I’m going for the kids’ portion!

With overweight and obesity stats in an upward trajectory, the National Consumers League and the Georgetown School of Business are partnering up for a survey on a simple topic: what do Americans know about portion sizes, calories of average foods, and how many calories we can eat each day without packing on the pounds? 

We have a health crisis in AmericaFrom 2015-2016, 39.8 percent of American adults were considered obesewhich means the body mass index (BMI) measurements of more than 129 million of us are considered obeseThe annual medical cost of obesity is estimated at $147 billion because heart disease, stroke, type 2 diabetes, and cancers are tied to obesity. What is particularly concerning is that more than a third of younger people, ages 20-39, are obese.  

In fact, the New York Times reported that roughly a fifth of our soldiers are obese! The military is trying to combat this problem by replacing sweet drinks with water and cutting out fried foods, but it’s not working. 

The United States Department of Agriculture’s Dietary Guidelines recommend that the average person should consume about 2,000 calories a day. Do most of us know that if you exceed 2,000 calories day regularly, you pack on the pounds? (That’s unless, of course, you’re getting a lot of calorieburning exercise or have a great metabolism.) Is that number too high for many of us? (It is for me. If I eat more than 1,650 calories, I know I’m going to put on weight.That’s what we want to find out with our research: what do Americans really know about this guideline? 

We will also be asking whether most Americans know how many calories are in average serving of common foods such as yogurt (150), hamburgers with bun (350), pizza (350 per slice), bagels (325), muffins (425), 4-piece fried chicken dinner with all the fixings (850-1,200), a 30oz. steak (1,400), a piece of cheesecake (650)big chocolate chip cookie (450)and an ice cream cone (300-400.) 

Also, dAmericans know what an average serving is? A Cheesecake Factory salad is not an average serving! Each of their salads have more than 1,300 calories. That’s too much for one meal. Unfortunately, restaurant serving sizes have increased a lot over the last several decades. 

Which brings me back to my headlinekids portions! I’ve begun sampling my local downtown DC upscale food spots popular with millennials like Roti, CAVAChoptThe custom is that you order a bowl of lettuce or spinach as a base and put lots of pretty healthy but also pretty caloric toppingsadd a protein for a few bucks extra, and crowned with shredded cheese and salad dressing. When you’re done, you have a big portion and lots of good food but also lots of caloriesalbeit not from hamburger and fries but still, calories! 

So try the kids’ portion! They are cheaper by a thirda lot less food, a lot fewer calories, and completely filling. My CAVA kids meal had a small white bread (unfortunately) pita, yogurt spread, two small spicy meatballs, cucumber salad, tomato salad, three pieces of fried breadand scoop of brown rice. In other words, a lot of food! I figured it was about 550 calories. Voila! A third of my 1,650 allowable daily intake of food. And I was stuffed. I’ll be trying other food outlets to check out the kids portions. And we recommend that other consumers do the samehelps to limit calories and prevent food waste when you’re eating out!

No more surprises: Congress and patients alike sick of surprise billing

headshot of NCL Health Policy intern Alexa

By NCL Health Policy intern Alexa Beeson

This July, the House Energy and Commerce’s Health Subcommittee passed the No Surprises Act (H.R. 3630) to protect patients from surprise billing. The Senate Health, Education, Labor and Pensions Committee also passed its companion to address surprise billing, the Lower Health Care Costs Act (S.1895). These bills were being considered after a press conference at which President Trump called for reform in surprise billing.

Stakeholder witnesses at the House hearing this June on H.R. 3630 included patient, provider, and insurance payer groups. Reimbursement models were discussed at length, but the unifying theme was that patients should be held harmless in surprise billing situations.

Surprise billing happens mostly in a small subsect of out-of-network providers; the patient has no idea about who’s in or out of network. Some professionals are out-of-network technicians subcontracted by an in-network facility, such as a last-minute anesthesiologist switch for a surgery, or any other non-disclosed provider. To get reimbursed for their services, providers send a bill to the patient for whatever wasn’t covered by the insurance company.

Surprise billing also occurred among patients who should receive reduced prices for care. Johns Hopkins Hospital filed suit on more than 2,400 patients in the last decade, collecting the equivalent of 0.03 percent of its operating revenue. Some of these patients were never told about their right to charity care, and many who qualify never received a discounted rate. These bill collections are inconsequential for Johns Hopkins but could bankrupt a patient.

