The immediate SNAP crisis is over for now. However, under the Big Beautiful Bill, SNAP benefits will be reduced. Nearly 200,000 of our neighbors — 17.85% of the state’s SNAP recipients — will be affected. When food assistance is reduced, our already strained rural health care systems will face a crisis they cannot absorb.
Western Massachusetts has 191,446 SNAP recipients. This is a looming emergency for our most medically fragile populations — people who will lose access to what, for many, functions as vital medicine.
Statewide, over half of all recipients are elderly or disabled. In western Massachusetts, about 100,000 SNAP recipients are older adults or people with disabilities managing chronic conditions that require adequate nutrition to prevent health crises.
Food as medicine in rural communities
Health care providers throughout western Massachusetts increasingly recognize nutrition as frontline medicine. For older adults managing diabetes — a condition affecting thousands of local seniors — SNAP enables consistent carbohydrate control and regular meals that prevent dangerous blood sugar fluctuations. Without these benefits, patients face impossible choices: skip meals, triggering hypoglycemia, or eat cheap, carbohydrate-heavy foods, causing hyperglycemia. Either path leads to our emergency rooms.
Cardiovascular disease requires a heart-healthy diet: fresh produce, lean proteins, and foods low in sodium and saturated fat. When SNAP disappears, people turn to cheap, processed foods. Blood pressure spikes. Heart failure worsens. Hospital admissions follow.
The average $240 monthly SNAP benefit is not supplemental. It is the front line between managing chronic conditions and catastrophic medical emergencies.
Where vulnerability meets rural reality
Our region faces urgent and unique challenges in this crisis. Western Massachusetts has fewer hospitals and specialists than eastern Massachusetts and operates near capacity. Smaller hospitals in North Adams, Greenfield, and Northampton have limited emergency resources. When nutrition-related health crises spike, our systems could collapse.
In Franklin and Berkshire counties, geographic isolation intensifies food insecurity. Many SNAP recipients live in hilltowns with minimal access to grocery stores. Emergency food pantries are already overstretched. The idea that pantries will compensate for the loss of SNAP is not just unrealistic in cities; it is impossible in rural western Massachusetts.
Western Massachusetts has more older adults and higher chronic disease rates than the eastern part of the state. We already face severe physician shortages. As SNAP recipients experience health crises, these systems will be overwhelmed.
The economic irrationality
Western Massachusetts receives $46 million in SNAP benefits monthly, helping reduce health care costs.
An emergency department visit costs $1,000 to $3,000. A diabetic crisis admission costs $10,000 to $20,000. Heart failure care in intensive care costs $30,000 to $50,000. These costs add up quickly. Each SNAP dollar saves $3 to $5 in health care costs. SNAP cuts add millions to health care costs, devastating rural hospitals and taxpayers.
When emergency food cannot replace medicine
Some argue that food pantries can fill the gap. This profoundly misunderstands both scale and medical reality. As Jennifer Lemmerman of Project Bread stated, “Emergency food providers are already stretched beyond capacity, and they cannot absorb the flow.” The Food Bank of Western Massachusetts does heroic work, but cannot replace reduced benefits.
Beyond overwhelming capacity, emergency food cannot meet critical dietary needs. Pantries cannot reliably provide low-sodium options for heart patients, diabetic-appropriate foods, or renal diet items. Accessing pantries is especially hard in rural areas due to long travel distances, limited hours, and the difficulty elderly or disabled people face when carrying heavy food bags.
SNAP cards provide dignity, choice, and crucial access to medically appropriate foods. Emergency food, no matter how well-intentioned, cannot replicate this, especially for 191,446 people scattered across a vast region in crisis.
A political choice
The reduction of SNAP benefits is a political choice, and one that could be reversed. This is more than policy. It is a decision to take food from people in western Massachusetts, with immediate, severe, and impossible-to-withstand consequences for our communities.
What must happen now
For 100,000 older adults and people with disabilities in western Massachusetts, SNAP is essential medicine. Without it, they go hungry and face acute health crises that flood emergency rooms and push health care systems beyond capacity.
Protecting our neighbors’ health and our health care system depends on action now.
James Lomastro lives in Conway and is a member of Dignity Alliance and served as a director of a food pantry during Covid.