and financial strain for nearly 2 decades. She shares what the evidence shows, why proposed changes raise red flags, and what she wants policymakers to understand.

SNAP has been shown to reduce food insecurity and improve health outcomes. What does the evidence tell us about its impact, and what happens when families lose benefits?

The evidence shows that SNAP reduces food insecurity and lowers healthcare use. Participants are more likely to take prescribed medications, have lower risks of diabetes and hypertension, and experience fewer diabetes-related hospital visits.

Food insecurity itself is tied to diabetes, hypertension, depression, and anxiety. Skipping meals changes metabolism, and the stress of choosing between food and medicine takes a toll. Over time, people who are food insecure often face disability years earlier—living with limitations like those of someone 14 years older. That translates into major costs for individuals, the health system, and society.

The pandemic served as a natural experiment: When temporary benefits ended in 2023, food insecurity rose, which underscores how closely SNAP is tied to health.

For the first time, states are being asked to share SNAP program costs. Why is this new cost-sharing rule such a concern?

SNAP has historically been funded almost entirely by the federal government, and it’s relatively inexpensive compared to other federal programs (about $2,000 per person per year for 40 million people). So, there isn’t a rationale for cutting SNAP’s budget because almost all the money, 94%, goes directly to buying food for families in need. Shifting costs to states will force cuts to benefit amounts, eligibility, or other essential services, leaving more families food insecure and raising healthcare costs.

There’s also a misconception that SNAP has high fraud rates. In reality, error rates are low, and most errors are small over- or underpayments caused by changes in households, not misuse. Framing this as fraud is misleading and using it to justify cost-sharing is shortsighted. Cutting SNAP doesn’t save money—it shifts costs onto health systems, Medicare, and Medicaid.

The proposals also include new work requirements. What would these mean for SNAP participants and their families?

The new work requirements pose challenges, especially for families with children and people with disabilities. Many SNAP recipients already work, often full-time, but still earn below the poverty line. Extending requirements to households with children as young as 7 years forces impossible choices when childcare is unaffordable. Expanding them to older adults adds another barrier, since many face health limitations that restrict the work they can do.

Another concern is that not all disabilities qualify for exemptions. Formal disability benefits are required, but determinations can take years. People with real health limitations risk losing food assistance while they wait. These rules don’t reflect people’s realities and may push families deeper into food insecurity.

An essential function for low-income families

Cutting SNAP is short-sighted; fewer benefits mean more food insecurity, and food insecurity drives worse health. We should be strengthening SNAP so benefits keep up with inflation, recognizing that SNAP dollars support local economies and translate directly into better health. Weakening the program doesn’t save money, it raises healthcare costs and harms families. Policymakers need to see SNAP for what it is: critical to keeping families healthy and children learning, now and in the future.

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