Food Assistance Take-Up and Infant Health: Evidence from the Adoption of EBT

More than 7 million individuals who were eligible for Supplemental Nutrition Assistance Program (SNAP) benefits in 2017 did not participate in the program. Incomplete takeup is common in many transfer programs, and may limit their effectiveness in reducing economic disparities. In this paper, I use a unique setting to shed light on the role that participation costs play in determining food assistance take-up, and to quantify the effects of increasing take-up on infant health at birth. I do this by studying a reform that made it easier to receive and use food assistance benefits in the US: the adoption of the Electronic Benefit Transfer (EBT) debit card for food stamp benefit disbursement. I estimate event study regressions using the county level rollout of EBT in California between 2002 and 2004 and find that EBT adoption led to a large and persistent increase in caseloads and applications for the program, as well as higher retailer participation in high poverty neighborhoods. I document that this rise in food stamp benefit take-up led to a meaningful increase in average birth weight for births most likely impacted by the policy, with effects concentrated in the bottom half of the birth weight distribution. These estimates provide new evidence that reducing the barriers to participation in food assistance programs can lead to potentially large gains in health for disadvantaged children.