Health insurance is a big worry for farmers

Shoshana Inwood
(University of Vermont photo)

A new study funded by the U.S. Department of Agriculture says that lack of access to affordable health care is one of the biggest problems facing American farmers, affecting their risk management, productivity, health, retirement, the need for a secondary source of income, and land access for new farmers.

"The rising cost of healthcare and the availability of affordable health insurance have joined more traditional risk factors like access to capital, credit and land as a major source of worry for farmers," principal investigator Shoshana Inwood of the University of Vermont said in a press release. She conducted the study with researchers from the Walsh Center for Rural Health Analysis, part of the research organization Norc at the University of Chicago.

The researchers interviewed farmers in 10 states, and sent 1,062 of them a mail survey in March 2017. In the interviews, many farmers said they knew someone who had lost a farm because of an uninsured illness or injury. Nearly three-quarters of the survey respondents said affordable health care was important to reducing their business risk, and half said they are not confident they could pay for a major illness without going into debt. "With an average age of 58, farmers and ranchers are also vulnerable to higher insurance premiums due to age-rating bands," the release said.

Farmers are also likely to have pre-existing conditions (64 percent in the survey), so many of them took off-farm jobs in order to qualify for group insurance policies, which must cover such conditions. With passage of the Patient Protection and Affordable Care Act, “A number of farmers in their 50s we spoke with said they had left off-farm employment in the last five years to commit to full-time farming because they and their families would not be denied health insurance in the individual market due to pre-existing conditions,” said Alana Knudson, co-director of the NORC Walsh Center.

Most states' expansion of Medicaid under the ACA was a boon to younger farmers, who said it allowed them to get health care for their children without having to take an off-farm job. There's another possible factor for young farmers: Almost half the farmers surveyed said they're worried they'll have to sell some or all of their farm if they need to pay for long-term medical expenses such as nursing-home care, and selling off land to the highest bidder could make it less likely that land is sold to young farmers who lack capital, said Inwood.

Farmers are looking to the U.S. Department of Agriculture to represent their concerns in national health-policy discussions, said Inwood. “We have a shrinking and aging farm population,” she said. “The next Farm Bill is an opportunity to start thinking about how health insurance affects the trajectory of farms in the United States.” The bill is up for renewal next year.