Subscribe to the MFSN News Digest.
As the sun sets on a chaotic summer during which many of us spoke out against Medicaid and SNAP cuts, we know we’re not alone in our commitment to identify more pathways to support the food needs of children and families, even in the face of these cuts to these proven programs. That’s why we’re excited to announce four new grantees for the Medicaid Food Security Partners Program (MFSPP), each receiving a $75,000 grant: Roadrunner Food Bank of New Mexico, Ohio Association of Food Banks, SC Thrive, and Feeding Texas.
As we welcome them, we thank our inaugural grantees: Voices for Georgia’s Children, Food Bank Council of Michigan, Oklahoma Policy Institute, and Federation of Virginia Food Banks, as their 18-month grant period concludes on August 31. Later this year, we’ll release case study write-ups about our journey together so that other states can learn from our experience. We look forward to continued collaboration and celebrate their hard-fought progress.
- Voices for Georgia’s Children has developed a stronger relationship with Georgia Medicaid leadership and is facilitating conversations to enable a data-sharing agreement between Medicaid and WIC, aiming to improve WIC outreach. Voices provided input on the Medicaid Managed Care Organization (MCO) procurement process to strengthen food and nutrition requirements that the health plans are subject to. Voices is also developing a postpartum food box plus SNAP/WIC navigation pilot with one of Georgia’s MCOs.
- Food Bank Council of Michigan was instrumental in this summer’s launch of the state’s In Lieu of Services (ILOS) program to pay for FIM programs for Medicaid enrollees, assisting in the development and implementation of the state’s ILOS policy guidance. FBCM secured a $1M grant for work on ILOS implementation support and FIM program development in southwest Michigan.
- Oklahoma Policy Institute advocated for recently passed legislation to integrate the Medicaid, SNAP, WIC, LIHEAP, and subsidized childcare applications. The bill calls for a feasibility study, a major stepping stone towards streamlining access to multiple nutrition and health-related benefit programs.
- The Federation of Virginia Food Banks developed legislation to fund a Medicaid ILOS program to pay for FIM programs, which was passed by state lawmakers but vetoed by the governor. It also formed a statewide Food Is Medicine coalition and wrote an op-ed published in The Virginian-Pilot calling for continued federal support of nationwide food programs.
In this digest, we share updates on anticipated impacts of the 2025 Reconciliation Bill, Medicaid 1115 waiver and ILOS developments in our Federal and State Policy Updates, and our Feature Story on the Center for Medicare and Medicaid Innovation (CMMI) MAHA Framework. Finally, we would love to connect with you in person – check out the Upcoming Events for opportunities to see MFSN staff.
2025 Reconciliation Bill
July 30th marked the 60th anniversary of the landmark legislation that created Medicare and Medicaid, which have provided healthcare to nearly one in four Americans. With H.R.1, the budget reconciliation bill, also referred to as the “One Big Beautiful Bill”, now law, fewer children and families will have access to these programs. The sweeping changes and cuts to healthcare and social safety net programs will negatively affect access to healthcare and food. MFSN is working to stay on top of the changing provisions, when they take effect, and the likely repercussions for millions of families. These are a few helpful resources:
Implementation Dates for 2025 Budget Reconciliation Law
KFF provides a timeline and description of specific healthcare provisions and when they are scheduled to take effect.
Rural Health Transformation Program
In the hours before the reconciliation bill was passed, lawmakers added $50 billion to address concerns about the potential devastation Medicaid cuts would have on rural areas. KFF provides a closer look at the $50B rural health fund in the new Reconciliation bill, though this fund likely does not make up for the cuts for rural hospitals.
States must submit proposals to CMS for how they propose to use Rural Health Transformation Program (RHTP) funds, scheduled to begin on October 1. Check out this SHVS map tracking what states are doing ahead of the deadline, especially to see whether you can submit a public comment – there are ways to frame FIM/food and nutrition security programming as part of “evidence-based chronic disease prevention and management. So far, seven states are requesting public input, and five have released an RFI.
Calculating the Impact of H.R.1
- The Congressional Budget Office (CBO) estimates 10M people will lose insurance. The Urban Institute estimates that 12M households participating in Medicaid and SNAP from 2019 to 2023 could lose access to both programs.
- A KFF analysis of CBO estimates reveals how Medicaid spending reductions could hit states unevenly, with Medicaid-expansion and rural states facing the biggest impacts.
