WIC participants often receive a monthly check or voucher, or more recently an EBT card. The USDA implemented new rules in 2006 that required foods to be more price-competitive. This has resulted in the closure of many "WIC Only Stores". Formerly, these stores charged the maximum permitted under the program, charging up to 16% more than regular stores for the same food. However, the WIC program is one of the most cost-effective government programs. A study of birth outcomes showed benefit-to-cost ratios ranging from $1.77 to $3.13 in Medicaid costs saved for each $1 spent on WIC.Citing: </ref>