Research

In 2025, Michigan implemented Medicaid In Lieu of Services (ILOS), which enables Medicaid health plans to offer healthy and medically tailored home-delivered meals, healthy food packs, and produce prescriptions as substitutes for other covered services. The Michigan Department of Health and Human Services also is investing in efforts to strengthen community-based food access. Through an eight-year partnership with the Trans Sistas of Color Project (TSoCP) in Detroit, Gamarel and the research team have documented that 78.3% of trans women of color surveyed were food insecure, 66.7% earned less than $1,000 per month, and 39% were unstably housed. Working with the executive director of the Trans Sistas of Color Project, the researchers will interview trans women of color about their experiences with food assistance, food pantries, food banks, and medically linked food pathways to identify structural factors shaping access. Based on those findings, they will convene trans women of color, administrators of Medicaid In Lieu of Services, and MDHHS staff to co-develop a policy brief with implementable recommendations to promote equitable access to food-as-medicine programs. 

Kristi Gamarel, associate professor at the School of Public Health