Public Health Medicare and Medicaid Look into Food Subsidies to Keep You Healthy Food Education, Food Subsidies, and Food Taxes By Tanya Feke, MD Updated on January 22, 2024 Fact checked by Sheeren Jegtvig Print Table of Contents View All Table of Contents Nutrition and Chronic Disease Food Education Food Subsidies Food Taxes "Let food be thy medicine and medicine be thy food." Hippocrates may have had a point. What we put into our bodies affects our health in countless ways. Aligning with the food-as-medicine movement, states are increasing taxes on processed foods, and Medicare and Medicaid are piloting programs for food subsidies. Monashee Frantz / OJO Images / Getty Images Nutrition and Chronic Disease Access to food is essential for life but access to healthy quality food can also help to decrease the risk of disease. It is one of the social determinants of health. According to the Centers for Disease Control and Prevention (CDC), 108 million adults in the U.S. have hypertension, 18.2 million have coronary artery disease, 30 million have diabetes, and 84 million have prediabetes. The modern-day American diet thrives on convenience. That often means processed foods with added sugar, fat, salt, nitrites, and food additives. High salt diets can provoke hypertension, high-fat diets can be associated with heart disease, and added sugar can increase the risk for diabetes. What we eat affects these chronic health conditions just as much as medications. Not everyone knows what foods to choose and those that do cannot always afford them. More educational and public health reforms are needed to make a difference. Food Education Most people need to learn more about nutrition, and that includes doctors and other medical professionals. The Food as Medicine Institute, based in Portland, Oregon, has an annual symposium on nutrition for medical professionals. The goal is to educate them so that they can better apply nutrition principles in clinical practice. One of the most important aspects of food education is making sure that people do not fall into pseudoscience. With the popularity of food as medicine, there is plenty of profiteering to go around. Many nutritional supplements and diet books do not have research or data to back up their claims. Not only could they be costly, but they could also be potentially dangerous. Buyer beware. Food Subsidies Whether from medications, doctor's visits, or hospitalizations, the Centers for Medicare and Medicaid Services (CMS) understands that people with chronic diseases have more healthcare expenses. With Medicare losing solvency by 2031, it has become more important than ever for the government to rein in costs. They may be turning to healthy food prescriptions to do just that. Preventing Chronic Disease By taking the preventive medicine approach, the government may be able to decrease the number of people who develop these burdensome conditions. Likewise, for those who already have chronic diseases, healthy lifestyles, including access and affordability to healthy foods, may be able to decrease the risk of flare-ups and increased spending. This is where food subsidies come into play. A 2019 study published in PLoS Medicine (Lee et.al.) looked at two different models for food subsidies, each offering a 30% discount on healthy foods, and found that millions of cardiovascular events could be prevented and billions of dollars saved. This was not the first study to show the benefits of food subsidies on healthcare spending and health outcomes. Peñalvo et al, and Niebylski et al., have also published notable studies in BMC Medicine and Nutrition, respectively. Today, there are two subsidy programs through the U.S. Department of Food & Agriculture that can help people 60 and older get the food they need to stay healthy. Senior Farmers' Market Nutrition Program: This program provides fresh food, vegetables, herbs, and honey to seniors with a low income. Commodity Supplemental Food Program: This program provides monthly food packages to people 60 and older who have a low income. Food Taxes Not all states tax groceries. The idea is that it is unfair for people with lesser means to spend a larger portion of their income on essentials like food and beverages. In fact, 32 states exempt groceries from taxes altogether. Another six states (Arkansas, Illinois, Missouri, Tennessee, Utah, and Virginia) tax groceries but at a rate lower than their state's sales tax. The question is what qualifies as "groceries?" Someone can certainly buy something at a grocery store and be taxed on it, even if they live in a tax-exempt state. Each state has a different interpretation, and not everyone agrees if candy and soda make the list. Even when these items are known to have low nutritional value, some states tax for them and others don't. As of January 2019, five states (Alaska, Delaware, Montana, New Hampshire, and Oregon) do not tax groceries, candy, or soda. California has a tax on soda. No one likes to pay more taxes but studies have shown that they have the potential to improve health outcomes and decrease health disparities. The disincentive to purchase these items may steer people towards healthier food choices and can lead to decreased rates of cardiovascular disease and diabetes. Also, income generated from a candy and/or soda tax could be redirected towards public health programs that can further benefit the community. While these taxes remain controversial, more states are taking them into consideration. Summary America needs to change how it eats to become a healthier nation. Food taxes on unhealthy foods like candy and soda may disincentivize people from making poor choices while food subsidies on healthy foods may improve access and affordability to quality foods like fruits and vegetables. Regardless, more public health initiatives need to be taken to improve the health of individuals and their communities. 5 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Lee Y, Mozaffarian D, Sy S, et al. Cost-effectiveness of financial incentives for improving diet and health through Medicare and Medicaid: A microsimulation study. PLoS Med. 2019 Mar 19;16(3):e1002761. doi:10.1371/journal.pmed.1002761 Peñalvo JL, Cudhea F, Micha R, et al. The potential impact of food taxes and subsidies on cardiovascular disease and diabetes burden and disparities in the United States. BMC Med. 2017 Nov 27;15(1):208. doi:10.1186/s12916-017-0971-9 Niebylski ML, Redburn KA, Duhaney T, Campbell NR. Healthy food subsidies and unhealthy food taxation: A systematic review of the evidence. Nutrition. 2015 Jun;31(6):787-95. doi:10.1016/j.nut.2014.12.010 Tax Foundation. Sales Taxes on Soda, Candy, and Other Groceries. Solbak NM, Xu JY, Vena JE, Csizmadi I, Whelan HK, Robson PJ. Diet quality is associated with reduced incidence of cancer and self-reported chronic disease: Observations from Alberta's Tomorrow Project. Prev Med. 2017;101:178-187. doi:10.1016/j.ypmed.2017.06.009 By Tanya Feke, MD Dr. Feke is a board-certified family physician, patient advocate and best-selling author of "Medicare Essentials: A Physician Insider Explains the Fine Print." See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? 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