National associations between pandemic electronic benefit transfer (P-EBT) implementation practices and state characteristics.

Background: The Pandemic Electronic Benefit Transfer (P-EBT) program replaced free and reduced-price school meals for low-income children during school closures and summers from 2020 to 2023. Evidence indicates that P-EBT disbursements were associated with a 40% reduction in food hardship and better maternal mental health among low-income households with children. As states had discretion in implementing the program, approaches varied across states. This study characterized patterns of P-EBT implementation and disbursement across all 50 states and Washington, D.C., in relation to state characteristics. Methods: We examined three outcomes, namely timing of first P-EBT disbursement in 2020, inconsistency of summer P-EBT participation through 2023, and annual per capita P-EBT disbursement amounts from 2020 to 2023, using ordered logistic, logistic, and linear regression models. Independent variables included measures of state economic resources, sociopolitical characteristics, and indicators of need for food assistance. To account for regional cost-of-living differences, we conducted a sensitivity analysis using a real state minimum wage adjusted for Regional Price Parity (RPP). Results: In unadjusted analyses, Republican gubernatorial affiliation was associated with later first disbursement, lower per capita disbursement, and inconsistent summer participation. In adjusted models, no state characteristics were significantly associated with the timing of the first disbursement. Each additional month of prior-year Supplemental Nutrition Assistance Program (SNAP) emergency allotments was associated with lower odds of inconsistent Summer P-EBT participation [odds ratio (OR) = 0.72, 95% confidence interval (CI): 0.57-0.90]. Higher Medicaid participation rates [regression coefficient (B) = $1,932.40, Conclusion: P-EBT was implemented more comprehensively in states with Democratic governors and in states with more comprehensive SNAP emergency allotments, Medicaid, and other safety-net programs. Indicators of economic conditions, such as poverty and unemployment rates, were not associated with implementation patterns. Findings underscore the role of political context in shaping food assistance implementation, with direct implications for the SUN Bucks program, which uses practices similar to P-EBT but is not yet implemented by all states.