Legislation to address balance or surprise bills will protect patients, ensuring they will only have to pay in-network rates for out-of-network emergency care. This will help patients avoid bills that can set them back, sometimes, hundreds of thousands of dollars. Although surprise bills only come from a small portion of providers, 1 in 7 insured adults will receive a surprise medical bill from an in-network hospital. The Kaiser Family Foundation found that 70 percent of such patients were not aware that the provider was out-of-network when they received the care.

Panelist Sonji Wilkes, a patient advocate, presented testimony about her struggle with a surprise bill sent after the birth of her son, who was diagnosed with hemophilia. That child was treated by a charitable out-of-network hematologist who did not charge them for her services. However, the NICU that observed the boy was subcontracted to a third-party provider. This meant that the NICU was out-of-network. The Wilkes were sent a $50,000 bill by the hospital that still haunts them 15 years later.

Thomas Nickels, the executive vice president of the American Hospitals Association, claimed that fixed reimbursement rates, such as a median benchmark or percentage of the Medicaid reimbursement value, would disincentivize insurers from maintaining adequate provider networks. Nickels supported the Alternative Dispute Resolutions method, which involves baseball-style arbitration where providers and payers settle on reimbursement value on a case-by-case basis.

Jeanette Thornton, a senior vice president at America’s Health Insurance Plans, argued that the New York model of baseball-style arbitration would create immense clerical burden, resulting in lost time and greater administrative costs. She argued the arbitration reimbursement model would raise costs for patients in the end. Instead, she advocated for the government-dictated fixed reimbursement rates.

Both versions of the bill call for a benchmark to resolve payments between insurance plans and out-of-network providers. This benchmark says health plans would reimburse providers with the median in-network rate already contracted within specific geographic areas. The House bill contains binding arbitration as a fallback in case either the provider or payer decide the payment was an unfair price.

The National Consumers League supports Congress’ tackling of this issue of surprise or balance billing. NCL has taken no position on how these bills are settled between the payer and provider, as long as patients are protected from outrageously expensive bills they can never hope to pay and were never anticipating. In addition, medical debt is the greatest contributor to consumers declaring bankruptcy, and balance billing is a contributor to that troubling consumer issue. The bottom line is that a bill for medical services should never cause bankruptcy, and a patient should never have to choose between medical treatment and food or housing. We are hopeful this issue will be resolved during this Congressional session.

Alexa is a student at Washington University in St. Louis where she studies Classics and Anthropology and concentrates in global health and the environment. She expects to graduate in May of 2020

NCL continues to advocate for breastfeeding mothers

headshot of NCL Health Policy intern Alexa

By NCL Health Policy intern Alexa Beeson

This July, Dutch airline KLM found itself in the middle of a breastfeeding snafu: “public decency” vs. “natural practice.” A mother wrote about the airline with a Facebook post describing how a KLM flight attendant asked her to cover up if she wanted to continue nursing her baby. The new mom said that, while contacting KLM to file a complaint, she was told that she should “be respectful of people of other cultures.”

Other moms went on Twitter to ask KLM about its official breastfeeding policy. KLM responded with: “Breastfeeding is permitted at KLM flights. However, to ensure that all our passengers of all backgrounds feel comfortable on board, we may request a mother to cover herself while breastfeeding, should other passengers be offended by this.” The National Consumers League is disappointed.

New moms should be encouraged, supported, and protected to breastfeed. It has so many health benefits for mom and baby including the prevention of allergies in babies and the reduced risk of developing certain forms of cancer in moms.

A few years back, NCL posted a Breastfeeding Mothers’ Bill of Rights, that included the following:

  • A mother should have the right to breastfeed her child in any public or private establishment where they both are legally present, without harassment or discrimination of any kind,
  • No establishment should enact a rule that prevents breastfeeding a child, and
  • Breastfeeding mothers should not be told to only do so in a discreet manner.

Breastfeeding is a safe, healthy, and natural act, through which mothers provide nourishment to their children. NCL stands with mothers wishing to express milk whenever needed, regardless of the presence of their child. In no way should breastfeeding ever be considered lewd, immoral, or indecent–you are feeding your baby! That has nothing to do with sex.

Memo to KLM: check with your lawyers. Both the United States and the Netherlands protect public breastfeeding. All 50 states have laws that allow breastfeeding in public or exempt breastfeeding from public decency laws. In the Netherlands, there are no specific laws regarding public breastfeeding, but it is widely socially accepted. Why then, on a flight from San Francisco to Amsterdam, should KLM be able to prevent a woman from breastfeeding?

