Summary

Using a variety of initiatives to contain costs, states have saved millions of dollars in the Women, Infants, and Children (WIC) supplemental nutrition program. For example, 10 states have contracted with manufacturers to obtain rebates on WIC foods in addition to infant formula, and some states have placed greater limits on WIC participants' food choices than have other states. Thirty-nine states have restricted the number of vendors or ensured that the prices vendors charge for WIC food are competitive. However, concerns by the states over how the cost-containment savings are allocated may discourage them from adopting or expanding the use of initiatives to contain costs. WIC program applicants already enrolled in federal assistance programs, such as food stamps and Medicaid, automatically meet the income eligibility requirements of the WIC program. States use various procedures to certify the income eligibility of applicants who do not participate in these programs. Thirty-two of the 48 states responding to GAO's survey indicated that they generally require these applicants to provide documents, such as pay stubs and letters, to verify their income. Fourteen states allow applicants to declare their incomes without providing supporting documentation.

GAO noted that: (1) the states are using a variety of cost containment initiatives to control the WIC program's costs; (2) for example, 10 states have contracted with manufacturers to obtain rebates on WIC foods in addition to infant formula, and some states have placed greater limits on WIC participants' food choices than other states; (3) separately, or in conjunction with efforts to contain food costs, 39 states use various practices to restrict the number of vendors or ensure that the prices vendors charge for WIC food items are competitive; (4) these and other practices to contain food costs have saved millions of dollars annually and enabled more individuals to enroll in the program, according to WIC directors; (5) while the use of cost containment practices could be expanded, certain obstacles, including the states' concern with how the program allocates the additional funds made available through cost containment initiatives, may discourage the states from adopting or expanding their use; (6) federal regulations provide that WIC program applicants who participate in the Food Stamp Program, Medicaid, and the Temporary Assistance for Needy Families Program automatically meet the income eligibility requirements of the WIC program; (7) the states use a variety of procedures to certify the income eligibility of the applicants who do not participate in these programs; (8) thirty-two of the 48 state WIC directors responding to GAO's questionnaire reported that their states generally require these applicants to provide documents, such as pay stubs and letters, to verify their income; (9) of the remaining 16 WIC directors, 14 reported that their states do not require documentation; (10) these states allow applicants to declare their income without providing supporting documentation; and (11) the other two directors reported that income documentation procedures are determined individually by the local WIC agencies.