Updates from the Medicaid Food Security Network

A note from Julian, co-lead of the MFSN: “Warm hearts make the cold bearable.”

This saying someone shared with me crystallizes these past weeks – with governmental violence against our neighbors [rest in power: Ruben Ray Martinez, Luis Gustavo Núñez Cáceres, Geraldo Lunas Campos, Víctor Manuel Díaz, Parady La, Renee Nicole Good, Luis Beltrán Yáñez–Cruz, Heber Sánchez Domínguez, Alex Pretti], severe winter storms, infectious disease outbreaks, and attacks on public benefits. Yet, we also embrace community and joy through Bad Bunny’s Super Bowl show, Lunar New Year, and Black History Month. There are too many named and unnamed champions to celebrate, but I take inspiration from Shirley Chisholm, the first Black woman in Congress and brain behind WIC, the Black Panther Party, whose community feeding programs inspired the National School Breakfast program, and the late Rev. Jesse Jackson, who was a strong and longtime advocate for SNAP. We at MFSN continue to be grateful for y’all’s daily work to feed our communities healthy food and to advocate for Medicaid policy changes that will move us toward a future rooted in the heroism of our ancestors!

 

 

MFSN Announcements

• New Policy Brief! MFSN releases a brief examining the cost-effectiveness of Food is Medicine (FIM) programs. It provides a guide and a spreadsheet calculator to estimate the effect of an FIM program on Medicaid capitation rates and is primarily intended to guide program design and policy discussions. Keep scrolling for an overview and key messages.
• New Initiative! Share Our Strength launches Benefits Integration in Care Coordination (BICC) to help healthcare systems better connect families to essential nutrition benefits. The program provides funding and support to streamline enrollment in SNAP and WIC by improving outreach, navigation support and data interoperability within healthcare systems.
• Soon to be released RFP! Our next round of funding for organizations advocating for state-level Medicaid food security policy change will go live in March. Stay tuned and please attend our March 12 Quarterly Convening to learn more.

What We’re Watching: Policy & Programs

Food Is Medicine

New Food is Medicine (FIM) Bills

The new MFSN state legislation tracker follows state bills aimed at improving nutrition/food security and access to programs such as SNAP/WIC, particularly through Medicaid policy. These include the recently passed FIM bill in West Virginia and the one recently introduced in Kentucky (HJR 25 and SJR 23).

 

VA Food is Medicine Bill Follows Study of In Lieu of Service Food and Nutrition Benefit

The Virginia House recently introduced a Food is Medicine bill (HB 1434) to establish a Medicaid benefit for nutrition services through July 1, 2027, including case management, nutrition counseling and instruction, home-delivered meals and pantry stocking, nutrition prescriptions, and grocery provisions. This follows a January 2026 report from the Joint Commission on Healthcare that recommended Virginia’s Medicaid program design and pursue an In Lieu of Service (ILOS) food and nutrition benefit for individuals with diet-related chronic conditions. MFSN submitted a comment supporting the report’s ILOS recommendation and suggested refinements as the state considers adoption.

 

Community Health Workers

Virginia and Florida Pursuing Expanded Role for CHWs in Medicaid 

Virginia legislation, filed in in House (HB 337) and Senate (SB 275), would direct the Department of Medical Assistance Services, in consultation with other agencies, to evaluate and develop a statewide strategy for integrating certified Community Health Workers into Medicaid managed care models, including navigation to SNAP, WIC and other HRSN supports, assess reimbursement mechanisms, and expand workforce training. Legislation introduced in Florida, (HB 935 / SB 1026) would authorize the Agency for Health Care Administration (AHCA) to pay for CHW services as an optional Medicaid benefit, beginning July 1, 2026.

 

Rural Health Transformation Program

States have a few months before CMS begins reviewing the progress of their plans for the first $10 billion allocation of the $50 billion RHTP fund, which will determine how much each state will receive in the second year. Each state was awarded a specific amount, ranging from $147M to $281M, but there is no guarantee that each will receive the same amount for each year of the five-year program.