Reading replies to this tweet is a happy reminder that people do, in fact, support a woman’s right to breastfeed in public. Many people were upset that KLM considered breastfeeding an offensive act. Others satirically asked whether KLM would force an adult to cover his head if his eating “offended” another passenger. A few people questioned why a woman needs permission from an airline to feed her child. KLM themselves called breastfeeding “the most natural thing in the world,” yet still uphold their policy of having the right to discourage mothers from breastfeeding.

No mother should never feel uncomfortable or judged by another while feeding her child or expressing milk. KLM’s policy shows they would rather cater to someone who is “offended” by the most basic act of feeding one’s child; that is wrong. KLM–you must do better! And all airlines should publish affirmative policies supporting breastfeeding. Women and their babies need our support.

Alexa is a student at Washington University in St. Louis where she studies Classics and Anthropology and concentrates in global health and the environment. She expects to graduate in May of 2020

The ‘tampon tax’: an unconstitutional loss to American consumers

headshot of NCL LifeSmarts intern Alexa

By NCL LifeSmarts intern Elaina Pevide

Bingo supplies in Missouri, tattoos in Georgia, cotton candy in Iowa, gun club membership in Wisconsin; what do these products and services have in common? They are all treated as tax-exempt by states that still put a tax on tampons.

Sales taxes on menstrual products, often referred to as “tampon taxes”, are still present in 35 states. Tampon taxes are cited as a major contributor to the “pink tax”, the heightened cost of products and services marketed toward women. For example, a purple can of sweet-smelling shaving cream for women will almost always cost more than its male counterpart across the aisle. This trend translates across industries. A 2015 study from the Joint Economic Committee found that women pay more 42 percent of the time for products from pink pens to dry cleaning. These pricier goods and services serve no benefit to the consumer and have no apparent improvement in function or quality. The pink tax cuts into women’s spending power and takes advantage of consumers simply on the basis of gender.

Tampon taxes and the pink tax have both been making waves recently as pressing feminist issues. While markups on products for women are unjust, activists are targeting the tampon tax as priority number one. Menstrual products, they argue, are necessities and states have the power to cut sales taxes on them by labeling them as such. States give tax exemptions to other items– like bingo supplies, tattoos, and cotton candy–that are far less vital to the health and success of consumers. Today, five states do not have sales taxes on any products, five states have always given hygiene products tax-exemption status, and five states have successfully fought to eliminate the tampon tax. Currently, 35 states remain with 32 having tried–and failed–to pass legislation on the matter.

States resistance to eliminate the tampon tax, typically for fiscal reasons, is at odds with the interests and demands of consumers. A survey of 2,000 women, conducted on behalf of menstrual cup company Intimina, found that three out of four women believe the tampon tax should be eradicated. Nearly 70 percent of those surveyed interpreted taxes on feminine products as a form of sexism.

Countless advocacy organizations have been established out of the need to provide consumers with affordable menstrual products and eliminate the tampon tax. One such group, Period Equity, recently launched a campaign with reproductive care company LOLA called “Tax Free. Period.”. Their campaign calls for the remaining 35 states with a tampon tax to eliminate it by Tax Day 2020. In the meantime, they’re gearing up for a legal battle to challenge the states that refuse to comply. Their argument? Taxes on a product that affect only women and other individuals who menstruate is a form of discrimination and thereby unconstitutional.

As reproductive rights groups await the response of state legislatures and federal courts on this issue, the half of Americans that use menstrual products in their lifetime are suffering. Women make less in wages than men but are forced to spend more. The tampon taxes expound gender inequality and costs American consumers millions of dollars each year–dollars that could benefit their families and stimulate the economy elsewhere. Period Equity’s tagline says it best: “Periods are not luxuries. Period.” It’s about time for American tax policy to reflect that reality.

Elaina Pevide is a student at Brandeis University where she majors in Public Policy and Psychology with a minor in Economics. She expects to graduate in May of 2020.

NCL to USDA: Portion control must be key strategy for fighting America’s highest-ever obesity rates

July 11, 2019

Media contact: National Consumers League – Shaunice Wall, MS, RD, shaunicew@nclnet.org, (202) 835-0331, Carol McKay, carolm@nclnet.org, (412) 945-3242, or Taun Sterling, tauns@nclnet.org, (202) 207-2832

Washington, DC—The National Consumers League (NCL) presented oral comments to the USDA’s Dietary Guidelines Advisory Committee today in Washington, DC, urging the committee to focus on portion control as a key strategy to address the rise of obesity.

