	Introduction and Background

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides supplemental nutrition-rich foods and nutrition education (including breastfeeding promotion and support), as well as referrals to health care and social services, to low-income, nutritionally at-risk women, infants, and children up to five years old. In FY2016, approximately 7.7 million people participated in WIC each month in programs run by 90 state agencies (50 states, District of Columbia, 5 U.S. territories, and 34 Indian Tribal Organizations). WIC and the Child Nutrition Programs were most recently reauthorized in 2010 through the Healthy, Hunger-Free Kids Act of 2010 (HHFKA, P.L. The WIC Farmers' Market Nutrition Program (WIC FMNP) is closely related to WIC and also authorized within Section 17 of the Child Nutrition Act (Section 17(m)). 111-296 . USDA-FNS provides cash grants for foods and "Nutrition Services and Administration" to 90 state agencies (50 states, District of Columbia, 5 U.S. territories, and 34 Indian Tribal Organizations), which operate the program through local WIC agencies and clinics. At the state level, state agencies are generally responsible for program operations within their jurisdictions. The majority of WIC's funding is distributed by USDA-FNS to states based upon allocation formulas described in federal regulations. Table 2 displays three years of federal WIC obligations. WIC has a number of federal and state eligibility requirements including categorical, financial, and nutritional risk tests. Applicants that currently receive or are eligible to receive Supplemental Nutrition Assistance Program (SNAP), Medicaid, or Temporary Assistance for Needy Families (TANF) are adjunctively eligible. The vast majority of participants reporting income (74.1%) are at or below the federal poverty level. Benefits and Services Provided

The WIC program provides grants to states to provide benefits redeemable for specified supplemental foods (i.e., the WIC food package) and specified services. The federal food package regulations and the basis for states' approved food lists are discussed in this section. Federal Requirements for WIC-Eligible Foods

The supplemental food package in a given state is the result of federal regulation and state policies. State agencies create their eligible food lists within this framework. The bulk of participants' benefits are for specific foods, but certain participants also receive a cash value voucher (CVV) for a specified monthly dollar amount to be redeemed for fruits and vegetables. Nutrition Education, Breastfeeding, and Referral Services

In addition to food benefits, WIC also provides nutrition education and related support. States are required to ensure that nutrition education, including breastfeeding promotion and drug abuse education, is available to all pregnant, postpartum, and breastfeeding participants in the program. Retail Food Delivery Systems and the Transition to EBT

Currently, most states have their participants redeem WIC benefits using a paper food instrument in the form of a check or voucher that specifies the types and quantities of foods that can be purchased at an authorized WIC vendor. WIC's 2010 reauthorization included the requirement that state agencies transition to using electronic benefit transfer (EBT) by October 1, 2020 (the end of FY2020). Over time, one of the ways that WIC has controlled costs has been to require competitive bidding for infant formula, which has resulted in infant formula being available to states at well below market costs, especially due to manufacturers' discounts in the form of rebates to states. In FY2013, there were over 48,000 WIC authorized vendors nationwide. Therefore, states consider and monitor WIC vendors' pricing as a means of cost containment.
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides nutrition-rich foods, nutrition education (including breastfeeding promotion and support), and health care and social services referrals to eligible low-income women, infants, and children. In FY2016, approximately 7.7 million people participated in WIC each month. WIC is authorized by the Child Nutrition Act, as is the related WIC Farmers' Market Nutrition Program (WIC FMNP). WIC, WIC FMNP, school meals, and the other child nutrition programs are typically reauthorized together; these programs were last reauthorized in the Healthy, Hunger-Free Kids Act of 2010 (P.L. 111-296).
WIC's funding is discretionary, and the bulk of program funds are allocated via formula grant to state agencies for food costs and "Nutrition Services and Administration." In FY2016, there were 90 state agencies (50 states, District of Columbia, 5 U.S. territories, and 34 Indian Tribal Organizations). These agencies operate the program through local WIC agencies and clinics. The program obligated over $7 billion in federal funds in FY2014.
WIC has a number of federal and state eligibility rules, including categorical, financial, and nutritional risk. Participants must fall into one of WIC's participant categories: pregnant, postpartum, and breastfeeding women; infants; or children (under five years of age). Financial eligibility is met if (1) a household has income at or below 185% of the federal poverty level, or (2) applicants receive benefits through Temporary Assistance for Needy Families (TANF), the Supplemental Nutrition Assistance Program (SNAP), Medicaid, or certain state programs. Households also must meet nutritional risk criteria and reside in the state of application.
WIC provides participants with monthly benefits redeemable for specified foods to supplement their diets, as well as related nutrition and health services. WIC-eligible foods are laid out in federal regulation, and state agencies develop their own approved food lists within this framework. At the WIC clinic, participants are provided the benefits to redeem specific foods (food package) for the participant's category and individual nutritional needs. Major changes to the federal WIC food package regulations have been made in recent years; for some participant categories, the food package now includes a cash-value voucher redeemable for fruits and vegetables. One way that state agencies control WIC costs is through their approved foods lists. These lists usually include one brand of infant formula, as state agencies are required to control infant formula costs through competitive bidding for infant formula rebate contracts. In addition to providing food benefits, states are required to ensure that nutrition education, including breastfeeding promotion and drug abuse education, is available to all pregnant, postpartum, and breastfeeding participants in the program. Agencies also work to refer WIC participants to health services and other public programs, particularly Medicaid.
Nearly all states administer their programs through a retail food delivery system, in which participants purchase foods at authorized retailers (vendors). Accordingly, many WIC policies at the federal and state levels pertain to vendor authorization and oversight as well as benefit redemption. Currently, most states distribute checks or vouchers for participants to purchase WIC foods at vendors; however, state agencies are increasingly transitioning to electronic benefit transfer (EBT), in part because the 2010 reauthorization law requires this transition by October 1, 2020. States authorize vendors for the program, considering factors like a vendor's inventory and capacity and geographic distribution of vendors. States also consider and monitor WIC vendors' pricing, as required by federal law, to help contain program costs.