Several 1115 waivers approved over the past few months further drive the integration of food is medicine into Medicaid. There are many notable developments to reflect on—approval to calculate, under certain circumstances, food supports at the household level in Massachusetts and the seemingly widespread dedication of funding to support critical infrastructure development among others. In this blog post, however, we want to focus in on one specific trend: increased attention to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
More specifically, approval of the demonstration projects in Arizona, Arkansas, Massachusetts, and Oregon requires each state’s Medicaid program to:
1. Capture the percentage of beneficiaries enrolled in WIC as part of Medicaid enrollment and renewal metrics; and
2. Create a plan for tracking and improving the share of Medicaid beneficiaries eligible and enrolled in WIC (and SNAP), relative to the number eligible.
It is especially exciting to see the explicit commitment on the part of state Medicaid programs to be active partners in strengthening WIC coverage rates. In 2019, the WIC coverage rate in Arkansas was only 49.1%. Arizona’s coverage rate was 55.8%. Coverage rates in Massachusetts and Oregon were 62.5% and 69%, respectively. In other words, everyone has room to improve.
Coverage Rate = Number of Participants / Number of Eligible Individuals
It is also notable that in each of the above instances the commitment has been created by the Centers for Medicare and Medicaid Services (CMS) as a condition of approval for the Medicaid program’s other food insecurity and nutrition programming. We cannot pretend to know what drove federal regulators in this direction. Still, it is interesting to think about what this may mean for how CMS is thinking about the limits of what Medicaid should cover (e.g., that Medicaid should not be covering unmet health-related social needs that would be resolved by participation in other social programs).
To date, we are not aware of any published draft or final implementation plans. We will update this blog post in the coming months as such plans become available. We hope we will be able to report back that state Medicaid programs are investing in improving WIC coverage rates in more robust, creative, and meaningful ways.