Committee hears plan to pilot 'food as medicine' Medicaid waiver to reduce chronic-disease costs
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Summary
Rep. Holly Jones proposed HB2355 to authorize a Section 1115 Medicaid demonstration (MoHealthNet) to pilot produce prescriptions, medically tailored meals and nutrition services; sponsors and health and agriculture groups said pilots can reduce hospital use and support local farmers, while members pressed on fiscal notes and program design.
Representative Holly Jones introduced House Bill 2355, a bill that directs the state to pursue a Section 1115 Medicaid demonstration waiver to test "food as medicine" interventions—produce prescriptions, medically tailored meals, nutrition counseling and related services—for a limited MoHealthNet (Medicaid) population. Jones described evidence from other states showing reduced hospital admissions and lower short-term Medicaid costs in pilot programs and framed the approach as prevention-focused, with potential long-term savings.
Witnesses across public-health and agricultural sectors supported the waiver. Amanda Berry (Empower Missouri) cited obesity and diabetes prevalence data and national evidence of savings; a Missouri Fresh RX pilot in St. Louis projected Medicaid savings and improved birth outcomes. Food-access organizations, farmers-market operators and community agriculture groups described existing produce-prescription and medically tailored meal pilots and offered local implementation experience and administrative capacity. The American Heart Association and other technical-assistance providers offered program language suggestions and said they would provide implementation help.
Committee members questioned program design, interaction with SNAP/WIC and how the waiver would define target populations; witnesses and sponsor pointed to a small initial demonstration population (approximately 4,000 participants referenced in the fiscal note) and emphasized the waiver's flexibility for the Department of Social Services to design clinical criteria, delivery mechanisms and provider eligibility. No vote occurred; the committee took testimony and signaled ongoing policy development.
