ABSTRACT The proposed five-year pragmatic trial em bedded in an existing program providing SNAP cross-enrollment outreach and enrollment assistance program among 900,000 Michigan Medicaid beneficiaries. This project will be conducted in partnership with Michigan Department of Health and Human Services and Benefits Data Trust and with guidance from an Advisory Committee that includes people with disabilities. The proposed study will leverage the program's random selection of households for treatment to estimate the effect of SNAP outreach and enrollment assistance among low-income adults with disabilities. Households are randomly selected for either an information-only arm or an information plus assistance arm while a 3"' equivalent group waits for treatment, forming a wait-list control by default. Medicaid data from adults aged 18 and older will be used to identify people with disabilities, defined for this study as individuals who: (a) receive disability benefits (e.g. SSDI, or, if younger than age 65, SSI); (b) are Medicaid eligible due to disability or blindness; (c) are eligible fa home and community-based services or (d) are home help recipients needing assistance with Activities of Daily Living. Outcomes will be measured using Medicaid claims and SNAP utilization data. Aim 1 characterizes Medicaid beneficiaries at baseline with disproportionately lower SNAP utilization (participation and benefit amounts) for people with and without disabilities and examine interactions with race/ethnicity, age, and presence of ambulatory care-sensitive conditions. Aim 2 evaluates the impact of a cross-benefit enrollment intervention on health care utilization, including inpatient hospital and emergency department utilization (emergency department visits; hospitalization and length of stay; end-of-the-month utilization; and utilization for ambulatory care-sensitive conditions) and on nursing home utilization (admission and length of stay) among community-dwelling adults with a disability. Aim 3 evaluates the impact of a cross-benefit enrollment intervention on SNAP utilization (participation and benefit amounts) and tests SNAP utilization as a mediator of intervention effectiveness health care utilization among community-dwelling adults with a disability. Aim 4 tests for effect modification of intervention impact based on race/ethnicity, age, and presence of ambulatory caresensitive conditions, among community-dwelling adults with a disability. Through these aims, this study evaluates a promising new intervention that may increase food access for low-income adults with disabilities. Results from this work are urgently needed to improve food access for low-income adults with disability and advance health equity - two critical public health priorities.