Understanding multi-program take-up of safety net programs among California families

Background The US safety net, which provides critical aid to households with low income, is composed of a patchwork of separate programs and many people with low-income benefit from accessing more than one program. However, little is known about multi-program take-up, that is, participation conditioned on eligibility. This study examined individual and multi-program take-up patterns, and sociodemographic factors associated with multi-program take-up of US safety net programs. Methods The Assessing California Communities’ Experiences with Safety Net Supports Study interviewed Californians and reviewed their 2019 tax forms between August 2020 and May 2021. Take-up of safety net programs was calculated among eligible participants (n=365), including the Earned Income Tax Credit (EITC), Supplemental Nutrition Assistance Program (SNAP), the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and Medicaid. Multivariable regressions identified sociodemographic factors associated with take-up of multiple programs. Results Take-up was highest for Medicaid (90.6%) and lowest for SNAP (57.5%). Among people who received benefits from at least one other program, take-up ranged from 81.7-84.8% for the EITC, 54.4-62.0% for SNAP, 74.3-80.1% for WIC, and 89.7-98.1% for Medicaid. Having lower income and being younger were associated with concurrent take-up of SNAP and WIC. Among SNAP and WIC recipients, having higher income, being older, and primarily English-speaking were associated with EITC take-up. Conclusion Individual and multi-program take-up vary between programs and by sociodemographic factors. Findings suggest opportunities to increase take-up of potentially synergistic programs by improving cross-program coordination, data sharing, and targeted recruitment of under-enrolled subgroups.11Supplemental Nutrition Assistance Program (SNAP); Special Supplemental Nutrition Program for Women, Infants, and Children (WIC); Earned Income Tax Credit (EITC); Medicaid; Child Tax Credit (CTC)