A Scoping Review of Access to Safety Net Programs in the U.S. during COVID-19 Pandemic: Opportunities and Challenges

Background: Many low-income families in the United States faced an employment crisis and multiple challenges in meeting basic needs such as food, healthcare, and housing during the COVID-19 pandemic. In response to this crisis, federal and state safety net programs, including the Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF), Medicaid, and Unemployment Insurance (UI), have adjusted their minimum benefits and eligibility requirements to provide more extensive support to those in need. However, there is a lack of information regarding the effectiveness of these policy changes in supporting low-income families and whether they have been able to take advantage of these safety net programs. This scoping review explores the existing literature on access to safety net programs among low-income families during COVID-19. This review aims to identify key challenges and opportunities when families and individuals access social safety net programs during COVID-19.

Methods: A PRISMA-compliant search was conducted on PubMed, Scopus, and PsycINFO databases using terms related to public assistance programs, COVID-19, access, barriers, and variation thereof. Criteria included peer-reviewed studies published in English between February 2020 and February 2023 (under the Public Health Emergency) in the U.S. Out of 744 studies identified, 251 duplicated studies were eliminated. The titles and abstracts of these 493 studies were then scanned, and the relevant studies were pre-selected (n=55). The complete text of the 55 pre-selected studies was reviewed, and 45 studies were excluded for not meeting the inclusion criteria. Finally, a total of 10 articles fulfilled the selection criteria.

Results: The findings of the review led to three categories: (1) target programs, (2) opportunities for safety net programs, and (3) challenges for safety net programs. Most studies focused on food assistance programs (e.g., SNAP, WIC, school meals program), while fewer studies have addressed Medicaid or cash benefits programs (e.g., TANF and UI). We identified two categories of opportunities related to improved access to programs: (a) program expansion (e.g., SNAP benefits increase and P-EBT) and (b) remote appointments. However, studies indicated that low-income families had challenges in access to benefits for the reasons of (a) their income being slightly over the threshold, (b) benefits being delayed, (c) administrative barriers accompanying much paperwork, and (d) their immigrant status.

Conclusions and Implications: The results of this review indicate multiple aspects that can either be a challenge or an opportunity for low-income families who are eligible for public benefits programs during COVID-19. In addition, the pandemic has also highlighted long-standing systemic issues that have hindered access to these programs even before the pandemic. Further research is needed to explore the long-term impact of these challenges on low-income families and to identify effective strategies to improve access to safety net programs during future crises. By doing so, policymakers and practitioners can better support the needs of low-income families and improve their ability to access necessary resources and services during times of crisis.