Economic Futures
Cash: The Key to Improving Health for Families
08. 04. 2025
The effects of financial precarity show up in the exam room every day. A new mom skipping a postpartum check-up because she does not have childcare. A young parent, stressed from balancing parenthood and paying the bills, also suffering from crippling heartburn. Parents forced to choose between going to work and being at their child’s side during cancer treatment.
Health is foundational to a family’s economic well-being, and in transitional life moments—pregnancy, the birth of a child, or an unforeseen illness—cash can provide stability to heal and live a good life. In our new report with the Health and Political Economy Project, The Resilience Factor: Cash as a Tool Toward Better Health for Young Families, we talked to doctors, nurses, doulas, and other healthcare providers who made the case for direct cash support as a practical, preventive intervention, one that helps stabilize families and allows providers to focus on predictable high quality care.
The need for new interventions is urgent. Healthcare is one of the biggest drivers of the affordability crisis facing families today, and the passage of the recent massive tax package, the “Big Bad Bill,” is poised to make things worse, from hospital closures to healthcare loss. An estimated 17 million people are expected to lose healthcare coverage, average premiums are expected to rise by $600 a year for over 20 million people, and deep cuts to Medicaid ($930 billion!) will hit families with children who have complex medical needs the hardest.
As families face healthcare challenges on all fronts, it’s essential to listen to providers on the frontlines, who have named cash as a powerful health intervention to help families thrive. As Dr. Abdul El-Sayed, a physician and public health expert, explained, “[Cash is] the missing ingredient between you providing medical care and your patient getting better.”
Cash provides flexibility and agency to families during times of crisis and joy. Take a childhood cancer diagnosis. When families receive this devastating news, parents often have to quit their jobs, relocate for treatment, or shoulder new caregiving expenses—upending any financial stability they had. “Families are torn out of whatever existing economic structure or safety net they have,” explained Dr. Kira Bona of Pediatric RISE, a program that provides direct cash to families navigating cancer treatment. In just three months, parents reported reduced financial hardships as they used the funds to keep up with bills like groceries and rent.
But stability isn’t just about survival—it’s about the moments that make life meaningful. Celebrating little joys, like a child’s birthday party, explained Dr. Tresha A. Gibbs, is vital for a child’s mental health and development. When families are stretched thin, these moments are often the first to disappear. Cash can help keep them within reach.
Providers also shared how cash supports patients’ health, pregnancy and the early years of welcoming a new child. For example, RxKids in Michigan, led by Dr. Mona Hanna, a pediatrician, is the nation’s first community-wide prenatal and infant cash prescription program giving mothers $1,500 during pregnancy and $500 a month for the first year of their child’s life. Results are promising: 59% of mothers reported cash made it easier to access healthcare, and 72% said it improved both their health and their infants’ health.
Cash also improves mental health—both for patients and providers. For parents, it creates time to rest, recover, and seek mental health support. As Dr. Zea Malawa of the Abundant Birth Project shared, “Moms have been using the money to get some therapy. It’s been a gift for these moms to be able to get culturally concordant therapy during and immediately after pregnancy as a beautiful way to get started in their parenting journey.”
For healthcare providers, cash can help prevent burnout. Dr. Malawa also described the emotional toll of watching patients suffer from root causes beyond her clinical reach—housing insecurity, food instability, lack of transportation—and the “real joy” of being able to offer upstream solutions like cash that can help address these causes.
The healthcare providers we spoke to are deeply committed to achieving the best health outcomes for their patients. But they can’t prescribe economic stability. Cash is one of the most effective tools we have to make that happen and help families thrive.
What Else We’ve Been Up To
We’re working to make sure families have what they need to thrive—by reimagining access to essentials like food and healthcare and advancing bold solutions. Here’s some of what we’ve been focused on lately:
Public Grocery Stores are Having a Moment
The idea of public grocery stores isn’t new—but it’s finally getting the attention it deserves. As families across the country face skyrocketing food prices and pervasive food deserts, more cities are exploring public options to expand access to affordable, healthy groceries. That includes New York, where the recent democratic primary for NYC mayor brought national attention to the idea of public grocery stores and renewed the conversation around how government can step in when the market fails.
Momentum is building around public grocery stores in Illinois, where ESIL helped launch the state’s first municipally owned grocery store in Venice, a historically Black community long overlooked by major chains. As ESIL Executive Director Sarah Saheb recently wrote, “Where the private market might see a neighborhood as unprofitable, like Whole Foods did in Englewood, a city leader can see it as a community where people live and deserve access to affordable food.” Learn more here.
ESP’s Shafeka Hashash named 2025 Aspen Ideas Festival Fellow!
We’re thrilled to celebrate ESP’s Director of Cash Initiatives Shafeka Hashash as a 2025 Aspen Ideas Festival Fellow!
Selected alongside a powerful cohort of changemakers, Shafeka joins a network of visionaries who are advancing bold ideas and making meaningful impact. They were each chosen for their significant accomplishments, dedication to organizing, storytelling and reimagining systems from the ground up.
At this year’s Aspen Ideas Festival, Shafeka brought her voice to the “Future of Work is Now” session, offering a powerful perspective rooted in her own lived experience. Alongside fellow changemakers, she discussed navigating the collapse of the American social contract. Through collective action and refusal to separate labor from dignity, this year’s Aspen Ideas Fellows are crafting bold new visions of what work can and should look like in a just society. Learn more about the 2025 cohort here.
ICYMI: Our Picks
This month’s headlines say a lot about where our systems are falling short—and where people are stepping up. From civic tech leaders defending Direct File to creators naming cash as a health solution, here are a few stories that caught our attention.
- Organizations are providing direct CASH to parents!!!
POP! Economy teams up with creator Alexis Rose (@travelingnursealex) to talk about The Resilience Factor, highlighting a few programs like Rx Kids, Philly Joy Bank, and Abundant Birth Project that are already giving cash to families to help build the stability they need to heal. “Direct cash is a preventative treatment. It helps minimize the health impacts from economic stress and there are so many of them. As healthcare providers, we have to be having these conversations,” explains Rose. - Guaranteed Income is for artists, too
Artists keep the world spinning. Their work tells the stories of who we are, and signals where society is headed, but many are freelancers or gig workers without a safety net. Unstable income and little access to benefits pose great challenges for culture bearers and producers. That’s where guaranteed income comes in. “Direct cash support helps artists build stability to keep creating and contributing to vibrant, resilient communities.” - Activists try to preserve IRS’s Direct File now that Trump has ended it
The Washington Post explores the timeline of events surrounding Direct File, one of the most successful civic tech tools in recent memory. Yet, despite its popularity, the Trump Admin shut it down, so we’re partnering with the people who built it to keep the game-changing resource alive. “Let’s get there in the future, rather than give up on the idea that it’s worth it to improve the tax system,” said Chris Given. - How Musk Monetized Government While Killing What Actually Works
Merici Vinton, former DOGE worker, Senior Advisor to the IRS Commissioner, and chief architect of Direct File (and now an ESP Future of Tax Fellow), pulls back the curtain on Elon Musk’s power play in Washington, DC. Musk didn’t go to D.C. to serve the public—he went to protect his projects from oversight and to gain influence. “While Musk dismantled agencies investigating his companies, civil servants like me built Direct File into a tax service more beloved than Netflix,” writes Vinton.