 

Most states include plans for food and nutrition security programs. A few examples:

• Delaware just released its RFP, which calls for addressing one of four initiatives, including Food is Medicine by “integrat[ing] nutrition-based interventions into rural health care delivery.”
• Kansas plans to use some of its funds to create an “Accountable FIM program” supported by CHWs.
• Louisiana aims to expand prevention and nutrition-based interventions to address chronic disease and maternal health.
• Virginia’s FIM initiative includes medically tailored meals and produce prescriptions for food-insecure patients with or at risk of chronic disease.

 

States applying for RHTP were encouraged to submit USDA waivers restricting SNAP purchases of sugary foods and drinks. You can track details and start dates of these waivers here.

 

A new brief by the Center for Health Care Strategies (CHCS) aims to help states build the infrastructure they need by offering best practices based on insights from previous large-scale state plans.

 

To stay up-to-date on RHTP, we’re following these resources:

Rural Health Transformation Program   

State Health and Value Strategies  

KFF

New Policy Brief

Calculating the Cost of Medicaid FIM Interventions

 

Though the cost savings of FIM are becoming more evident, their use in evaluating health insurance cost-effectiveness is still in its early stages. This brief provides a framework and methodology for calculating and analyzing the cost-effectiveness and policy implications of FIM programs. Its goal is to help policymakers and advocates apply established actuarial methods to conduct balanced analyses of the predicted costs and potential savings from FIM programs by providing a step-by-step guide to using a spreadsheet calculator that will estimate a FIM program’s impact on Medicaid capitation rates. This calculator covers cost assumptions, including the target population and meal/box costs, highlights considerations for offsetting costs and improving Return on Investment (ROI), and details how to test the cost limits of proposed FIM programs.

 

Key points:

• The FIM calculator assesses if a program’s cost is reasonable within the annual managed care budget, but it is not intended to formally evaluate first-year savings.
• Due to ongoing FIM grocery studies and other assumptions/limitations, the tool’s precision is limited; its main purpose is to guide program design and policy decisions.
• Despite limited detailed data, the calculator will enhance understanding of how FIM costs relate to broader healthcare costs.
• We include projected savings from eligible, but unenrolled, Medicaid members joining SNAP and WIC as part of wraparound services typically included in FIM programs.
• Focuses on predicting costs for FIM grocery programs delivered through In Lieu of Services (ILOS).

 

Look for this icon  as you work through the calculator. Various tips are provided throughout the document to help you test different scenarios

Upcoming Events and Opportunities

February 27: States interested in building or expanding FIM capacity are invited to submit a Letter of Intent for the new Rockefeller-funded FIM State Officer Program. The Center for Health Care Strategies (CHCS) will select up to 10 states to receive funding to hire FIM state officers within their Medicaid, public health, or other government agencies. Learn more.

 

February 27: Frontline Justice invites those whose work helps community members navigate the legal system or find resources to stabilize their lives to submit a proposal for a community justice worker convening on May 13, before the Equal Justice Conference. The organization is particularly interested in proposals led by people with lived or community experience.

 

If your state has a community justice program or has been exploring the idea, there’s still time to share your thoughts and experience in the Frontline Justice National Community Justice Worker Survey, also due on Feb 27.

 

March 4: Camden Coalition is currently seeking proposals for workshop presentations for Putting Care at the Center 2026 in Oakland, CA. Workshops should target a broad audience and focus on one of several areas, including food and nutrition.

 

March 10: The Medicaid Food Security Partners Program (MFSPP) Cohort 3 request for grant proposals will be released.

 

March 12: Join the next MFSN Quarterly Convening at 1 pm ET/10 am PT. Speakers include: Gina Plata-Nino, FRAC; Neena Schultz, National Association of Community Health Workers (NACHW); Maya Stefanovic, UnitedHealthcare; and Jessica Osenbrugge, Roadrunner Food Bank of New Mexico. Register here.