- A study published in JAMA Health Forum found coverage losses could drive up the number of deaths and preventable hospitalizations by 2034.
- The Food Research and Action Center (FRAC) examines the shifting economic burden in its breakdown of the financial impact of SNAP cuts and cost-share changes on state budgets.
States Respond to Medicaid and SNAP Cuts in H.R.1
Michigan Governor Urges Trump to Lengthen Transition Time for Medicaid Cuts
Governor Gretchen Whitmer called for a three-year period to allow the state to work with stakeholders and create a framework that would ensure Medicaid’s stability.
Colorado Tries to Soften Impact Of Medicaid Cuts in “Big Beautiful Bill”
Colorado submitted an application, days before the bill became law, aimed at exempting the state’s Medicaid program from new federal funding limits.
Indiana Plans Aggressive New Budget Method to Control Growing Medicaid Costs
Indiana’s Family and Social Services Administration plans to adopt a new budget methodology and develop new cost-saving initiatives by estimating a two percent state budget contribution.
Massachusetts Governor Creates Anti-Hunger Task Force
Governor Maura Healey forms the Anti-Hunger Task Force to explore ways to lessen the impact of federal SNAP changes on the state.
What other strategies are you hearing about in your state? Please share them to MFSN@strength.org
Feature Story
In our feature story, we discuss areas of alignment between MFSN work, the FIM movement, and the CMS Innovation Center Strategy to Make America Healthy Again, which was published in May 2025, but is worth a deep dive now as some of the CMMI framework’s ideas also appear in the recent draft MAHA Commission report (the Administration delayed its release by a few weeks, and Politico released a draft version).
Framed as a list of desired policies (for more, check out coverage from Food Fix), the draft MAHA Commission report calls for “Food for Health” and an NIH MAHA Chronic Disease Task Force to advance Whole Person Health research. However, the report largely ignores the role of food insecurity as a driver of diet-related illness and doesn’t acknowledge how SNAP and Medicaid cuts threaten the ability of families to eat healthily. Groups like CSPI have criticized how the report mainly prioritizes voluntary industry action instead of regulations to improve food system health and safety. MFSN Steering Committee member Gina Plata-Nino of FRAC was quoted in the Atlantic, raising concern about proposed “MAHA food boxes” for SNAP participants because of implementation problems with similar food boxes during the COVID pandemic.
The draft MAHA report also calls for continued SNAP choice restriction (even though these policies create more risks than benefits). The USDA recently approved waivers for West Virginia, Florida, Colorado, Louisiana, Oklahoma, and Texas to ban soda, candy, snack cakes, and other items from SNAP. This brings the total to 12 states with food choice restriction waivers.
Federal and State Policy Updates
Medicaid 1115 Waivers & In Lieu Of Services (ILOS) Updates
Maine proposes covering Food is Medicine in 1115 Renewal Application
Submitted on June 27, 2025, Maine’s renewal application proposes expanding its 1115 demonstration to emphasize whole-person care by establishing HRSN benefits that improve outcomes for individuals and families with nutrition-sensitive conditions through nutrition case management, MTMs, MTGs, and produce prescription programs. This 1115 waiver is similar to those approved under the Biden Administration, and we’ll be watching to see how it progresses.
North Carolina Legislature Discontinues Healthy Opportunities Pilot (HOP) Funding
North Carolina’s FY2026-2027 budget did not include funding for HOP, an 1115 waiver demonstration project to address health-related social needs of rural Medicaid enrollees. As a result, all services stopped on July 1, 2025, and health plans have notified members and providers of the change. NCDHHS and partners are hopeful the recent health and economic impact of the program will revive funding in the future.
Texas Legislature Passes HB 26 ILOS – nutrition counseling and a perinatal MTM pilot
Texas HB 26, effective September 1, 2025, allows Medicaid Managed Care Organizations to offer nutrition counseling and instruction, as in-lieu-of services (ILOS) when medically appropriate and cost-effective. The bill also allows the Medicaid agency to conduct a pilot program for pregnant Medicaid participants with chronic conditions, providing medically tailored meals and “other evidence-based nutrition support services” (for more on Medicaid for pregnant people, read KFF’s explainer). The pilot’s results will be reported to the Legislature.