“Unfortunately, while the current version of the Dietary Guidelines mentions portion size – it appears to be mostly an afterthought among the various strategies to improve diets and fight obesity,” said NCL Executive Director Sally Greenberg. “Portion balance is not mentioned in the guidelines’ executive summary; this is despite the fact that larger portion sizes have greatly contributed to the problem of overweight and obesity.”

Nationally, 39.6 percent of adults and 18.5 percent of children were considered obese in 2015-2016, the most recent period for which NHANES data were available. These figures represent the highest percentages ever documented and obesity rates are projected to affect half of all adults, or 115 million adults, by the year 2030. There are also substantial economic losses associated with obesity. The estimated annual medical cost of obesity in the United States was $147 billion in 2008 U.S. dollars; the medical cost for people who have obesity was $1,429 higher than those of normal weight. 

“One promising, and we think underutilized, strategy for tackling the obesity epidemic is helping consumers understand and implement appropriate portion control,” said Greenberg. “This simple step to improving public health should not be marginalized in the forthcoming edition of the Guidelines; rather it should be one of the key points stressed by the Dietary Guidelines Advisory Committee and form a cornerstone of the Dietary Guidelines.”

NCL’s full testimony is available here (PDF).

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About the National Consumers League

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

Oral argument for ACA case will determine the fate of millions

Nissa ShaffiOn Tuesday, July 9, the U.S. Court of Appeals for the 5th Circuit will hear oral arguments that will determine whether or not the Affordable Care Act (ACA) may be overturned. Throughout the course of its life, the ACA has been under the specter of possible repeal. While there have been piecemeal attempts to strike down the legislation over time, none have been as concerning as the most recent Texas v. United States case, which argues that since the individual mandate is no longer enforced, ACA  would be unconstitutional.

The individual mandate requires that most people maintain a minimum level of health insurance or be subject a financial penalty. In 2017 however, the Tax Cuts and Jobs Act (TCJA), set the individual mandate to $0 as of 2019. As a result of this ruling, the Texas v. United States case was filed by 20 Republican state attorneys general and governors. The plaintiffs argue that the ruling rendered the individual mandate futile, as it no longer produces revenue for the federal government, and since Congress declared the individual mandate to be “essential” when enacting the ACA, this would now make the entire law invalid.

In an ideal situation, the court would maintain the ACA as it exists today, absent the individual mandate. If the ACA is repealed along with the protections that come with it, close to 20 million people would lose their health coverage. Those affected will include mostly low-income adults and children with chronic or pre-existing conditions, dependent adult children ages 26 and younger, Medicare and Medicaid enrollees, employer and employee groups, and more.

Repealing the ACA would jeopardize Medicaid expansion, further burdening uncompensated care and provider reimbursement. In addition, repealing the ACA would increase health care costs among the uninsured by $50.2 billion, result in more than 9 million people losing federal subsidies to purchase health insurance via the marketplace, and would endanger consumers’ ability to obtain essential health benefits.

California’s Attorney General, Xavier Beccerra, is leading a coalition of 21 Democratic attorneys general who have intervened to defend the ACA. Advocates interested in joining these efforts can contact izzy@xavierbecerra.com – please do so and sign the petition by July 14. In addition, organizations can participate in the TXvUS Tweetstorm to express their concerns regarding this case, using the hashtags #TXvUS and #WhatsAtStake, on July 9th at 2 pm EST/ 11 am PST.

NCL is a zealous supporter of the ACA and notes that it is still the law of the land. We are following the developments of this case closely and will continue to fight for access to affordable healthcare for all Americans. For more information on developments of this case, please click here.

FDA acts to protect women’s health

Nissa Shaffi

Last April, the U.S. Food and Drug Administration (FDA) issued a ban on all sales of pelvic surgical mesh products after determining that the manufacturers, Boston Scientific and Coloplast, failed to “demonstrate [a] reasonable assurance of safety and effectiveness.”

The ban comes on the heels of a 2016 reclassification of the product by the FDA, resulting in a class III (high-risk) designation. As a result, the manufacturers were required to undergo meticulous review and obtain premarket approval by the FDA in order to continue sales of their products in the United States.

A surgical mesh is a medical device used to treat urogynecological or pelvic organ issues. Most commonly, surgical mesh has been used to treat pelvic organ prolapse (POP). POP is a type of pelvic floor disorder that occurs when the muscles and tissues supporting pelvic organs become weakened–often resulting in urinary incontinence typically seen as a result of childbirth or advanced age.

