Clinical Trials Logo

Clinical Trial Summary

More than a dozen states have proposed or plan to implement work requirements in Medicaid, and similar requirements already exist nationally in the Supplemental Nutritional Assistance Program (SNAP), yet evidence on the effects of these policies is limited. In cooperation with the state of Virginia, the investigators plan to conduct a randomized controlled trial studying the impacts of work requirements in public programs on insurance coverage, SNAP participation, employment, and health, with a particular focus on changes in racial/ethnic and geographic disparities in these outcomes. The COVID-19 epidemic and concurrent economic downturn creates additional urgency around these issues, and the investigators will use a combination of national administrative data and a new population survey to assess disparities in employment, health care, and food insecurity during this crisis.


Clinical Trial Description

Work requirements are becoming increasingly common in major public assistance programs, with federal requirements for most adults to work in order to participate in the Supplemental Nutritional Assistance Program (SNAP, previously known as food stamps), and more than a dozen states proposing similar requirements in Medicaid. Proponents of work requirements contend that these policies increase beneficiary engagement in work and community activities that may lead to higher incomes and better health. On the other hand, opponents of work requirements suggest that many low-resource households will lose much-needed benefits, without commensurate improvements in employment. The investigators propose a randomized controlled trial of work requirements in Virginia, leveraging state support for exempting a portion of Medicaid expansion enrollees from the state's proposed work requirements. The investigators are also working with the state to explore the impact of work requirements in SNAP. They will study the impacts of each policy on health insurance coverage, access to care, employment, food insecurity, and health outcomes using a mix of administrative data and a new beneficiary survey. Our analysis will oversample several populations of interest, including racial/ethnic minorities and low-income rural residents. In doing so, investigators will identify the overall policy impacts of these policies, and will also assess who is most affected by each component to determine the impact of these policy changes on racial, ethnic, socioeconomic, and geographic disparities. Meanwhile, the COVID-19 epidemic and concurrent economic downturn create additional urgency around the issues of employment and participation in social programs. Using a combination of national administrative data and a new population survey, this study will also provide a timely assessment of disparities in employment, health care, and food insecurity during the current public health and economic crises. ;


Study Design


Related Conditions & MeSH terms


NCT number NCT04888832
Study type Interventional
Source Harvard Medical School (HMS and HSDM)
Contact Timothy J Layton, PhD
Phone 573-353-1566
Email Layton@hcp.med.harvard.edu
Status Not yet recruiting
Phase N/A
Start date July 2023
Completion date December 2024

See also
  Status Clinical Trial Phase
Completed NCT03436589 - The Indiana SNAP-Ed Long-term Study N/A
Completed NCT02789215 - Proposed Meal Changes for CACFP: Impact on Child Food Intake and Costs N/A
Active, not recruiting NCT05601804 - TARGETing Healthy Weight Loss in the Context of Food Insecurity
Recruiting NCT04045184 - Food Assistance, Diabetes, and HIV
Recruiting NCT06146621 - Targeting Access and Knowledge of Earned Income Tax Credit (EITC) Utilization and Policies N/A
Withdrawn NCT05502757 - Fruit & Vegetable Provision Study N/A
Completed NCT03930472 - #WYMarketsMatter: Testing Two Farmers Market Voucher Strategies to Increase Food Security Phase 2
Completed NCT05593510 - Food Pantry Client and Staff Preferences for Nutritious no Prep Ready-to-eat Meals N/A
Recruiting NCT05429892 - FRESH Delivers: An Innovative Approach to Reducing Tobacco Use Among Rural/Black African American Smokers N/A
Recruiting NCT05517577 - An Integrated Community-based Intervention Package in Improving Maternal and Neonatal Health Outcomes N/A
Completed NCT03400605 - Parkdale Infant Nutrition Security Targeted Evaluation Project: Infant Feeding
Completed NCT03566095 - Voices for Food: Food Policy Councils, Food Security and Healthy Food Choices N/A
Completed NCT05752721 - Impact of Online Ordering on Low-Income Adults' Food Security in Online Food Pantry Settings N/A
Completed NCT02526147 - WFP Cash, Food, and Voucher Study in Ecuador N/A
Completed NCT06374303 - Novel Intervention to Improve Food Insecurity Among Individuals With Opioid Use Disorder: A Randomized Clinical Trial N/A
Completed NCT03810300 - Sustainability of Impacts of Cash Transfers, Food Transfers, and Behavior Change Communication in Bangladesh N/A