 

April 26-28: Join anti-hunger advocates from across the country at the 2026 FRAC National Anti-Hunger Policy Conference in Washington, DC, for networking, interactive training, and content-rich sessions, followed by an advocacy day on Capitol Hill. Register here.

 

May 12–13: Join health leaders from across New Mexico at the 2026 New Mexico Symposium on Health, presented by Nicotine Free New Mexico, in Albuquerque, NM, for two high-impact days of collaboration, bold ideas, and action to advance health equity statewide. Public health professionals, healthcare providers, policymakers, and advocates will explore innovative, community-driven solutions addressing prevention, nutrition, and equitable access to care. Learn more.

 

June 1-2: The Center for Health Law and Policy Innovation (CHLPI), Food is Medicine Coalition, National Produce Prescription Collaborative (NPPC), and Tufts FIM Institute are organizing the first Food is Medicine Conference (FIMCON) in Washington, DC. After the conference on June 3, there will be a FIM Advocacy Day on Capitol Hill. Check here for details on both events.

 

Policy Highlights & Resources

State Policy Updates

Massachusetts Outlines Plans for 1115 Demonstration Extension Request in Late 2026.

On January 23, 2026, the Massachusetts Department of Health and Human Services released details of its forthcoming 2028–2032 Section 1115 Demonstration waiver extension request and two opportunities for public input on February 9th and February 25th. The state plans to seek continued authority for its ACO (Accountable Care Organization) Program and for nutrition and HRSN services, citing their impact on reducing health care utilization and cost. The state anticipates requesting continued authority for all HRSN Supplemental Nutrition Services (home-delivered meals, food boxes, food prescriptions, nutrition education, and kitchen supplies). They are also considering requesting continued authority for nutrition transportation, “application assistance” and “benefits maintenance”, and other nutrition services not implemented under HRSN Supplemental Services, as well as potential changes to the ACO program to improve access, quality and efficiency.

 

California Strategy Safeguarded Some Medicaid Social Services Funding from Trump

Medicaid spending on certain nonhousing social services, such as mental health care, drug counseling and job training, will not end with the expiration of California’s 1115 waiver on December 31. That’s due to a decision years ago by the state to include these wraparound programs under ILOS (In Lieu of Services), a designation confirmed by a Centers for Medicare & Medicaid Services spokesperson. This means these services will continue to be reimbursed under Medicaid, despite the Trump administration’s opposition to such spending. However, California has ended Medicaid coverage of weight loss drugs for obesity, but will continue to cover GLP-1s for other health issues, such as type 2 diabetes

 

Indiana to Bid $68B in Medicaid Contracts this Summer

Indiana’s Family and Social Services Administration (FSSA) is expected to release a Request for Proposals (RFP) in August 2026 for all four of the state’s Medicaid managed care programs: Healthy Indiana Plan, Hoosier Healthwise, Hoosier Care Connect, and Pathways for Aging. The programs cover approximately 1.4 million enrollees. The target date for the new contracts is January 1, 2029.

 

New Hampshire and New York Pursue Different Approaches to Offset Federal Medicaid Cuts

Starting in July 2026, New Hampshire will implement monthly Medicaid premiums ranging from $60 to $270, with the program expected to raise $23 million for fiscal years 2027 and 2028. While New York Governor Kathy Hochul is proposing a nearly $4 billion increase to her state’s Medicaid budget, despite a $10.3 billion budget decline driven by reduced federal aid.

 

Hawai’i: New process connects eligible families to SNAP and WIC

SNAP-eligible families in Hawai’i will now be automatically referred to WIC. The state recently announced that the Health Department, which administers SNAP, will send monthly referrals to the Department of Human Services, which administers WIC, to ensure that families who meet the income eligibility requirements for both programs have maximum access to nutritious food and health supports.

