Costs, Reach, and Benefits of COVID-19 Pandemic Electronic Benefit Transfer and Grab-and-Go School Meals for Ensuring Youths’ Access to Food During School Closures

Question  What were the operating costs, costs and benefits to families, and proportion of eligible youths who received benefits of 2 programs aimed at replacing school meals missed when US schools were closed owing to COVID-19 from March to June 2020?

Findings  In this economic evaluation, among 30 million youths eligible to receive free or reduced-price meals, the Pandemic Electronic Benefit Transfer (P-EBT) program (state agencies sent debit cards loaded with the cash value of missed school meals to families) reached 89% of eligible students and cost $6.46 per meal. Grab-and-go school meals (school food service departments provided prepared meals for off-site consumption) reached 27% and cost $8.07 per meal.

Meaning  These findings suggest that during times when youths cannot access school meals, state and federal agencies should support cost-efficient programs for schools to distribute prepared meals and activate programs such as P-EBT to efficiently reach eligible youths.

Importance  School meals are associated with improved nutrition and health for millions of US children, but school closures due to the COVID-19 pandemic disrupted children’s access to school meals. Two policy approaches, the Pandemic Electronic Benefit Transfer (P-EBT) program, which provided the cash value of missed meals directly to families on debit-like cards to use for making food purchases, and the grab-and-go meals program, which offered prepared meals from school kitchens at community distribution points, were activated to replace missed meals for children from low-income families; however, the extent to which these programs reached those who needed them and the programs’ costs were unknown.

Objective  To assess the proportion of eligible youths who were reached by P-EBT and grab-and-go meals, the amount of meals or benefits received, and the cost to implement each program.

Design, Setting, and Participants  This cross-sectional study was conducted from March to June 2020. The study population was all US youths younger than 19 years, including US youths aged 6 to 18 years who were eligible to receive free or reduced-price meals (primary analysis sample).

Exposures  Receipt of P-EBT or grab-and-go school meals.

Main Outcomes and Measures  The main outcomes were the percentage of youths reached by P-EBT and grab-and-go school meals, mean benefit received per recipient, and mean cost, including implementation costs and time costs to families per meal distributed.

Results  Among 30 million youths eligible for free or reduced-price meals, grab-and-go meals reached an estimated 8.0 million (27%) and P-EBT reached 26.9 million (89%). The grab-and-go school meals program distributed 429 million meals per month in spring 2020, and the P-EBT program distributed $3.2 billion in monthly cash benefits, equivalent to 1.1 billion meals. Among those receiving benefits, the mean monthly benefit was larger for grab-and-go school meals ($148; range across states, $44-$176) compared with P-EBT ($110; range across states, $55-$114). Costs per meal delivered were lower for P-EBT ($6.46; range across states, $6.41-$6.79) compared with grab-and-go school meals ($8.07; range across states, $2.97-$15.27). The P-EBT program had lower public sector implementation costs but higher uncompensated time costs to families (eg, preparation time for meals) compared with grab-and-go school meals.

Conclusions and Relevance  In this economic evaluation, both the P-EBT and grab-and-go school meal programs supported youths’ access to food in complementary ways when US schools were closed during the COVID-19 pandemic from March to June 2020.