Oklahoma Embraces ‘Food is Medicine’ with SB 806
SB 806, or the Food is Medicine Act, tasks the Oklahoma Health Care Authority (OHCA) with pursuing an 1115 waiver, ILOS, or some other Medicaid pathway to expand nutrition supports within the state’s Medicaid program. The bill, signed on May 8, 2025, directs HCA to explore pathways for implementation that will meet federal approval.
Medicaid and Medicare Updates
CMS Removes SDOH screenings from the Medicare Hospital IQR Program
CMS finalized the removal of two Social Drivers of Health (SDOH) measures from the Hospital Inpatient Quality Reporting (IQR) program in its July 31 final rule, updating Medicare payment policies for inpatient and long-term care hospitals. The measures – Screening for SDOH and Screen Positive Rate for SDOH – can no longer be included in the CY 2024 reporting period and the FY 2026 payment determination. MFSN and our Steering Committee partner, Children’s HealthWatch, submitted public comments in June, noting the importance of food security screenings as part of assessing and improving nutrition security.
CMS Launches New Process to Remove Immigrant Medicaid Enrollees
Starting in August, CMS will send states monthly enrollment reports identifying individuals whose citizenship or immigration status needs confirmation based on Department of Homeland Security data. States must review, verify, and act on these cases, potentially adjusting coverage or ending coverage based on non-citizen eligibility rules. At the same time, there are legal efforts underway to prevent Medicaid from sharing enrollee information with the Department of Homeland Security and ICE for immigration enforcement purposes.
CMS Makes Policy Change on Continuous Eligibility for Medicaid and CHIP
CMS will phase out 1115 waivers that allow extended continuous eligibility and Medicaid workforce initiatives. It plans to allow existing initiatives to expire and limit future demonstration approvals to proposals with “clear health outcomes, cost-effectiveness, and accountability”. Multiple states have used continuous eligibility 1115 waivers to extend enrollment for children regardless of income beyond the mandated 12 months, based on the evidence that continuous coverage improves health outcomes, reduces costs for children and families, and increases government efficiency through reducing burdensome paperwork.
CMS Targets Duplicate Medicaid Enrollment Under New Initiatives
CMS announced three new initiatives in July aimed at reducing duplicate enrollment in Medicaid, CHIP, and subsidized Marketplace coverage. It cites but does not share a 2024 analysis of enrollment data that claims 2.8 million individuals were improperly enrolled across multiple states in Medicaid, CHIP, or an ACA Exchange plan simultaneously. State Health & Value Strategies and Manatt have written about unintentional multi-state and multi-program enrollment inefficiencies, which often occur when people move from one state to another.
Medicaid and CHIP Payment and Access Commission Releases Brief on Medicaid Financing
The Medicaid and CHIP Payment and Access Commission (MACPAC) published a brief in August, examining the distribution of Medicaid spending. It showed how spending varies across different eligibility groups, service categories, and delivery systems. They also note the significant differences in state financing strategies, such as provider taxes, intergovernmental transfers, and supplemental payments.
Resources & Recommended Reading
Tookit: Using Administrative Advocacy to Improve Access to Medicaid, SNAP, TANF, and WIC
This CBPP toolkit outlines the fundamentals of administrative advocacy to improve access to these public benefits. The toolkit also provides guidance on including people with lived experience in administrative advocacy.
Use the Medicaid Food Security Policy Dashboard to learn state policy examples
We wanted to remind folks about the MFSN Policy Dashboard, which was produced through review of state Medicaid Managed Care Contracts, 1115 waivers, and other publicly available policy documents to develop a compendium of examples of how Medicaid addresses food insecurity among children and families. This tool is not exhaustive, and we’re updating it with 2025 information as we speak.
Cracking the Code on ‘Food is Medicine’ Referrals
Food Bank News examines how Island Harvest, a Long Island food bank, is placing dietitians on-site at hospitals and clinics, where they enroll patients into a FIM program with healthy food boxes, nutrition education, and SNAP application assistance. Island Harvest has also started delivering healthy food boxes for Medicaid enrollees, a service paid for through New York State’s Medicaid 1115 waiver.
Public Perceptions of ‘Food Is Medicine’ Policy and Implications for Policy
This Urban Institute report analyzes public perceptions of “Food Is Medicine” (FIM) programs, including medically tailored meals, medically tailored groceries, and produce prescriptions, and found that despite low general awareness, interest in FIM programs is high among those who stand to benefit most.
