The Largest Increase to SNAP Benefits in the Program's History

 By Center for American Progress

In October 2021, millions of people who use the Supplemental Nutrition Assistance Program (SNAP) will see an increase to the benefits that help them feed themselves and their families. This change was made possible by a seemingly obscure process: the reevaluation of the U.S. Department of Agriculture's (USDA) Thrifty Food Plan (TFP). The TFP is the most frugal of the four plans that the USDA develops to estimate the costs and contents of a healthy diet, and it has special policy importance as the basis for determining the maximum amount of SNAP benefits available to families. For years, SNAP recipients, anti-hunger advocates, and academic experts have argued that the TFP underestimates the cost of a nutritionally adequate diet. To address these concerns, Congress directed the USDA to regularly reevaluate the TFP using recent dietary guidance and current food prices, among other factors, in the 2018 bipartisan Farm Bill.   In August 2021, the Biden administration's USDA revealed the results of the reevaluation and cost update to the TFP as well as its impact on the SNAP program. According to the agency, SNAP benefits will increase by about 25 percent—an average of $36.24 per person each month, or $1.19 per day. Although relatively modest, this represents the single largest permanent increase in SNAP benefits in the program's history.   The long-awaited, science-driven update to the TFP will yield immediate benefits for the more than 40 million people who use SNAP to feed their families. Moreover, it's an important step toward improving food assistance and, ultimately, building a more compassionate, comprehensive social safety net. Read more about the details here.

Largest real-world study of COVID-19 vaccine safety

The Clalit Research Institute, in collaboration with researchers from Harvard University, analyzed one of the world’s largest integrated health record databases to examine the safety of the Pfizer/BioNTech BNT162B2 vaccine against COVID-19. The study provides the largest peer-reviewed evaluation of the safety of a COVID-19 vaccine in a nationwide mass-vaccination setting. The study was conducted in Israel, an early global leader in COVID-19 vaccination rates.

Previous efforts to characterize vaccine safety have relied on voluntary active reporting by vaccinated individuals, which is known to be incomplete. The present study relies on the analysis of millions of anonymized electronic medical records, which are far more comprehensive.

Furthermore, in order to provide the necessary context for interpreting vaccine safety findings, this study is the first to examine a wide range of adverse events both among vaccinated individuals and among unvaccinated individuals who were infected with the coronavirus. Thus, two separate analyses were conducted:

1. Vaccination Outcomes Analysis: 884,828 vaccinated individuals aged 16 and over were carefully matched with 884,828 unvaccinated individuals based on an extensive set of sociodemographic, geographic and health-related attributes. Individuals were assigned to each group dynamically based on their changing vaccination status (235,541 individuals moved from the unvaccinated cohort into the vaccinated cohort during the study). Rates of the 25 potential adverse events within three weeks following either vaccine dose were compared between the two groups. This analysis took place from December 20, 2020, the launch of Israel’s national vaccination campaign, through May 24, 2021.
2. Infection Outcomes Analysis: To provide context for the vaccine safety findings above, a separate analysis was conducted that estimated the rates of the same 25 potential adverse events among 173,106 unvaccinated individuals who were infected with the coronavirus, compared to 173,106 carefully matched controls who were not infected with the coronavirus. This analysis took place from March 1, 2020 (the beginning of the COVID-19 pandemic in Israel) through May 24, 2021.

The vaccine was found to be safe: Out of 25 potential side effects examined, 4 were found to have a strong association with the vaccine.

Myocarditis was found to be associated with the vaccine, but rarely – 2.7 excess cases per 100,000 vaccinated individuals. (The myocarditis events observed after vaccination were concentrated in males between 20 and 34.) In contrast, coronavirus infection in unvaccinated individuals was associated with 11 excess cases of myocarditis per 100,000 infected individuals.

Other adverse events moderately associated with vaccination were swelling of the lymph nodes, a mild side effect that is part of a standard immune response to vaccination, with 78 excess cases per 100,000, appendicitis with 5 excess cases per 100,000 (potentially as a result of swelling of lymph nodes around the appendix), and herpes zoster with 16 excess cases per 100,000.

In contrast to the relatively small number of adverse effects associated with the vaccine, high rates of multiple serious adverse events were associated with coronavirus infection among unvaccinated patients, including: Cardiac arrhythmias (a 3.8-fold increase to an increase of 166 cases per 100,000 infected patients), kidney damage (14.8-fold increase; 125 excess cases per 100,000), pericarditis (5.4-fold increase; 11 excess cases per 100,000), pulmonary embolism (12.1-fold increase; 62 excess cases per 100,000), deep vein thrombosis (3.8-fold increase; 43 excess cases per 100,000), myocardial infarction (4.5-fold increase; 25 excess cases per 100,000), and stroke (2.1-fold increase; 14 excess cases per 100,000).

