National Healthcare Reform

Given the strong research and practice evidence in support of the need and benefits of medically informed food and nutrition services, it is surprising that when the Patient Protection and Affordable Care Act (the ACA) was passed in 2010, it contained no comprehensive coverage of medically-tailored food for any severe disease population.


National Healthcare Reform Innovations

From a policy perspective, the specific combination of a prescribed diet and the food that fulfills it is not integral to any program in either the Department of Agriculture (hunger-related issues) or the Department for Health and Human Services (healthcare issues). If a person has any other debilitating illness, from kidney disease to cardiovascular disease to cancer, there are only the agencies in FIMC to help them. This fact is particularly critical for persons between the ages of 18 and 60 who are ineligible for existing, though not medically tailored, food and meal program assistance designed for seniors and children. FIMC agencies raise the majority of their funds privately.

Medicaid and private insurance provided through the exchanges do not provide the wrap-around social supports that help deliver lower healthcare costs and positive health outcomes for people living with critical illness. Medicaid does not cover immigrants (except in certain states). Furthermore, only a little more than half the states in the nation have opted to expand Medicaid, and much has been written on what that failure will mean for the health of the most vulnerable living in those states.

If we are going to achieve a more coordinated national response to our quest to reduce healthcare spending and improve health outcomes nationwide, food and nutrition services must be included in all healthcare reform efforts.


Through the ACA, much innovation was pushed to the states, which gave localities a chance to innovate and test interventions. FIMC agencies have made monumental progress on this front. In states around the country, we have participated and succeeded in partnerships through Medicaid 1115 Waivers, Medicaid 1915(c) Waivers, Delivery System Reform Incentive Payment (DSRIP) Programs, Accountable Care Organizations, Bundled Payment Pilots, Medicare and many others. For a detailed breakdown, please see our Research and Partners tabs.