A transvaginal surgical mesh is intended to provide additional support to the pelvic floor muscles to reinforce a weakened vaginal wall for treatment of POP. A urethral sling surgical mesh is supposed to provide support to the urethra or bladder to address urinary incontinence. Surgical mesh comes in two forms: synthetic and animal derived. Synthetic surgical mesh remains in the body indefinitely and acts as a permanent implant. Animal derived mesh, made from the intestine or skin of pig or cow, are absorbable and lose durability over time.

The most frequent complications from these devices include vaginal scarring, mesh erosion, increased risk of infection, and painful urination. Nearly 10 million women worldwide have received mesh implants, with about 10 to 15 percent of these women suffering from complications. Following the ban, there are currently no FDA-approved pelvic surgical mesh products available for sale in the United States.

The FDA advises that women who have already received a transvaginal mesh for the surgical repair of POP should continue their routine follow-up care with their provider and need not take any additional action if they are satisfied with their procedure. Patients should notify their provider if they experience any adverse reactions, such as bleeding or pain, following the procedure.

Given the grave injury these devices have caused in women patients, the National Consumers League questions how they ever received FDA approval in the first place. Nevertheless, banning the devices now is better than keeping them on the market. We must expect better from our healthcare regulators. Thankfully, we now have stronger safety standards that have brought an immediate halt to the sale of these unsafe medical devices.

To read the FDA’s full report on transvaginal mesh, click here.

NCL Health Policy Intern Alexa Beeson contributed to this blog.

NCL applauds USP for new and revised compounding standards

Every day, thousands of consumers in the United States—including those with rare diseases or allergies to commercially available drugs—rely on specially and individually made medicines known as compounded drugs. Compounding is critically important for patients but, if done improperly, this process can pose significant risks to patients and healthcare workers alike. Patients could—and have—received contaminated drugs or preparations that are subpotent, contaminated, or super-potent. Healthcare workers, in turn, can face risks of exposure to hazardous drugs.

A stark example is the 2012 series of medical errors that resulted in the contamination of compounded medicines, which in turn caused a deadly fungal meningitis outbreak in the United States—killing more than 70 people and causing more than 750 cases of infection in 20 states.

To reduce these public health risks, Congress and other policymakers have swung into action. Today, compounding requires universal standards that advance public health and patient safety priorities. A key player in this is the United States Pharmacopeia (USP), a scientific non-governmental standards-setting organization, which recently published new and revised compounding standards to help produce consistent quality compounded medicines and ensure that patients receive medicines that are the right strength, quality, and free of contaminants.

These updated standards reflect the latest advancements in science and clinical practice, and incorporate input from thousands of stakeholders in the medical and public health community—patients, healthcare practitioners, policymakers, academicians, and industry. The standards complement robust implementation of existing laws intended to ensure quality compounded products with the goal of protecting the safety of patients.

Consumers have an important role to play as we roll out the new guidelines for quality compounding and implementation of the new USP standards:

  • If you receive compounded medicines through your pharmacist or healthcare provider, report any resulting adverse events to your healthcare provider.
  • Sign up for FDA email alerts on safe compounding.
  • Remember to always contact your healthcare provider if you have questions or concerns about your health.

NCL is encouraged to see that the revised USP standards are consistent with FDA guidances. We applaud the efforts of FDA and USP to collaborate with the public health community to help protect patient safety.

Alabama’s abortion ban is an assault on reproductive freedom

Nissa Shaffi

On May 14, 25 white male legislators in Alabama decided the fate of reproductive health for millions of women in their state. This astonishingly homogeneous group supported the Human Rights Protection Act [SB 314] 25-6. Although women make up 51 percent of Alabama’s population, only 15 percent of women serve in Alabama’s state legislature. A mere three women were present for the vote.

The measure is draconian. It will prohibit abortion in all cases, even in instances of rape or incest, and will only permit the procedure in situations where the mother’s life is in danger or if the child presents a “lethal anomaly.” Physicians convicted of performing abortions could face Class A felony charges–carrying a punishment of up to 99 years. To put this into perspective, if a woman is raped and impregnated, her rapist would face less time in prison than would the provider who aborted the pregnancy.