The research was conducted by Dr. Noam Barda, Dr. Noa Dagan, Yair Ben-Shlomo, Dr. Eldad Kepten, Dr. Jacob Waxman, Reut Ohana and Prof. Ran Balicer from the Clalit Research Institute, Dr. Doron Netzer of Clalit Health Services, as well as Prof. Miguel Hernán and Prof. Marc Lipsitch of the Harvard T.H. Chan School of Public Health, Prof. Isaac Kohane of the Department of Biomedical Informatics at Harvard Medical School, and Prof. Ben Reis of Boston Children’s Hospital and Harvard Medical School.

This study focused on adverse events that may develop in the short to medium term after vaccination, and those with clinical significance. The study did not focus on common immediate symptoms such as redness and discomfort at the injection site or fever. Symptoms that occurred within 6 weeks of the vaccine (three weeks after each vaccine dose) were defined as an adverse event of the vaccine if they occurred more frequently among the vaccinated group compared to the control group.

The results of this study validate and complement the previously reported findings of the Pfizer/BioNTech Phase-III randomized clinical trial, which, with 21,720 vaccinated individuals, could not precisely and comprehensively assess vaccine safety. The present study’s large size allows a more detailed assessment of the vaccine’s safety across a wider range of adverse events.

“The extensive nationwide rollout of Israel’s COVID-19 vaccination campaign provided the Clalit Research Institute with a unique opportunity to assess, through its rich and comprehensive digital datasets, the safety of the vaccine in a real-world setting, without needing to rely on individual-driven active reporting of side-effects” said Prof. Ran Balicer, senior author of the study, Director of the Clalit Research Institute and Chief Innovation Officer for Clalit. “These results show convincingly that this mRNA vaccine is very safe and that the alternative of ‘natural’ morbidity caused by the coronavirus puts a person at significant, higher and much more common risk of serious adverse events. These data should facilitate informed individual risk-benefit decision-making, and, in our view, make a strong argument in favor of opting-in to get vaccinated, especially in countries where the virus is currently widespread,” added Prof. Balicer, who also serves as Chairman of Israel's National Expert Advisory Team on COVID-19 response.

“This study sheds light for the first time on the significant side effects of the coronavirus vaccine. Since this is a more comprehensive analysis based on electronic medical records, these are more reliable assessments than those published to date which have relied on voluntary active reporting systems,” explains Doron Netzer, Chief Medical Officer of Clalit’s Community Health Division.

Prof. Ben Reis, Director of the Predictive Medicine Group at the Boston Children’s Hospital Computational Health Informatics Program and Harvard Medical School, said, “To date, one of the main drivers of vaccine hesitancy has been a lack of information regarding potential side effects of the vaccine. This careful epidemiological study provides reliable information on vaccine safety, which we hope will be helpful to those who have not yet decided about vaccination.” He continued, “Those who have hesitated until now to get vaccinated due to concerns about very rare side effects - such as myocarditis – should be aware that the risks for this very same side effect are actually higher among unvaccinated infected individuals."

Prof. Miguel Hernán, Director of the CAUSALab and Professor at the Harvard T.H. Chan School of Public Health, said, “This research is a perfect example of how randomized trials and observational healthcare databases complement each other. The original trial of the Pfizer/BioNTech vaccine provided evidence of its safety, but the estimates were too imprecise given the small sample size. This analysis of Clalit’s high-quality database emulates the design of the original trial, uses its findings as a benchmark, and expands upon them to confirm the vaccine’s safety on a wide range of adverse events. This combination of evidence from randomized trials and observational studies is a model for efficient medical research, something which is especially important in COVID times.”

Prof. Marc Lipsitch, Director of the Center for Communicable Disease Dynamics and Professor at the Harvard T.H. Chan School of Public Health, said, “In all studies of vaccine safety, a major challenge is to ensure that those we are comparing to identify the vaccine’s side effects are similar in the other characteristics that may predict whether they will experience these side effects. This is especially hard in the context of a rapidly growing, age-targeted vaccine campaign. Clalit’s extraordinary database made it possible to design a study that addressed these challenges in a way that provides tremendous confidence in the inferences that come out of the study.”

