WIC has proven effective in improving the health of children and mothers. This could be a big year for the program.
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WIC enrollments have been languishing for years. But with a new administration determined to make a dent in poverty, has WIC’s time come?
Since 1974, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) has proven successful among low-income pregnant and postpartum women and kids up to age 5 in mitigating some effects of malnutrition, including anemia, childhood obesity, low birthweight, and school unreadiness. As many as 12,000 WIC clinics serve 6.3 million people across the country, but the program doesn’t have the reach it should: Enrollments among those currently eligible are just above 50 percent and are even lower—42 percent—for kids in the 1 to 4 age range.
“For how effective WIC proved to be to improve health outcomes, it doesn’t get the attention it deserves,” said Aditi Vasan, a pediatrician at the Children’s Hospital of Philadelphia.
Unlike SNAP, which serves some of the same demographic and is a food benefit program, WIC is technically a preventive health program. It offers breastfeeding support, nutrition education, vaccination information, and provides funding for infant formula and certain vitamin- and mineral-rich foods, like milk, eggs, iron-fortified breakfast cereals, and beans. Once, a mom swapped paper vouchers for these items at the supermarket; the Healthy, Hunger-Free Kids Act of 2010 required states to switch to EBT cards by October of 2020. Vasan co-authored a new study on the effects of that switch, motivated, she said, by “patients in my practice telling me the vouchers were like a scavenger hunt: You have to match the food to the voucher and you hope you have a trained cashier to ring you up so you don’t you have to stand there with everyone waiting on line behind you.” EBT, her study showed, boosted enrollment by 8 percent overall, and 9.12 percent in the 1 to 4 age range. WIC’s own tracking shows that North Carolina and Kentucky have boosted enrollments by 20 percent since February of 2020.
“We know that children under the age of 6 aren’t receiving school-based meals unless they’re in kindergarten, and they’re too old for formula. That means they’re particularly vulnerable.”
While Georgia, New Jersey, Mississippi, Maine, Washington, D.C., Puerto Rico, and some tribal communities are still working to implement EBT, there are several other potentially significant changes pending for WIC that could improve the program’s reach and scope. If they all manage to fly under an administration that seems determined to make a dent in poverty—and in the WIC-eligible’s access to its benefits—this could be, according to Brian Dittmeier, senior public policy counsel for the National WIC Association, “a fantastic opportunity.”
For starters, on April 9 the Biden administration proposed that the U.S. Department of Agriculture use $1 billion from its discretionary accounts to boost funding for “critical nutrition programs.” WIC in particular was called out as requiring more financial support as increases in participation are expected to rise, and for its ability to “combat rising food insecurity, which has disproportionately harmed families of color,” according to a USDA press release.
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Additionally, the WIC Act is now pending in Congress. If it passes, it would expand eligibility for children up to age 6—a seemingly small change that would bridge a large gap for kids who aren’t yet in school and therefore can’t partake of free meals through the National School Lunch and School Breakfast programs. “We know that children under the age of 6 aren’t receiving school-based meals unless they’re in kindergarten, and they’re too old for formula,” says Vasan. “That means they’re particularly vulnerable.” The Act would bring 600,000 more kids into the program, according to Pennsylvania Senator Bob Casey, a co-sponsor of the bill along with Susan Collins of Maine and four congressmembers, including Rosa DeLauro of Connecticut and Jenniffer González-Colón of Puerto Rico.
WIC provisions are supposed to be revised every five years under the Child Nutrition and WIC Reauthorization Act (CNR)—although the last update was in 2010.
Another provision in the WIC Act would allow postpartum women and infants to enroll for a two-year period. WIC currently requires that all participants recertify in person every year. Although many WIC clinics are known as cheerful and supportive environments and in-person health assessments are an important part of the program, this, said Vasan, represents “an administrative burden that exists by design to create barriers to get[ting] benefits. Traveling in person to a WIC office with an eligible child or children is incredibly inconvenient for families that are also balancing jobs and other responsibilities.” Proponents hope that two-year enrollments will keep babies and new moms from dropping out.
WIC provisions are supposed to be revised every five years under the Child Nutrition and WIC Reauthorization Act (CNR)—although the last update was in 2010. “People started working on [a revision in 2015]; it went fairly far in the Senate committee in 2019, but it was stalled by a disagreement around the school nutrition standards, and then Covid started,” said Geri Henchy, director of nutrition policy at anti-hunger nonprofit Food Research & Action Center (FRAC) in Washington, D.C. “Now they have the new Dietary Guidelines and an administration that will not allow special interests to influence the revision process.”
Up for consideration under the CNR: The WIC Farmers Market Nutrition Program, which was authorized in 1992 to expand access to fresh produce, could get a bump; at the moment, it’s only valued at $30 per year per participant. There could also be a “plus-up” to fruit and vegetable access at supermarkets, expanding the value from $9 per child and $11 per mother each month to $35 a month per person; this would build on a provision in the American Rescue Plan that authorized states to increase money for fresh produce during the summer months, through September 2021. Dittmeier thinks greater availability of healthier food—which is connected to decreases in child obesity rates—could help convince families it’s worth the effort to stay enrolled in WIC.
Some vendors that previously accepted WIC dropped the program with the switch away from paper vouchers, determining that the cost of building a check-out system to accept EBT was prohibitive.
Covid-19 caused the USDA to issue a slew of WIC waivers; for the first time ever, some states could allow online enrollments, telehealth visits, and distribution of four months’ worth of benefits at a time. Dittmeier called the waivers “an absolute game changer in terms of connecting families with services.” The CNR will consider whether to make these waivers permanent—an outcome Vasan said would be “revolutionary,” with the potential to make quick innovations upon which to build further important changes to the program.
Continued efforts to expand enrollments will not go off without a hitch or two. Some vendors that previously accepted WIC dropped the program with the switch away from paper vouchers, determining that the cost of building a check-out system to accept EBT was prohibitive; some states are counteracting this by absorbing that cost themselves. And WIC has other technological challenges. For example, it lags years behind SNAP in allowing on-line grocery orders—although this is also being considered under the CNR.
Nevertheless, WIC advocates are optimistic that big changes are afoot, and that they will make a big difference in getting eligible moms and kids signed up, and keeping them enrolled. As Henchy put it, “WIC’s time has come.”