In addition to Alabama’s extreme measure, five other states are considering so-called “Heartbeat Bills” prohibiting an abortion beyond six to eight weeks of pregnancy if a fetal cardiac activity is detected. Semantics matter because, at six weeks, a fetus technically only consists of “a group of cells with electrical activity.” This time frame is crucial because most women are not even aware that they are pregnant and therefore cannot make a timely decision.

We’ve been here before. Before Roe v Wade–the 1973 landmark case that declared the criminalization of abortion to be unconstitutional, thus securing a woman’s right to choose–200 women died annually because they could not access abortions legally.

Banning abortions will not prevent women from getting them. Indeed, shunning women and their healthcare providers only creates an environment where women must seek dangerous methods to end their pregnancies. An estimated 30,000 maternal deaths occur worldwide as a result of clandestine abortions in countries where the procedure is illegal. Restrictive abortion laws threaten reproductive freedom and endanger lives.

Statistically, abortion rates drop in countries where contraception is easily accessible and where the procedure is legal. For example, in countries like Israel and New Zealand, abortion is subsidized by the government. Additionally, creating social infrastructures that support motherhood–such as paid maternity leave and offering affordable childcare–reduce the incidence of abortion.

The National Consumers League strongly opposes punitive and cruel bills like the one in Alabama. Abortion is not a decision women enter into lightly. These are often excruciating decisions, which ultimately must be at the discretion of a woman and her doctor. These bills strip women of their agency to make safe and informed choices about their body, health, and lives. Alabama’s laws and their ilk are regressive and endanger the health of women, especially those of limited means. We call on all state legislators to recognize this fact and lift these terrible restrictions.

Amazon and other retailers launch program allowing SNAP beneficiaries to order food online

Shaunice Wall is NCL’s Linda Golodner Food Safety and Nutrition Fellow

On April 18, 2018, Amazon and other retailers launched a two-year test (pilot) program to boost food access to some of New York’s 2.7 million Supplemental Nutrition Assistance Program (SNAP) participants. Beneficiaries will be able to use their SNAP benefits to order groceries online and have them delivered directly to their door.

photo of supermarket produceSNAP is one of the most efficient and important public benefit programs,” said Shaunice Wall, NCL’s Linda Golodner Food Safety and Nutrition Fellow. “SNAP helps reduce food insecurity and improves the nutrition of millions, especially among the most vulnerable Americans. For many Americans living in food deserts, online food retailers are sometimes the only way to stock refrigerators,” NCL supports this collaboration between USDA and Amazon.

“People who receive SNAP benefits should have the opportunity to shop for food the same way more and more Americans shop for food–by ordering and paying for groceries online,” said U.S. Secretary of Agriculture Sonny Perdue. As technology advances, it is important for SNAP to advance too, so we can ensure the same shopping options are available for both non-SNAP and SNAP recipients.

Stats on the rise of e-commerce sales in America in 2017

The pilot will test both online ordering and payment. It will also work to ensure that orders are processed safely and securely, according to the United States Department of Agriculture (USDA). SNAP participants will be able to use their benefits to purchase eligible food items, but not pay for service or delivery charges. 

The program will also add a new SNAP redemption option, with broad selection, low prices, and the convenience of home delivery without requiring a membership fee. As Amazon expands participating areas throughout the life of the pilot, they believe the program will dramatically increase access to food for customers living in rural and remote locations.

The USDA defines food deserts as communities where one-third of the population lives at least one mile away from a supermarket in an urban area and 10 miles away in a rural area. For SNAP beneficiaries, it is often the simplest – or sometimes the only – option to use their electronic benefit transfer (EBT) card at convenience stores or gas stations, which often have only a sparse supply of produce and fresh protein.

The pilot will start with SNAP households with EBT cards issued by New York. Online retailers will only be able to deliver in New York. The plan is for the pilot to eventually expand to other areas of New York as well as Alabama, Iowa, Maryland, Nebraska, New Jersey, Oregon, and Washington. Lessons learned will then allow expansion of online purchasing in SNAP.

“The ultimate goal of this pilot is to pave the way for a national rollout once the USDA identifies the best path to large-scale implementation,” says Amazon. NCL recognizes that the advancement of SNAP takes on a larger significance because of the argument by conservatives that the program “costs too much, has grown too quickly, encourages government dependency and discourages work.” NCL supports SNAP and this exciting online system, if it works, well, will address the dearth of healthy food options for millions of Americans in food desserts or who cannot, for lack of transportation, health or disability reasons, get to a supermarket and choose from healthier options.

For more information, please visit the SNAP Online Purchasing pilot webpage.