Medically Tailored Meals Cut Costs and Improve Health, Study Finds, but Medicaid Cuts Loom

The study looked at about 1,900 Massachusetts residents. It was led by Dariush Mozaffarian, a cardiologist and professor at Tufts University. "It actually saves the healthcare system money," Mozaffarian said. "That's a really big deal, because most things in healthcare don't."

In a quiet Boston neighborhood, a kitchen bustled on a weekday morning as volunteers sliced chicken breasts, stuffed bell peppers, filled trays, and labeled each item. The work was part of an experiment to offer nutritious, medically tailored meals to Medicaid patients unable to shop for groceries or cook for themselves. Vanessa Georges, who is in remission from throat cancer, said the meals helped her rebuild muscle mass, strength, and confidence. "These meals have given me a second chance," she said. Georges also said she spends less time at the doctor's office.

The policy backdrop is difficult. The 2025 law known as the One Big Beautiful Bill Act slashed projected Medicaid funding by more than $900 billion. Many Republicans who backed the bill believe federal health spending is too high and riddled with fraud. Sen. John Kennedy, a Louisiana Republican, has accused California of "outrageous fraud" for using Medicaid dollars to fund housing and nutrition programs.

Amaya Diana, a policy analyst at KFF, said states will have to make tough choices in the next few years as they figure out how to fill funding gaps. "If states are not able to offset the loss of federal funds with new taxes or reductions in other state spending, they may have to make program cuts," she said. KFF is a health information nonprofit that includes KFF Health News.

Thirteen states have received federal waivers to use Medicaid dollars to pay for meals, part of an approach known as "food is medicine." Three other programs are awaiting federal approval.

President Donald Trump's support for social services has wavered. While the first Trump administration allowed states to pursue medically tailored meals and other social supports, the second Trump administration rescinded Biden-era guidance for Medicaid initiatives that address social needs. It has not detailed a new policy. Administration officials have warned that they will be more focused on the budget impacts of such initiatives.

"They signaled they're going to be a lot more skeptical," said Kurt Hager, an assistant professor at the University of Massachusetts Chan Medical School who studies nutrition programs and helped lead the Massachusetts study. "Instead of using a broad-based approach nationwide, they're going to make decisions on a state-by-state basis."

At the same time, health leaders in Trump's administration have made nutrition a major focus, including by promoting less-processed foods. Robert F. Kennedy Jr., who leads the Department of Health and Human Services, and Mehmet Oz, administrator of the Centers for Medicare & Medicaid Services, have pushed hospitals to serve healthier foods to boost patient outcomes. Oz said in a social media video in June that the health care system is often willing to pay for surgeries "but not always willing to pay for the nutrition that might help prevent those outcomes in the first place. That's bothered me my whole career." He added that the agency is evaluating several strategies, including medically tailored meals, to prevent illness and hospitalization. CMS officials did not respond to several emailed requests for comment.

Katie Garfield, who studies social determinants of health at Harvard Law School's Center for Health Law and Policy Innovation, said the lack of federal guidance is stirring uncertainty for states that want to pursue nutrition programs in Medicaid. "We're still waiting to see that big step forward around 'food is medicine' interventions," she said. "We need to see that step forward to resolve some of the uncertainty." U.S. Rep. Jim McGovern, a Massachusetts Democrat, said lawmakers have had a hard time engaging administration officials on medically tailored meals.