Do EBT cards improve WIC participation?


An investigation examines whether moving from paper vouchers to electronic benefits transfer (EBT) cards improved participation numbers for Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

Programs like the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and Supplemental Nutrition Assistance Program have numerous benefits for the children and parents that they serve. However, the paper vouchers and the food stamps that were used in the past were easy to recognize and could be stigmatizing for both adults and children. An investigation in JAMA Pediatrics looked at whether moving from the paper voucher system to an electronic benefits transfer (EBT) card system, which allows participants to use a card that looks like a debit or credit card, led to an increased level in participation.1

The investigators looked at state-level WIC monthly benefit summary administrative data to find participation in the program between October 2014 and November 2019. They compared states that did implement EBT in their WIC program in the time period against those that didn’t start using EBT.

Before and during the study period, there were a total of 36 states that implemented EBT in their WIC program. States with EBT and without EBT had similar baseline rates of food insecurity and poverty. Three years after the implementation of EBT in the WIC program, participation in the program had increased by 7.78% (95% CI, 3.58%-12.15%) in states that were exposed when compared to unexposed states. In the analyses, the participation increased 7.22% in pregnant and postpartum women (95% CI, 2.54%-12.12%), 4.96% among infants aged younger than 1 year (95% CI, 0.95%-9.12%), and 9.12% among children aged 1 to 4 years (95% CI, 3.19%-15.39%; P for interaction = .20). The results remained robust for state unemployment and poverty rates, population, and Medicaid expansion status following adjustment.

The investigators concluded that moving from paper vouchers to an EBT card was linked to a significant as well as sustained increase in the enrollment of state WIC programs. The intervention and others like that that help simplify the ability to redeem the benefits could be an important way to improve enrollment levels.


1. Vasan A, Kenyon C, Feudtner C, Fiks A, Venkataramani A. Association of WIC participation and electronic benefits transfer implementation. JAMA Pediatr. March 29, 2021. Epub ahead of print. doi:10.1001/jamapediatrics.2020.6973

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