 

New Coalition Launches “Food as Health Care” in Pennsylvania

Advancing FIM in Pennsylvania is the top item on the policy agenda of The “Food as Health Care” Coalition, an alliance of health systems, community-based organizations and food system leaders in the state. The Coalition aims to support the Commonwealth in implementing its 1115 Medicaid waiver, which will offer FIM interventions to eligible populations such as pregnant individuals, individuals experiencing homelessness, and those with chronic health conditions. Gov. Josh Shapiro’s 2026-2027 budget proposal sets aside $900K in funding for the program.

 

OK Complete Health and Fresh Rx OK launch PRx program for type 2 diabetic members

The Fresh Rx Oklahoma program will deliver fresh, locally grown produce biweekly to Tulsa residents with type 2 diabetes who are enrolled in Oklahoma Complete Health, Oklahoma’s Centene-affiliated Medicaid managed care organization. This year-long initiative will include nutrition education and regular clinical check-ins to monitor A1C levels, blood pressure, and weight. The Oklahoma Food is Medicine Act is credited with catalyzing this partnership to scale up healthcare financing of the existing Fresh Rx OK program.

 

Federal Policy Updates

CMS Releases 2026 Medicaid and CHIP Beneficiary Profile

The Medicaid and CHIP Beneficiary Profile shows a decrease in Medicaid and CHIP enrollment from 78.7M in February 2025 to 76.7M (including 69.5M enrolled in Medicaid) in October 2025. The Profile also includes a snapshot of participants in 2023:

• SNAP participation: 38% of households with at least one household member covered by Medicaid or CHIP reported receiving SNAP benefits in the 12 months prior to being surveyed.
• By age group: The largest participation was in the 26-44 age group, with 25.1M, followed by the 3-11 age group, with 21.5M.

 

Medicaid Tech Companies Pledge $600M to Support System Improvements

CMS announced that 10 health technology companies with existing Medicaid contracts have pledged $600 million in no-cost or discounted services to help states implement new Medicaid community engagement (work requirement) rules and modernize their systems. This could include free integrations with SNAP and Medicaid, automating Medicaid community engagement compliance for individuals who already meet SNAP work requirements.

 

APM Adoption Survey Reveals Health Plans’ Commitment to Value-Based Care Models

The 2025 Alternative Payment Model (APM) Adoption Survey, released by AHIP and CMS, looked at data across commercial, Medicaid, Medicare Advantage, and original Medicare. They found that 44.9% of all health care payments in 2024 were tied to APMs, a slight decrease from 45.2% in 2023. Still, 70% of health plan respondents expect APM activity to increase over the next two years, citing provider readiness and health plan engagement as key facilitators. APMs shift payment from fee-for-service models to arrangements that reward quality, efficiency, and improved patient outcomes. Moreover, APMs can generate flexibility for healthcare payment and provision for nutrition supports. In this survey, 93% of respondents believe APM adoption will improve care coordination, which could be an opportunity to integrate navigation into SNAP, WIC, and other HRSN services.

 

Resources

A Progressive Revenue Playbook Addressing Federal Disinvestment and State Fiscal Challenges

The article explains how H.R. 1 could reduce federal support for key programs and create new budget pressures for states. It also shares a “progressive revenue playbook” outlining ways states could raise revenue to help offset federal cuts.

 

Food Is Medicine Community Action Plan

The Food Is Medicine Community Action Plan is an ongoing online resource from Food & Society at the Aspen Institute that shares community-centered strategies, case studies, and practical insights for designing, funding, evaluating, and expanding food-based health interventions across the U.S. by bringing together healthcare leaders, food system partners, community organizations, and policymakers to advance real-world solutions that connect nutrition with improved health and equity. It translates evidence about how food can support health into actionable guidance and examples that help communities implement and scale programs like medically tailored meals, produce prescriptions, and other nutrition interventions.

