On Monday, a bill that would create a “food prescription” pilot program for Medi-Cal beneficiaries with health conditions was introduced to the Assembly.
Assembly Bill 368, authored by Assemblyman Rob Bonta (D-Oakland), specifically aims at getting healthier food to people to help “treat, reverse, and prevent chronic health conditions like diabetes, hypertension, and depression.” The bill further notes that these diseases are most disproportionate to the general population in minority communities.
Health providers, if finding that someone with Medi-Cal has an underlying health condition, would offer a food prescription. While the types and portions of foods were not narrowed down in the bill, they would be given in the form of “renewable food prescriptions, produce prescriptions, and healthy food vouchers, boxes, groceries, or prepared meals.” Nutrient-rich foods hinted in the bill to be given out include “fruits, vegetables, legumes, nuts, seeds, whole-grains, lean proteins, and seafood”, along with services such as “behavioral, cooking, or nutrition education, coaching, and counseling.”
The pilot program would initially start in three counties in the state and would be based on the similar food prescription program in Alameda County, as well as a bill last year, AB 3118, also authored by Bonta, that fizzled out and failed to make it past committee.
Assemblyman Bonta wrote the bill not only to address nutritional needs in low income and minority communities, but to help those with conditions that would put them at higher risk of COVID-19.
“Just as a health provider would write a prescription for an antibiotic for an infection, a prescription for nutritious food can have the same healing effect,” explained Assemblyman Bonta in a press release on Monday. “It is morally wrong to have millions of Californians not have adequate access to healthy food because of where they live or their socioeconomic standing.
“AB 368 is bold, innovative, and ambitious. The current COVID-19 health pandemic is not only harming our families and neighbors, but also draining billions of dollars of state and federal resources.”
Many lawmakers have already come out in support of AB 368, including Alameda County Supervisor Wilma Chan, whose County has overseen the similar county-wide program.
“By addressing underlying health conditions impacting communities of color, we can also make them more resilient in the face of the pandemic,” explained Supervisor Chan. “We need only look at statistics from the California Department of Public Health to see that African-Americans and Latinx represent a disproportionately higher percentage of COVID-19 deaths and hospitalizations compared to their representation in the population partly due to higher levels of preexisting health conditions and poverty in their communities.”
Possible problems with AB 368
However, many experts have noted that undertaking such a program statewide, even in the form of a pilot program, carries many risks and ignores all underlying causes of malnutrition in those communities.
“This is a dangerous bill on many fronts,” explained food desert research assistant Karl Abrams to the Globe. “This is a lot like former President Trump’s ‘America’s Harvest’ box idea from a few years ago. But while he was aiming for welfare fraud and cutting back on SNAP, Bonta is going after nutrition and health. But it still has the same flaws, if not more.
“He forgets that a lot of people don’t have big fridges or even appliances like microwaves and stoves. He’s aiming for lower-economic class people, and that’s exactly the group who don’t have that sort of thing. I know the bill comes with lessons and cooking help, but my God, if you are taught how to cook the food on a stove when you don’t even have a stove, then it’s kind of pointless, isn’t it? And insulting. Most know how to cook alright but just don’t have the appliances for it, but the bill doesn’t say anything about that or offers a solution there.”
“There’s a lot of well-intentioned food programs in California that aim for healthy foods, but in doing so, ignores cost and affordability. Some don’t allow buying things like ramen for example because of it’s low health value. In reality, poorer people do buy ramen but pair it with healthy things for a fuller meal, but lawmakers don’t look at that. Or things like food deserts, where poorer people don’t have access to healthier food or supermarkets in the first place. A food prescription still ignores that. If people have to go out to get it, then you better hope they can travel far and have a reliable source of transportation. If it’s being sent by delivery, then you better hope that follows them to long-term motels and other housing crisis housing, which, if you look at other state programs, probably won’t. Or hope you have all the kitchen appliances needed to make it properly, which many don’t.”
“Points for trying, but this is more of a short-term, only covering a few measure rather than a tangible solution like bringing in low-cost supermarkets with healthy foods into poorer areas or other solutions that at least attempt a solution where people can get healthier food within the constraints of where they are at. A food prescription is only a short-term solution that doesn’t help everyone who needs help.”
AB 368 is expected to be brought to an Assembly committee in the coming months.