Low participation rates among low-income people eligible for food stamp benefits have prompted a number of outreach and public education efforts. In 2002, the Food and Nutrition Service awarded $5 million in grants to community-based organizations in 15 States to investigate how to increase participation among people eligible for food stamp benefits. The evaluation of these grants describes the features and outcomes of these 18 projects.

Most discussion of payment accuracy in the Food Stamp Program focuses on the overall level and cost of payment errors. Rarely does the discussion focus on the impact of payment errors on individual households affected. This analysis – based on 2003 food stamp quality control data – leads to two broad conclusions. First, virtually all households receiving food stamps are eligible. Thus, the problem of erroneous payments is not so much one of determining eligibility, but rather one of attempting to finely target benefits to the complicated and changing circumstances of low-income households. Second, most overpayments to eligible households are small relative to household income and official poverty standards. As a result, most food stamp households are poor, and they remain poor even when overpaid.

A fundamental issue in the design of the Food Stamp Program (FSP) is the form benefits should take. Advocates of the current coupon system argue that coupons are a direct and inexpensive way to ensure that food stamp benefits are used to purchase food. Coupon advocates contend that, despite some evidence of fraud and benefit diversion under the current system, food stamps are used largely to purchase food. In addition, they contend that coupons give household food budgets some measure of protection against other demands on limited household resources. Advocates of cashing out the FSP argue that the current system limits the food-purchasing choices of recipients and places a stigma on participation. Moreover, they cite the cumbersome nature and cost of coupon issuance, transaction, and redemption.

A fundamental issue in the design of the Food Stamp Program is the form the benefits take. From the inception of pilot programs in the early 1960s to the contemporary program, the vehicle of choice has been the food stamp coupon, a voucher that can be redeemed for food at authorized retailers. For nearly that same period analyses have considered the relative merits of cash--or, in practice, checks--as an alternative. Advocates of the current coupon system argue that coupons are a direct and inexpensive way to ensure that food stamp benefits are used to purchase food, that the unauthorized use of food stamps is relatively limited despite some evidence of fraud and benefit diversion, and that coupons provide some measure of protection to food budgets from other demands on limited household resources. Advocates of cash benefits argue that the current system limits the purchasing choices of participants; places a stigma on participation; does not prevent the diversion of benefits (as evidenced by the existence of illegal trafficking); and entails excessive costs for coupon production, issuance, transaction, and redemption.

This study is the analysis of the relationship between prenatal participation in the Special Supplemental Food Program for Women, Infants, and Children (WIC) and infant mortality among Medicaid newborns.