Association of the Implementation of Child Tax Credit Advance Payments With Food Insufficiency in US Households

Importance: A key component of the American Rescue Plan Act of 2021 included an expansion of the Child Tax Credit with advance payments beginning in July 2021, a "child allowance" that was projected to dramatically reduce child poverty. Food insufficiency has increased markedly during the economic crisis spurred by the COVID-19 pandemic, with disparities among marginalized populations, and may be associated with substantial health care and social costs. Objective: To assess whether the introduction of advance payments for the Child Tax Credit in mid-July 2021 was associated with changes in food insufficiency in US households with children. Design, Setting, and Participants: This cross-sectional study used data from several phases of the Household Pulse Survey, conducted by the US Census Bureau from January 6 to August 2, 2021. The survey had 585 170 responses, representing a weighted population size of 77 165 153 households. Exposure: The first advance Child Tax Credit payment, received on July 15, 2021. Main Outcomes and Measures: Household food insufficiency. Results: The weighted sample of 585 170 respondents was mostly female (51. 5%) and non-Hispanic White (62. 5%), with a plurality aged 25 to 44 years (48. 1%), having a 4-year degree or more (34. 7%) and a 2019 household income of 75 000 to 149 999 (23. 1%). In the weeks after the first advance payment of the Child Tax Credit was made (July 21 to August 2, 2021), 62. 4% of households with children reported receiving it compared with 1. 1% of households without children present (P <. 001). There was a 3. 7-percentage point reduction (95% CI, -0. 055 to -0. 019 percentage points; P <. 001) in household food insufficiency for households with children present in the survey wave after the first advance payment of the Child Tax Credit, corresponding to a 25. 9% reduction, using an event study specification. Difference-in-differences (-16. 4%) and modified Poisson (-20. 8%) models also yielded large estimates for reductions in household food insufficiency associated with the first advance payment of the expanded Child Tax Credit. Conclusions and Relevance: This study suggests that the Child Tax Credit advance payment increased household income and may have acted as a buffer against food insufficiency. However, its expansion and advance payment are only a temporary measure for 2021. Congress must consider whether to extend these changes or make them permanent and improve implementation to reduce barriers to receipt for low-income families.