Effects of WIC Physical Presence Requirements on Benefit Redemption: Evidence from Remote Services during COVID-19

• In Event: Transforming WIC: Policy Shifts and Impacts

Abstract

Introduction: Despite an extensive body of research documenting WIC’s beneficial health effects, the program struggles to reach all eligible families: only 51 percent of eligible individuals received benefits in 2021. In addition to low program uptake, WIC also faces challenges to achieving full benefit utilization because of the program’s complicated benefit redemption process that involves identifying WIC-eligible foods and quantities in stores. Indeed, many WIC participants redeem only a fraction of their benefits once enrolled, constraining the full nutritional impact of the program.

Researchers have attributed WIC’s low take-up to the program’s policy of mandatory in-person appointments, and recent studies, leveraging COVID-era waivers of in-person requirements, find that remote services improved WIC access and were viewed as a convenient change by WIC enrollees. However, eliminating WIC’s longstanding practice of face-to-face appointments may exacerbate barriers to benefit redemption. In-person appointments can support benefit use by promoting personalized food packages and mitigating the learning costs associated with WIC benefit redemption. This presents something of a dilemma for policymakers attempting to balance goals of program accessibility and benefit utilization: transitioning from in-person to remote appointments may soften barriers to program enrollment but harden barriers to benefit redemption. In this paper, I investigate the relationship between WIC physical presence requirement waivers and WIC benefit redemption.

Methods: I analyze data from two main sources: (1) longitudinal WIC administrative records from state WIC agencies, collected and maintained by the US Census Bureau in partnership with US Department of Agriculture (USDA), covering the universe of WIC participants in four US states and (2) information on physical presence waiver use from a comprehensive survey of all local WIC agencies from the USDA. Leveraging household and geographic variation in exposure to remote WIC services, I implement a triple difference research design to estimate the effect of relaxing physical presence requirements on WIC benefit redemption.

Results: Using data on the universe of WIC participants across four US states between 2018 and 2021, I find that physical presence waivers reduced monthly household WIC redemption for new enrollees by about $15, or about 17 percent of the pre-waiver sample average. Additional analysis indicates that estimated effects were primarily driven by changes at the intensive—rather than extensive—margin (i.e., remote services primarily affected the amount redeemed rather than whether any redemption occurred).

Conclusions: While eliminating WIC’s in-person requirements for certification appointments can ease compliance burdens and improve program uptake, my findings imply that remote-only appointments may have had unintended consequences of reducing benefit redemption. The challenge ahead for social policy researchers, WIC administrators, and policymakers is to consider how remote services could be used in ways that support program access but do not exacerbate barriers to benefit redemption.

Author

• Clay Fannin, University of Wisconsin-Madison
  Presenting Author