The SNAP Cycle and Diabetes Management During a One-Time Change in Disbursement Schedule

Objective. The 2018-2019 federal government partial shutdown resulted in a one-time disruption to the usual disbursement schedule of Supplemental Nutrition Assistance Program (SNAP) benefits nationwide. We assess the relationship between this disruption and hyperglycemia and hypoglycemia medical encounters among beneficiaries with diabetes. 

Research Design and Methods. To estimate whether the one-time change in benefit disbursement affects the monthly cycle of hyperglycemia or hypoglycemia encounter rates, we use linked administrative Medicaid claims and SNAP disbursement data from West Virginia in a fixed effects (FE) model with interactions between week of the month and the two months of interest – January and February 2019. We control for week, month, year, and county effects as well as individual characteristics, and we cluster standard errors by individual.

Results. We find that the early disbursement of SNAP benefits in January 2019 resulted in a spike in hyperglycemia four times the rate in a typical month. Further, we find a decrease in both hyperglycemia and hypoglycemia in late February. 

Conclusions. Our findings suggest that the early distribution of benefits led to a temporary increase in food consumption among West Virginia Medicaid beneficiaries with diabetes. Findings from late February also imply that individuals may have a way to prepare for reduced food resources. These results shed new light on the effects of unexpected changes to the timing of safety net payments as well as understanding unintended consequences of government shutdowns.