The research was funded in part by the newly announced Ivan and Francesca Berkowitz Family Living Laboratory Collaboration at Harvard Medical School and Clalit Research Institute. “The strengthening of the scientific collaboration between Harvard and Clalit made possible by the Berkowitz Living Laboratory Collaboration is already bearing fruit and giving us a foretaste of the value of healthcare systems instrumented for research,” said Prof. Isaac Kohane, Chair of the Department of Biomedical Informatics at Harvard Medical School and co-Director of the Ivan and Francesca Berkowitz Family Living Laboratory Collaboration along with Professor Balicer. “Israel offers a unique environment in which to study the vaccine and its effects, and this study is an excellent example of what can be accomplished through such close scientific collaborations.”

Health Insurance Company CEO Compensation

CONNECTICUT CITIZEN ACTION GROUP 

On April 13, 2021, five health insurance companies sent Governor Ned Lamont a letter, threatening to move jobs from Connecticut to other states should the state enact a Public Option. This report, by the Connecticut Citizen Action Group, looks at CEO compensation at these five insurance companies:  Anthem  CIGNA  CVS Health (which acquired Aetna in 2018)  Tufts/Harvard Pilgrim  UnitedHealth Group 

Soon after receiving this letter, the Governor and legislative leadership abandoned the Public Option proposal. Subsequent reports will examine the role of the greed of insurance companies in limiting access to care and undermining public health. Visit ccag.net or updates and more information. 

Anthem Gail K. Boudreaux $17,109,952 

Cigna David M. Cordani $79,000,000 

Harvard Pilgrim Health Care/ Tufts Health Plan * Michael Carson  $2,558,227; Thomas Caswell $2,221,779 

CVS Health Karen S. Lynch $11,307,916 

UnitedHealth Group Dirk C. McMahon  $12.606,484; Andrew Witty$12,857,176 

TOTAL $137,661,534 30 ARBOR ST STE 107  HARTFORD, CT 06106  (860) 233-2181  FAX: (860) 233-2189  E-MAIL: ACTION@CCAG.NET  WEBSITE: WWW.CCAG.NET 

Putting People First Produced By UAW Members Local 376 

In the words of former CIGNA executive Wendell Potter: 

“At Cigna, my top job objective was to enhance shareholder value. It was not to make sure our employers or customers were getting a good value for all the money they handed over to their insurer - it was not to make sure people enrolled in our health plans were getting the care their doctors said they needed. No, it was to make sure Wall Street and already rich investors were happy. “I want to apologize to the people of Connecticut for the work I did during my career to mislead them and obscure important information. I want to apologize for the role I played in perpetuating a hugely expensive and grossly unfair health care system for no reason other than to protect profits and make Wall Street happy. “I was especially upset to see the insurance executives threaten this year to pull out of CT if the legislature passes the Public Option. As if they really care about the fate of their employees. Ask them how many people they have laid off and how many of those jobs have been shifted overseas... Really look closely at how these companies really behave and what they are doing to their workforce.” 

Knowledge of these diverted resources and tactics is necessary for an informed and engaged public.

Modernizing SNAP Benefits Will Help Millions of Families Afford Healthy, Nutritious Diet

 

Center on Budget and Policy Priorities

The U.S. Department of Agriculture (USDA) today announced an update to the Thrifty Food Plan, which is used to set benefit levels for the Supplemental Nutrition Assistance Program (SNAP). This science-driven and long-overdue reevaluation will be welcome news for families across the country, many of whom will be better able to afford a healthy diet with greater SNAP benefits.

The Thrifty Food Plan is a set of foods that represent a nutritionally adequate diet that low-income households can purchase and prepare, assuming they take significant steps to stretch their food budget. The cost of the Thrifty Food Plan is the basis for SNAP benefit levels.

Congress directed USDA in the bipartisan 2018 farm bill to reevaluate the Thrifty Food Plan by 2022 to better reflect current information. Specifically, in section 4002 of the law Congress gave USDA the following instructions:

By 2022 and at 5-year intervals thereafter, the Secretary shall re-evaluate and publish the market baskets of the thrifty food plan based on current food prices, food composition data, consumption patterns, and dietary guidance. [7 U.S.C. 2012(u)]

Today’s announcement, based on analysis completed by USDA’s nutritionists, researchers, and policy experts and informed by external stakeholders, fulfills that directive in time for SNAP benefits to be adjusted October 1, the start of fiscal year 2022. A 125-page report includes substantial details about USDA’s methodology for the update.

