Text Messages to Support Enrollment in Government Benefits: Simple. Effective. Legal?

The blog post was written by Daniel Necz, Harvard Law School LL.M Candidate, and Rachel Landauer, Clinical Instructor

New research from North Carolina adds to the evidence that participation in nutrition assistance programs such as the Supplemental Nutrition Assistance Program (SNAP) has a positive impact on health outcomes. However, the researchers also found that many study participants who were eligible for SNAP did not enroll—a pernicious pattern across many different types of public assistance programs.

Health care has a role to play in boosting take-up rates (i.e., the percentage of benefit-eligible individuals who participate).

Kaiser Permanente, a non-profit, integrated health care system, is disrupting the trend by increasing outreach efforts about government benefits including SNAP and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Kaiser Permanente’s Food for Life strategy uses text messages to provide eligible members with information on enrollment and the application process.

The team has been able to demonstrate that this seemingly simple tool is an effective one—one resulting in many more people having access to available essential services and resources. Since the start of the program two years ago, almost 100,000 members across eight states have applied for SNAP benefits, 32,000 members have enrolled, and more than $26 million in benefits has been paid out.

“But is it legal?”

Concern about a misstep in the eyes of a law is often a barrier to new and innovative programming at the intersection of health care and health-related social needs, particularly among smaller health care organizations. To support the diffusion and scaling of the initiative, Kaiser Permanente partnered with Harvard Law School’s Center for Health Law and Policy Innovation to review federal and California state rules regulating the undertaking. We found that with the right policies and procedures in place, both federal and California state law likely permit health care organizations to implement such campaigns.

Our new resource highlights several legal and regulatory considerations for FQHCs, Medicaid plans, and other entities in California. CHLPI is now embarking on a review of additional states. Readers interested in learning more are welcome to contact us.