One Big ‘Duh’: Haley’s plan to crowdsource public health policy

Last week Governor Nikki Haley announced that South Carolina plans to seek a waiver from the United States Department of Agriculture (USDA) for the purpose of limiting what can be purchased using federal Supplemental Nutrition Assistance Program (SNAP) benefits — known more commonly as “food stamps” — to a list of healthy items.

Hey, re-election season is in the air, and nothing fires up the Tea Party faithful quite like picking a fight with the Obama Administration. And a fight with the Obama Administration over food stamps? The campaign television ads practically write themselves!

Haley hasn’t actually proposed a serious plan yet to submit to the USDA for consideration. She knows she doesn’t need to submit a serious plan. She’s fully aware that any such plan to limit SNAP purchases will be rejected.

At least eleven other states have sought waivers from the USDA to limit purchases with SNAP to “healthy” foods in recent years – under both the Bush Administration as well as the Obama Administration – and none of these waivers has ever been granted.

In 2004 Minnesota Governor Tim Pawlenty sought to bar SNAP recipients from using benefits to purchase candy and soda in his state. The waiver was denied by the USDA for numerous reasons, including the fact that Minnesota’s proposed policy would change the definition of “food” as it’s written in the federal Food Stamp Act. It would’ve created administrative difficulties and uncertainty about regulation and enforcement too. (Interestingly, the Bush Administration’s USDA also warned of the risk of “the reintroduction of a stigma to participants and [perpetuation of] the myth that participants do not make wise purchasing decisions.”)

More recently, in 2011 Mayor Michael Bloomberg sought to prohibit the purchase of sodas and other sugary beverages with SNAP benefits in New York City. The USDA rejected the waiver on pretty much the same grounds — determining which beverages may or may not be purchased with SNAP benefits would be too hard to implement and enforce, and there was no way of knowing if a ban on purchasing sugary drinks would work anyway.

Difficulties in administering and enforcing potentially 50 different state SNAP schemes is a valid excuse for not granting these waivers, but there are other realities at play too.

Food manufacturers, retailers, and even big banks — which contract with states to process EBT transactions — are huge beneficiaries of SNAP, making millions of dollars each year through the system as it exists now. They exert tremendous influence through campaign contributions and lobbying to fight health-related reforms on the state and national levels. In fact, Nikki Haley has received close to $90,000 in campaign contributions from the food and beverage industry in the past decade – most of it since she began running for governor. Since the 2010 gubernatorial election, the American Beverage Association, the South Carolina Soft Drink Association, and Coca Cola have all been regular contributors to Haley’s re-election campaign-in-waiting — usually in >$1000 donations. (Contributions for statewide races are capped at $3500 per cycle.)

These folks are going to fight hard against any efforts to curb the millions of dollars in government subsidies that line their pockets via SNAP’s current scheme. Will Haley really push for reforms so damaging to her high dollar contributors? Maybe, but color me still unconvinced. Hand that feeds you, biting, etc.

What would Haley’s plan to reform SNAP look like?

Even if Haley knows — and we know — that a proposal to limit items for purchase with SNAP benefits will be rejected, let’s pretend for a moment that that’s not the case and that Nikki Haley also intends to submit a tenable proposal to the USDA for consideration.

A few questions concerning the Haley Administration’s plan to crowdsource state public health policy:

  • How would such a master list of foods and beverages be compiled?
  • Who would decide what’s on the list?
  • Would these people have expertise in nutrition?
  • How would the criteria for qualifying foods and beverages be determined?

When Minnesota attempted to disqualify “soda” and “candy” for purchase with SNAP benefits in 2004, the USDA noted that under Minnesota’s proposed criteria, a Kit Kat bar would not qualify as “candy,” but a Hershey bar would qualify as “candy” – because a Kit Kat bar contains flour.

  • How would recipients and retailers know what could and couldn’t be purchased with SNAP benefits?
  • Would there be a program to educate them? How much would it cost?
  • Who would be responsible for enforcing such a proposed policy? The USDA? SCDSS? The local grocery store cashier?
  • If the responsibility for enforcement were to fall on retailers, how much of a check-out delay would this cause?
  • Does the Haley Administration have the legal authority to seek to enact such changes without passing a state law?

According to this article in The State, Lillian Koller, Haley’s head of the Department of Social Services, envisions the process going something like this:

… Rather than a top-down request put together by government bureaucrats, (Koller) wants to hear from all sides of the issue in a series of public meetings. The waiver request will grow out of what state leaders hear in those meetings.

“I don’t think it’s been framed that way before. The power is in all these people,” Koller said in motioning to the variety of health advocates who had gathered at a statewide obesity task force meeting.

Their ideas will be gathered, along with those of food stamp users, food manufacturers and retailers. To Koller, the goal is simple and makes so much sense “it’s like one big ‘Duh!’” …

The meeting will help determine what purchases should and shouldn’t be allowed. Haley thinks it shouldn’t be difficult.

It’s like “one big ‘duh,’” y’all!

We’re only talking about $1.4 billion of SNAP benefits spent in the state annually and 45,000 items in the average grocery store! Surely we can knock out this itemized list at a few public roundtable meetings and expect the food and beverage industry lobby to roll over and play dead!

Side note: I attempted to research what I can only assume is Ms. Koller’s extensive work experience and expertise in the field of nutrition. Her biographical page on DSS’s website is completely blank, so it wasn’t much help, but I did find several articles detailing how she was sued in a federal class action suit at her previous post at Hawaii’s Department of Human Services — over her department’s failure to process and distribute SNAP benefits in the timetable dictated by federal regulations.

What should Haley do instead?

Haley is on to something: South Carolina does have a major obesity problem. A third of our population is obese, and the number of obese South Carolinians has tripled in the past two decades. It’s literally killing us.

As First Lady Michelle Obama highlighted earlier this week, the state of Mississippi launched an initiative several years ago to take on their state’s childhood obesity epidemic. They enacted a series of major reforms in public schools, including making school lunches healthier and increasing exercise programs. The state has seen a 13.3% decline in obesity among elementary school students since 2006.

I mean… if Mississippi can figure this stuff out, y’all? (And their Republican governor led the charge on this.)

Instead of wasting time grandstanding and focusing on unachievable red-tape Washington solutions at these roundtable meetings Haley has planned, why not use that time to bring community members together to solicit new ideas for addressing obesity in South Carolina — reforms we could enact right now that would produce measurable, achievable results?

What are your ideas?

Related Reading: Food Stamps: Follow The Money (PDF)