USDA explains that it used the same mathematical model for this revised Thrifty Food Plan as it did for prior updates, and it relied on the most recent available data about the four factors identified in the 2018 farm bill. The revised plan reflects current nutritional guidelines and includes a broader range of healthy foods than the prior plan (released in 2006) while still expecting families to economize their food purchases.

The cost of the revised plan is higher than the prior plan and will result in a meaningful but modest increase in SNAP benefit levels. The maximum SNAP benefit will rise by 21 percent (not including the regular annual inflation adjustment, which this year is about 1.5 percent). The average benefit will rise by about $1.20 per person per day, according to USDA. This will result in average benefits per person per day rising from about $4.25 to about $5.45 in fiscal year 2022, CBPP estimates (without the temporary, pandemic-related increases that are now in place but expire in the coming months).

Until now, the Thrifty Food Plan had been adjusted only for inflation since the 1970s, even as our understanding of what constitutes a healthy diet changed. That’s left SNAP benefits badly out of line with the most recent dietary recommendations and the economic realities most struggling households face when trying to buy and prepare healthy foods. Indeed, roughly half of households receiving SNAP benefits are food insecure, reflecting the reality that their SNAP benefits combined with their income aren’t enough to afford food.

The outdated Thrifty Food Plan relied on a very narrow range of less expensive foods to stay within the same low-cost constraint over the years. For example, it assumed that a family of four each week consumed several pounds of beans and 40 pounds of lower-fat and skim milk and yogurt (equal to about 4.5 gallons of milk or 20 32-ounce tubs of yogurt). By contrast, it included only small amounts of foods that many families typically eat, such as eggs and cheese.

Scientific evidence now emphasizes the importance of eating a broad range of foods, including more whole grains; red, orange, and leafy green vegetables; lean proteins; and seafood. USDA’s update reflects this evidence, basing the Thrifty Food Plan on a more varied set of healthy foods that meet current nutritional standards and are more in line with what households actually eat. For example, the updated plan includes more red and orange vegetables than the 2006 version did.

Previous plans also assumed that families have the time to prepare most of their meals from scratch, counting on them to spend one to two hours cooking each day. In reality, the typical working person spends under an hour, and sometimes less than 15 minutes, on daily meal preparation. Preparing a healthy meal requires both time — to plan menus, travel to and from a grocery store, comparison shop to minimize costs, and prepare meals — and money. The updated plan includes healthy foods that take less time to prepare, even if they cost modestly more, such as pre-sliced frozen vegetables or ready-to-cook cuts of lean meat. For example, the updated plan assumes that nearly all beans are purchased in canned form, unlike the previous version, which relied heavily on dried beans.

SNAP households aren’t limited to buying only the foods in the Thrifty Food Plan, but SNAP benefits that include more realistic assumptions will better reflect the cost of a healthy diet — allowing households to buy healthier foods — and will make a difference for families who often run out of benefits before the month ends. The increase will be particularly important for families who live in high-cost areas where housing takes up a larger share of their income, leaving less for food.

While the increase in SNAP benefits resulting from the revised Thrifty Food Plan will make benefits more adequate going forward, SNAP households’ benefits will rise by only about 7 percent in October. That’s because a temporary 15 percent increase in SNAP benefits established by the December 2020 COVID-19 relief bill and extended by the American Rescue Plan is slated to expire at the end of September. Thus, in October, the temporary 15 percent increase will end and the 21 percent Thrifty Food Plan increase will take effect. (The regular annual inflation adjustment will also take effect in October.)

Another pandemic-related SNAP benefit measure that has provided SNAP participants with emergency supplementary benefits will end when federal or state COVID-19 public health emergency designations expire. At that time many households will experience a substantial cut to their SNAP benefits.

Increased SNAP benefits will help address the disproportionate impacts of benefit inadequacy on people of color. Poverty and food insecurity rates are higher among Black and Latino households due to racism and other structural factors, including unequal education, job, and housing opportunities, that contribute to income disparities. Because of SNAP’s role in addressing higher food insecurity among people of color, ensuring benefits are adequate is especially important in these communities.

This benefit increase will also have positive impacts on children, for whom the effects of food insecurity are particularly detrimental. Children participating in SNAP face lower risks of nutritional deficiencies and poor health. SNAP also can affect children’s ability to succeed in school. One study, for example, found that test scores among students in SNAP households are highest for those receiving benefits two to three weeks before the test, suggesting that SNAP can help students learn and prepare for tests. Additional studies show that receiving SNAP benefits has significant long-term benefits for children, including improved health, educational attainment, and labor market outcomes.