A bustling farmers market outside Mt. Sinai Hospital in New York City, offering healthy food to patients and doctors alike. Photo: Amelia Moore

In the Rush to Repeal Obamacare, A Reminder: Food Policy Is Health Policy

, senior analyst, Food and Environment | December 20, 2016, 3:34 pm EDT
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2017 is nearly upon us. And while the year ahead seems full of uncertainty, some things never change, including the tendency of many Americans to make New Year’s resolutions to improve their diets and lose weight.

But the day-to-day “what to eat” decisions of individual Americans are fickle and heavily shaped by the food environment around us. Which is why, as the incoming president and Congress set out their policy priorities—including a long-planned repeal of Obamacare—it’s worth looking at potential policy changes that could make it harder for Americans to keep their resolutions in 2017 and beyond.

In a new UCS video, my colleagues Ricardo Salvador and Mark Bittman team up to cook a healthy, traditional New Year’s stew of black-eyed peas and collard greens and discuss why it’s so hard for many Americans to eat that way. They talk about the need to align federal dietary guidelines (which say we should all be eating a lot more fruits and vegetables) with policies and incentives that shape what farmers grow, and note that the next president should pursue such a policy alignment. In a different political context, that might happen. In the one we currently find ourselves in, it’s unlikely.

What’s worse, a number of federal policies and programs aimed at helping Americans eat well and stay healthy may now be at risk. Here are three:

  • Obamacare: Over the last six years, Republicans in Congress have held something in the neighborhood of 60 votes to repeal the Affordable Care Act (aka Obamacare). With Trump’s election, they’re gearing up to do it for real in the new year. Of course, it will be harder than they think, and they have no clear plan for how to replace it—the Center for American Progress has detailed the chaos that may ensue, and we are starting to hear the phrase “repeal and delay,” which would push off implementing repeal until 2019 or 2020. There are legitimate reasons to revisit the Affordable Care Act and seek to fix its imperfections. Healthcare policy experts have ideas about how to do it, and I’ll leave that to them. But among the important elements that should be retained in whatever comes next is the law’s emphasis on disease prevention. For example, the ACA guarantees full coverage of obesity screening and nutrition counseling for at-risk children and adults. Such services are critical for identifying risks of costly and devastating illnesses before they are full-blown, and helping at-risk patients address them.
  • School lunch program: The Healthy, Hunger-Free Kids Act of 2010 was an early signature achievement of the Obama administration. It reformed nutrition standards for taxpayer-subsidized school meal programs for the first time in 30 years, and the rules subsequently implemented by the USDA have shown success in helping the nation’s children—especially its most vulnerable kids—eat more fruits and vegetables and less junk food at school. The law was due for reauthorization in 2015, but debate stalled over House attempts to weaken key provisions, and its prospects in the next Congress are uncertain. Just last week the conservative House Freedom Caucus has put out its regulatory hit list for the incoming Congress, which includes the USDA’s school lunch standards (along with the FDA’s added sugar labeling requirement).

We can’t afford to turn back the clock on food and health policy

Earlier this month we heard the jarring news that US life expectancy has declined for the first time since 1993. The exact causes of the slight dip last year—and even whether it is a data anomaly—are not yet known. But it’s a good bet that the nation’s worsening epidemic of obesity and related diseases has something do with it.

So while the incoming Congress and Trump team ponder what to do about health insurance, child nutrition programs, and other pressing issues, here’s a suggestion: let’s focus on preventing the major causes of death and disease, reducing the need for expensive healthcare in the first place, and keeping people healthier longer. Building on food policies that work, rather than tearing them down, would be a good place to start.

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