Executive Summary

• A surge in unemployment during COVID-19 caused more families to become eligible for the Special Supplemental Nutrition Program for Women, Infant, and Children (WIC). Yet, national program participation barely budged.
• Many “online” states that digitized enrollment and benefit reloading processes for WIC saw increases in WIC participation, ranging from 2% to 20%. However, states that remained “offline” experienced declines in participation, limiting overall national participation growth. Lack of WIC access in offline states is problematic because individuals in these states are at higher risk of food insecurity and poor nutritional outcomes than those in online states.
• Offline states should transition to remote services to improve uptake while online states should continue improving digital enrollment and reloading processes.

Introduction

Despite a steep increase in economic instability during COVID-19, national participation in the Special Supplemental Nutrition Program for Women, Infant, and Children (WIC) barely responded to the crisis. WIC provides nutritious foods, nutritious education, and breastfeeding support to low-income pregnant and post-partum individuals, infants, and children up to age 5. Studies have associated WIC participation with improved nutritional outcomes, including reductions in obesity and low weight births.

The WIC eligibility rate (percentage of target population eligible) slightly increased from 48%-49% between 2019 and 2020. Despite this expected trend, the program’s participation rate continued to fall to 50% by 2020. Notably, WIC participation changes during the pandemic varied across states, between a 20% decrease and 21% increase. While WIC participation exceeded the 2020-2021 national growth rate of 2% in 19 states, participation experienced little growth or decline in other states. In these 31 states, the number of eligible individuals receiving benefits likely fell during the period, meaning greater proportions of the target population in these states lost access to vital nutritional assistance.

Statewide Variation in WIC Participation Growth

Despite minor changes in national WIC participation during COVID-19, statewide growth largely varied. While 19 states experienced growth in participation over 2%, other states experienced negligible growth or decline. This variation persisted across eligible age groups, as statewide children participation growth varied between a 22% decrease and 25% increase and pregnant and post-partum participation growth ranged from a 20% decline to 7% increase. Certain factors motivated statewide variation in WIC participation trends.

Switching from Paper Vouchers to Electronic Benefits

In 2010, Congress designated 2020 as the deadline for states to transition from paper vouchers to electronic benefit transfer (EBT) cards to reduce how long beneficiaries spend checking out WIC-approved foods. Traditionally, WIC participants needed to visit a WIC office monthly to reload benefits on their EBT cards. However, the 2021 Families First Coronavirus Response Act (FFCRA) allowed states to use physical presence waivers to let individuals remotely enroll in WIC and reload their EBT cards monthly.

While 41 states were quick to adopt this measure, 9 (Arkansas, Louisiana, New Mexico, Missouri, Ohio, Pennsylvania, Utah, Texas, and Wyoming) did not budge. States who decided to remain “offline” justified their decision with benefits that accompany in-person reloading, such as nutrition education, health check-ins, and digitization costs. Regardless, these states ignored critical barriers that would prevent their recipients from traveling to WIC offices during COVID-19, such as transportation access, childbearing, and health risks. As a result, offline states had 14% less WIC participationthan online states by January 2021.

This disparity is concerning because individuals in offline states are possibly more susceptible to food insecurity than those in online states. Studies have linked access to WIC to improved food security, particularly among children. One study reported a 20% decrease in food insecurity among children enrolled in WIC, for instance. As a result, eligible individuals in offline states were more likely to be food insecure than those in remote states, which could contribute to poor health outcomes among the target population, including worse diet quality, lower birth weight, and increased risk for infant mortality. 

Suggestions for the Future

The United States Department of Agriculture (USDA) extended the rights for WIC agencies to apply COVID-19 waivers, including the physical presence waiver, until September 2026. Off-line states that did not leverage the physical presence waiver during COVID-19 should transition to remote services to expedite enrollment and reloading processes for beneficiaries. States that have adopted the waiver should continue providing online benefit reloading and enrollment. They can further smoothen the enrollment process by allowing individuals to schedule appointments online rather than only calling during business hours.

WIC provides life-saving nutrition and breastfeeding services to low-income pregnant and post-partum individuals, infants, and children up to age 5 during critical periods of development. Accordingly, WIC agencies should take steps to ensure that none of their target population is neglected.