Offsetting the Effects of Medical Expenses on Older Adults' Household Food Budgets: An Analysis of the Standard Medical Expense Deduction.

The Supplemental Nutrition Assistance Program (SNAP) provides critical nutrition assistance to over 40 million Americans each month. Low-income older adults (60 and older) and disabled participants experience additional budgetary constraints because of high out-of-pocket medical expenses. In recent years, some states have adopted a "Standard Medical Expense Deduction" (SMED) for senior and disabled beneficiaries, making it easier to report medical expenses in the SNAP application process. We conduct a descriptive national analysis that shows increases in benefit levels and reporting of medical expenses for states that have implemented SMED. We then present descriptive findings from Medicare claims data among a sample of low-income older adults in need of food assistance in Georgia. Average medical expenses among this sample approach $200 per month, whereas those for persons diagnosed with multiple chronic conditions exceed $300 per month. Policy implications of this analysis include the need for more states to consider adoption of SMED or alternative estimating approaches, leading to increases in benefit levels for the neediest beneficiaries and decreases in administrative burden among state agencies. We present two possible policy approaches states might take to receive approval for these changes from U.S. Department of Agriculture.