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2025 saw sweeping changes to Medicaid and SNAP, two public programs that many Community Servings clients depend on to access healthcare and nutrition support for themselves and their households. These changes, which impact program eligibility and financing, will become effective over the coming years. Among the likely consequences, these changes are expected to create new budgetary constraints for state governments across the U.S. This means new challenges for the Food is Medicine field and, more importantly, new challenges for populations living with severe, complex, and chronic illnesses.
In this blog, we will:
- Break down why the policy changes matter to the practice of medically tailored nutrition, and
- Offer suggestions for advocacy and resilience
For an extended discussion of the federal and state policy landscape, read the AMPL Institute’s 2026 View of the Field report, where this information originally appeared.
WHY MEDICAID MATTERS IN FOOD IS MEDICINE
For years, the Medicaid program has been the primary driver of Food is Medicine policy innovation across the country. With federal approval, state Medicaid programs use flexible Medicaid authorities, such as Section 1115 demonstrations and Managed Care In Lieu of Services, to authorize the provision and evaluation of Food is Medicine services. These Medicaid pathways have supported Food is Medicine providers in the field and advanced the integration of medically tailored nutrition into healthcare in significant ways, facilitating pilot implementations of medically tailored meals, medically tailored groceries, and other nutrition services as reimbursable Medicaid benefits.
THE CHALLENGES THAT MAY RESULT FROM MEDICAID CHANGES
Given the changes to Medicaid, state governments face the challenge of balancing their budgets with less federal funding while also implementing new and complex administrative requirements. Diminishing resources may reduce state capacities for innovative programming.
These changes do not restrict 1115 demonstrations or other Medicaid authorities that are currently used to authorize Food is Medicine. More generally, however, growing budgetary pressure may force states to make difficult choices to reduce costs. This could leave medically tailored nutrition providers without sustainable pathways for reimbursement or for serving new populations. The result could be an even greater reliance on philanthropy among nonprofits in a time of plummeting access to healthcare services and nutrition supports.
So how can advocates for medically tailored nutrition (MTN) strengthen their advocacy and make their programs as resilient as possible?
We spoke with Katie Garfield, Director of Whole Person Care at the Center for Health Law and Policy Innovation of Harvard Law School, about practical ways community-based providers of MTN can continue making inroads and plan for the future as state budgets come under strain.
Engage and educate state leaders early
Elected officials need to hear from the experts in their communities. Advocates are encouraged to let policymakers know how clients benefit (or could benefit) from MTN. Help state leaders understand the value of MTN before any tough conversations about budget take place.
Some policymakers may not understand the interrelated nature of health outcomes and access to medically tailored nutrition, or nutrition supports more broadly. Explain to stakeholders the proven impact of medically tailored meals, for example, on healthcare utilization and costs. Cite the peer-reviewed research that associates medically tailored meals with averted hospitalizations and cost-savings. If possible, show the economic value of nutrition services within your state.
Center client and patient testimonials
Collect and share the stories of individuals served. Testimonials validate your value proposition and help stakeholders put names and faces to constituents and empathize with the real-life experiences of the populations served.
Consider all available funding pathways
Learn about the full array of funding pathways in your region, including philanthropy, healthcare, and government grants. In the event of lapses in funding, prepare to pivot as needed so that organizations avoid direct service interruptions and preserve existing infrastructure.
“I would encourage CBOs to tap into as many different funding streams as possible,” Garfield says. “Funding sources such as 1115 waivers have been really important and fruitful over the last couple years, and it’s my strong hope that will continue. But CBOs should make sure they are aware of other funding streams and tap into as many as possible. Diversity of funding is what’s going to make CBOs resilient over the long term in times of uncertainty.”
Develop a plan for potential program refinements
If budgetary decisions in your state require hard conversations, Garfield advises providers to develop a clear vision for potential program refinements. “As we look at a future of state budgetary pressures, I think it can be helpful for FIM providers in this moment to be thinking about whether there are ways to refine their target populations and interventions to be as impactful as possible,” Garfield explains. “Being prepared could lead to refining a program as opposed to eliminating it altogether when budgetary pressures threaten innovative programming. Making sure that FIM advocates on the ground are prepared to respond meaningfully in these cases is really important.”