SNAP work requirements increase mental health care use

Objective We measured the impact of Supplemental Nutrition Assistance Program (SNAP) work requirements on mental health care use. Data Sources and Study Setting We used 2015-2018 West Virginia Medicaid and SNAP data. Study Design Nine counties were exposed to SNAP work requirements. Using an event study framework, we assessed how this changed the probability and number of visits for depression and anxiety in the treatment versus the control group. Data Collection/Extraction Methods The sample included individuals aged 18-49, enrolled in both SNAP and Medicaid at the start of the study. Dually eligible individuals were excluded. Principal Findings At baseline, the probability of having a mood disorder visit was 6.1% among women and 5.3% among men, rising by 0.9 percentage points (SE 0.4, relative change +14.1%) among women and 0.7 percentage points (SE 0.3, relative change +13.0%) among men after exposure to work requirements. The probability of having an anxiety visit rose by 1.0 (SE 0.4) percentage points among women, a 17.8% relative increase over the baseline of 5.8%. Among men, the likelihood of having an anxiety visit increased by 1.0 percentage points (SE 0.5), a relative change of 24.3% over a baseline probability of 5.0%, though this effect occurred much more gradually compared to women. Conclusions Exposure to SNAP work requirements was associated with increases in health care use for mood disorders and anxiety among enrollees. The policy's effect differed between men and women.