Maximizing the Impact of Nutrition Interventions with Local Food Procurement
A report from CHLPI outlines how state governments can strengthen FIM programs by strategically prioritizing local food procurement – boosting health outcomes, lowering healthcare costs, and stimulating local economies – offering a powerful model for policy and community resilience. They provide several state case studies and articulate how including local food procurement in FIM brings in cross-sector and cross-political buy-in from stakeholders who care about supporting local agriculture.
Elevance Health to Work with Community Health Centers to Integrate Food as Medicine programs
In partnership with the National Association of Community Health Centers (NACHC), Elevance Health plans to incorporate its food as medicine program into community health centers for Medicaid members at risk for diet-related chronic conditions.
Child Tax Credit Increased Food Security
A new JAMA study co-authored by MFSN Steering Committee partner Children’s HealthWatch provides the first comprehensive look at how the expanded CTC improved health and economic stability for families with young children- reducing anxiety, food insecurity, and housing instability, while also identifying barriers that limited access for many eligible households. This research comes out at the same time as a JAMA study about declines in children’s health and safety, and a companion editorial that calls out the role of anti-poverty programs to reverse this trend.
‘Food Is Medicine’ Could Revolutionize Health. This Doctor Is Making It Happen
In an article with Men’s Health, Dr. Dariush Mozaffarian, director of the Tufts Food is Medicine Institute, explains how FIM is moving into mainstream care through initiatives like Medicaid pilots across 18 states, Medicare Advantage, and insurer-backed produce prescriptions, while warning that misuse of the term “healthy food” can undercut its transformative potential.
MFSN’s National Summit Report: Lessons Learned & Future Strategies
The Medicaid Food Security Network (MFSN) team released its National Summit report in June, which compiled insights gained from the inaugural event held in May. It is a comprehensive summary of sessions focused on Medicaid policy changes, data sharing, equity and dignity in programs, and research and evaluation for Food is Medicine (FIM) and food security strategies.
Upcoming Events & Opportunities
September 4: Join the MFSN Quarterly Convening at 1 pm ET/10 am PT. This session will highlight the potential for Food is Medicine (FIM) in Medicaid to generate long-term healthcare savings in an environment impacted by federal cuts to Medicaid and SNAP. Learn about the speakers and register here.
September 8: The Hunger Vital Sign National Community of Practice meets at 1 pm ET to explore how healthcare providers, community organizations, and technology platforms are working together to address food insecurity and other health-related social needs (HRSNs). Registration information is here.
September 12 is the deadline to comment for this year’s FY 26 Physician Fee Schedule public comment cycle. It’s a key opportunity to comment on whether CMS should create a reimbursement structure for medically tailored meals. The proposal is a particular way CMS could create a benefit, through the incident-to pathway, in Medicare Part B (outpatient services) for older Americans and people with disabilities.
The Food is Medicine Coalition will share a template through their listserv for organizations interested in submitting their own comment. FIMC will share this template the week of September 1st.
September 15-16: Join MFSN grantee SC Thrive at their annual training exploring the theme, SMART Technologies: Enhancing Human Potential, focusing on how innovation and technology can help us better serve our communities. Learn more and register here.
September 22: The Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) are currently accepting nominations for members of a new Healthcare Advisory Committee tasked with providing strategic guidance on the care provided by government insurance programs. They’re looking for experts in chronic disease management, financing in federal health programs, and delivery system reform.
September 28-30: Look for Dr. Julian Xie, Share Our Strength’s MFSN Director, at the Civitas 2025 Annual Conference: Bridging Data and Doing. Agenda and registration details are here.
October 7-8: MFSN grantee, FBCM, hosts the first Michigan Food as Medicine Summit in East Lansing, MI. Look for Share Our Strength/MFSN team members Katrina Scott and Sarah Mills. Check out the agenda and registration for the two-day event here.
October 8-9: Join Julian and HealthBegin’s Kathryn Jantz in Boston for the 3rd Annual Tufts Food Is Medicine National Summit. Look here for this year’s themes and speakers, including MFSN Steering Committee member Katie Garfield, Center for Health Law and Policy Innovation. You can also register for online attendance.
Questions? Story Ideas?
Please email MFSN@strength.org and include shareable language and links for content being submitted for consideration.