Biden Administration Releases National Strategy on Hunger, Nutrition and Health

From the National Rural Health Association

Alongside the White House Conference on Hunger, Nutrition, and Health this past Wednesday, the Biden Administration released its National Strategy on Hunger, Nutrition, and Health. Please see below for a summary highlighting the most rural-relevant proposals.

The National Strategy is made up of five pillars, each with corresponding goals and action items to achieve the listed goals:

Pillar 1: Improve Food Access and Affordability

Help more individuals experiencing food insecurity benefit from federal assistance programs.

  • The Administration will work with Congress increase funding for Older Americans Act nutrition programs. This will help address rural seniors’ unique health, social, and nutritional challenges associated with shopping and cooking.
  • The Administration will make it easier for eligible individuals to access federal food and health services. The Department of Agriculture (USDA) will partner with other agencies to increase outreach and awareness for SNAP to older adults and other populations.
  • USDA, through American Rescue Plan funds, will expand online shopping for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). NRHA is hopeful that this will expand access for rural residents that travel longer distances to grocery stores.
  • The Administration will support Congress in removing unnecessary barriers for SNAP recipients, like the inability to purchase hot and prepared foods with SNAP dollars.

Invest in community and economic development to increase access to food. Almost 40 million Americans live in areas where no grocery stores are nearby, including rural areas.

  • The Federal Trade Commission will publish a report summarizing how supply chain distributions have affected grocery stores, including independent grocery stores that often serve rural communities.
  • The Federal Emergency Management Agency and USDA will partner to integrate food security as a priority area when conducting outreach with state, local, and Tribal leaders for disaster planning and messaging. This is especially important for rural areas when there are natural disasters and other emergencies.

Pillar 2: Integrate Nutrition and Health

Provide greater access to nutrition services to better prevent, manage, and treat diet-related diseases.

  • Expand Medicare and Medicaid beneficiaries’ access to food as medicine by supporting legislation to create a pilot program for Medicare coverage of medically tailored meals for beneficiaries with diet-related health conditions.
  • The Centers for Medicare and Medicaid Services (CMS) will use its 1115 demonstration authority to pilot innovative coverage options for diet-related interventions. For example, CMS just announced that it approved Oregon and Massachusetts’ Medicaid state plans for nutritional assistance and medically tailored meals.
  • The Administration will support legislation to expand nutrition and obesity counseling to more Medicaid beneficiaries, specifically in states that have not expanded Medicaid and have large rural populations. The Administration also supports expanding nutrition and obesity counseling to Medicare beneficiaries who currently may only seek counseling in a primary care setting with a primary care practitioner. CMS will examine its authority to increase access to such counseling.
  • Indian Health Services (IHS) will implement a National Produce Prescription Pilot Program. Produce prescriptions provide fresh fruits and vegetables as a medical treatment or preventative service for patients who are eligible due to diet-related health risk or condition or food insecurity.
  • The Department of Veterans’ Affairs (VA) will implement produce prescription programs and mobile food pantries that will aid our rural veteran population.
  • CMS will develop a strategy to increase access to diabetes prevention and treatment for Medicare and Medicaid beneficiaries. NRHA looks forward to this work as rural residents are at a greater risk for diabetes.
  • CMS will support efforts to develop the data infrastructure needed for food insecurity and other social determinants of health (SDOH) elements to be captured in electronic health records. NRHA is hopeful that CMS will support rural providers in this endeavor.

Pillar 3: Empower All Consumers to Make and Have Access to Healthy Choices

Create healthier food environments and a healthier food supply.

  • The Administration will work with Congress to expand incentives for purchasing fruits and vegetables with SNAP.
  • USDA will make investments to support local and regional food and farm businesses.
  • USDA will establish Regional Food Business Centers to support local food business growth, particularly in rural and underserved areas like Appalachia, Colonias, the Mississippi Delta, and in Tribal communities.

Pillar 4: Support Physical Activity for All

 Build environments that promote physical activity.

  • Expand the Centers for Disease Control (CDC) State Physical Activity and Nutrition Programs to all states and territories. The Administration will work with Congress to expand the Program from 16 states to nationwide.

Pillar 5: Enhance Nutrition and Food Security Research

  • HHS and USDA will create a 2025 Dietary Guidelines Advisory Committee with a diverse membership, including geographic diversity. The committee will review dietary guidelines with a health equity lens.
  • USDA will conduct research to better understand nutritional needs of Native Americans and Native Alaskans.
  • USDA will leverage its partnership with the University of North Dakota to better understand Native diets and Indigenous foods.
  • CMS will measure SDOHs, including food insecurity, for at-risk Medicare Advantage beneficiaries.