Changing patterns of SNAP take-up and participation and the role of out-of-pocket medical expenses among older adults

We use longitudinal data from the nationally representative Health and Retirement Study from 2002 to 2016 to document how Supplemental Nutrition Assistance Program (SNAP) participation and estimated take-up changed over time for older adults and the role that out-of-pocket medical expenses has played in these changing patterns. We rely upon the state adoption of Medicaid expansion of the Affordable Care Act as a source of identifying variation and do not find evidence that Medicaid expansion changed estimated SNAP take-up or participation. These findings suggest that out-of-pocket medical expenses are unlikely to be a major driver of SNAP take-up decisions for the nondisabled population under age 65.