Starting Jan. 1, people using the Supplemental Nutrition Assistance Program in Indiana, Iowa, Nebraska, Utah and West Virginia will encounter new restrictions on what kinds of food and beverages they can buy with benefits, under waivers the U.S. Department of Agriculture approved for those states.

The restrictions are being advanced as part of a federal effort led by Health Secretary Robert F. Kennedy Jr. and Agriculture Secretary Brooke Rollins. In a statement in December, Kennedy said the administration cannot continue “a system that forces taxpayers to fund programs that make people sick and then pay a second time to treat the illnesses those very programs help create,” a framing the administration linked to goals including reducing chronic diseases such as obesity and diabetes that officials associate with sweetened drinks and other treats.

Under the waivers taking effect Jan. 1, Utah and West Virginia will prohibit SNAP from being used for soda and soft drinks. Nebraska’s waiver will bar the purchase of soda and energy drinks, while Indiana’s waiver will target soft drinks and candy.

Iowa’s waiver is described as the most restrictive to date, with SNAP limits applying to taxable foods including soda and candy, along with certain prepared foods. The Food Research & Action Center said the list of items did not provide enough detail for SNAP participants to shop without being rejected at the checkout, and it said additional items—including some prepared foods—would be disallowed even when they were not clearly identified in notices sent to households.

Retail and health policy experts raised concerns about whether the waivers can be implemented smoothly and whether they will improve diet and health. The National Retail Federation predicted that the changes could mean longer lines and more customer complaints as people learn which foods are affected. Separately, a nutrition science expert at the University of Michigan, Kate Bauer, said it would be “a disaster waiting to happen of people trying to buy food and being rejected,” and the National Grocers Association and other industry trade groups estimated that implementing SNAP restrictions would cost retailers $1.6 billion at first and then $759 million each year.

Advocates for people receiving assistance said the approach could add financial and dignity burdens. Food Research & Action Center SNAP director Gina Plata-Nino said, “Punishing SNAP recipients means we all get to pay more at the grocery store,” and she criticized the notices for lacking enough information about what purchases would be allowed. The waivers also appear to be creating anxiety for some recipients, including Marc Craig, 47, of Des Moines, who said he has been living in his car since October and that the new rules would make it harder to figure out how to use the $298 in SNAP benefits he receives each month. Craig said the process increases the stigma he feels at the cash register, adding: “They treat people that get food stamps like we’re not people.”

Health experts said the waivers focus on one piece of nutrition while overlooking other factors that affect SNAP recipients’ health. Anand Parekh, a medical doctor and chief health policy officer at the University of Michigan School of Public Health, said the restrictions “don’t solve the two fundamental problems, which is healthy food in this country is not affordable and unhealthy food is cheap and ubiquitous.”

The waivers represent a departure from decades of federal SNAP policy, which has generally allowed benefits to be used for “any food or food product intended for human consumption,” with exceptions that include alcohol and ready-to-eat hot foods, and a prohibition on tobacco. The new approach follows prior waiver requests in which the government rejected proposals based on research saying restrictions would be costly and difficult to implement and might not change buying habits or reduce health problems such as obesity.

The Agriculture Department said the state waivers enacted now and in coming months will last for two years, with a possible three-year extension, and that each state must assess the impact of the changes.