February 18, 2026
To: Representative Stinnett, and Members, House Health and Mental Health Committee
From: Amanda Berry, Food Security Policy Manager, Empower Missouri
Re: Support for HB 2355
Empower Missouri is the state’s largest anti-poverty advocacy organization, working across rural and urban communities to advance policies that promote economic stability, affordability, and opportunity for Missouri families. Through our statewide Food Security Coalition, we partner with community organizations, service providers, faith leaders, and policy experts to ensure every Missourian has access to affordable, healthy, and nutritious food.
HB 2355 authorizes Missouri to pursue a federal Section 1115 Medicaid waiver to test targeted nutrition services through MO HealthNet for participants with nutrition-related chronic disease, with the explicit purpose of reducing the need for medical care.¹ Food is Medicine is prevention. Prevention costs less than treatment. Helping people access healthy food before illness escalates is one of the most practical ways to contain healthcare costs.
From a budget perspective, this matters because chronic disease related to inadequate nutrition is a primary driver of healthcare spending, particularly within Medicaid. National evidence shows that medically tailored meals (MTMs) can lead to a 70% decrease in ED visits; a 52% decrease in inpatient hospital admissions; a 72% decrease in skilled nursing stays; and a 16% decrease in healthcare costs.7 Avoiding these high-cost services is one of the most effective ways to reduce long-term healthcare spending.
Missouri already has evidence that this approach produces meaningful health improvements and cost avoidance. A Missouri-based Fresh Rx pilot in the St. Louis region found that providing healthy food to expecting Moms through 60 days after delivery increased food security by 44 percentage points and reduced low-birthweight births by 5.3 percentage points compared to the Medicaid average. Based on these results, the program projected approximately $5.3 million in annual Medicaid savings in St. Louis City alone.³ These projections measure short-term savings only. They do not include the long-term economic and health benefits of preventing low birthweight, or the lasting stability created when families bring home a healthy baby instead of facing the trauma and financial strain of preventable complications
Additional Missouri pilot work reinforces the financial impact. BJC’s Community Health Improvement team launched a Medically Tailored Meals program for 182 days, then compared participants’ hospital use before and during the program and found approximately $1,614 saved per participant through reduced hospital utilization during that time. These real-world results demonstrate how prevention-focused nutrition support can lower costs in a relatively short time frame while improving health stability.
State and national modeling reinforce these findings. Researchers at the Tufts Food Is Medicine Institute estimate that produce prescription programs for individuals with diabetes could generate approximately $101 million in net healthcare cost savings in Missouri over ten years⁴, and after program costs, Medically Tailored Meals’ annual per patient savings would be $2,362. At the national level, medically tailored meal programs are projected to prevent as many as 1.6 million hospitalizations annually and generate $13.6 billion in net healthcare savings.² These results consistently show that nutrition-based interventions can reduce medical utilization by preventing health crises before they occur.
At the same time, limited access to healthy food continues to place a measurable burden on the healthcare system. Feeding America estimates that inadequate access to healthy food is associated with nearly $1 billion in avoidable healthcare costs annually in Missouri, driven by higher rates of emergency department use, hospitalizations, and complications from diet-related chronic disease.⁵ In practical terms, Missouri is already paying for the consequences of poor access to healthy food through increased medical spending.
This bill supports and strengthens Missouri’s agricultural economy by prioritizing the inclusion of community-based organizations and local growers to support the purchase of locally grown food in nutrition prescriptions.”¹ This provision helps align healthcare spending with Missouri agriculture by creating a stable and consistent market for locally produced food.
Healthcare-backed purchasing supports specialty crop producers, sustains small and mid-sized farms, and encourages investment in aggregation, processing, and distribution infrastructure. Research shows that locally produced food purchases generate a multiplier effect of $1.32 to $1.90, meaning each dollar spent on local food can generate additional local economic activity.⁶ When healthcare dollars are spent on Missouri-grown food, the benefits extend beyond health outcomes to support farmers, food businesses, and rural communities.
HB 2355 is not a permanent expansion of services. It is a structured, evidence-based demonstration designed to test whether prevention-focused nutrition interventions can improve health and reduce avoidable costs. It represents a practical, fiscally responsible policy that Empower Missouri strongly supports and respectfully urges the committee to advance, as it offers meaningful relief for Missouri families while supporting long-term health, productivity, and economic stability across the state.
References
- Missouri General Assembly. House Bill 2355, Food Is Medicine Act.
- Food Is Medicine Institute. Advances in the Field of Food Is Medicine: Annual Report 2025. https://www.healthcarexfood.org
- Operation Food Search. Fresh Rx Pregnancy Program Outcomes and Medicaid Cost Savings. https://www.operationfoodsearch.org/wp-content/uploads/2021/08/FreshRxFactSheet-Digital.pdf
- Lee Y, Mozaffarian D, Sy S, et al. Health and economic impact and cost-effectiveness of produce prescription programs for diabetes in the United States. Diabetes Care. 2025. https://tuftsfoodismedicine.org
- Feeding America. The Healthcare Costs of Food Insecurity in the United States. https://public.tableau.com/app/profile/feeding.america.research/viz/TheHealthcareCostsofFoodInsecurity/HealthcareCosts
- Union of Concerned Scientists; Johns Hopkins Center for a Livable Future. Maximizing the Impact of Nutrition Interventions with Local Food Procurement.
- (Center for Health Law and Policy Innovation Harvard Law School. Food as Medicine Coalition, 2024
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