Recommended Reading

Food Is Medicine (FIM)

The Future of Nutrition Interventions in Medicaid

In a JAMA commentary, Drs. Kurt Hager and Seth Berkowitz contend that two flawed perspectives threaten FIM innovation: treating healthcare-funded FIM programs (produce prescriptions and medically tailored meals and groceries) and federal programs such as SNAP and WIC as interchangeable, and failing to fully recognize nutrition as an essential component of clinical care. Clinical FIM interventions and federal nutrition programs are complementary health strategies – where SNAP supports household food security alongside FIM programs tailored for diet-related conditions.

 

A Nutrition Forward Approach to SNAP

This Manatt piece discusses elevating SNAP’s connection to nutrition in the context of SNAP-Ed’s elimination and the proliferation of SNAP restrictions on unhealthy foods and beverages. The article highlights three main strategies for leveraging SNAP’s current infrastructure to expand access to nutritious food. They call for support for SNAP nutrition incentive programs, stronger connections between SNAP and healthcare, including enhancing cross-enrollment support between Medicaid and SNAP, and better connecting SNAP and FIM, and advancing nutrition education.

Both pieces resonate with the MFSN brief on how Food is Medicine is Complementary with SNAP and WIC to improve the diets of children and families.

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Prescribing Prevention: How Nutrition Access is Shaping Affordable Healthcare

Integrating personalized nutrition support directly into routine healthcare workflows has the potential to improve patient health outcomes and reduce healthcare costs. A new initiative, a collaboration between Elevance Health and the National Association of Community Health Centers (NACHC), aims to demonstrate this by embedding nutrition supports into standard healthcare procedures, training providers on how to incorporate them, and creating reimbursement pathways.

 

Evolving food as medicine programs to advance health equity: insights from two decades of practice

The Nourishing Our Community (NoC) Program at Boston Medical Center offers a “replicable” model for other health systems seeking to integrate FIM initiatives and advance health equity. This study details the historical development and key adaptations of NoC, one of the first FIM initiatives in the US.

 

FIM Programs for Pregnant Women in the U.S.: A Systematic Review

Perinatal FIM is on the rise, and this evidence review shows promising outcomes. However, additional research is needed to address limitations in reporting, funding, and program implementation. Our Sept 2025 MFSN quarterly convening showcases emerging case studies in building the evidence base for perinatal FIM.

 

Medically Tailored Grocery Delivery for Food Pantry Clients with Diabetes

A study in the Journal of Nutrition Education and Behavior found that home delivery dramatically increased engagement in medically tailored grocery programs for individuals with diabetes and food insecurity, boosting participation from 18% (pickup) to 97% (delivery). This high engagement led to a clinically significant result: a 0.56% reduction in participants’ HbA1c levels.

 

Additional Readings on FIM

Produce prescriptions help Medicaid patients overcome nutrition insecurity

“Game Changing” Food is Medicine Program Revs Up

Medically Tailored Meals: A case for federal policy action

Feasibility of an Indigenous FIM Program for Patients With Heart Failure in Rural Navajo Nation

Trainings & Workshops

Frontline Justice – SNAP & Medicaid Benefits Training for Community Workers: With looming changes to work requirements and increased administrative challenges to accessing public benefits, Frontline Justice is developing SNAP and Medicaid training for frontline workers to help their communities exercise their legal rights to get and maintain their benefits.

 

Developed with support from the National Community Justice Worker Task Force, these self-paced trainings focus on simple, but effective ways to counter delays and denials– methods that have already recovered over $23.6M in benefits in Alaska alone. If you’re interested in bringing these trainings to your organization, email nikole@frontlinejustice.org. To learn more about the work of CJWs, check out this brief about an Alaska community justice program that helped eligible but not enrolled families receive SNAP benefits.

Connect with the Network

Join our LinkedIn group:  Stay connected, get updates and calls to action in between our News Digests by joining our new MFSN LinkedIn group.

 

Contact Us:  Subscribe to our quarterly News Digest. To submit content for consideration, please email MFSN@strength.org with shareable language and links to content.