Study: Over 1/3 of rural Americans skip care due to costs

Commonwealth Fund graph from Health Policy Survey data

Over a third of rural Americans will skip needed health care because they can't afford it, The Commonwealth Fund reports, based on its 2020 International Health Policy Survey. It "found that 36 percent of rural Americans did not get the care they needed due to costs, which is more than double the rate for rural residents in six other countries the study looked at," reports Lauren Sforza of The Hill. "Less than 10 percent of rural residents in the United Kingdom, Norway and Sweden reported that they did not get medical care due to costs."

Sfioza adds, "The survey found that nearly 25 percent of rural Americans reported serious problems with being able to pay their medical bills or not being able to pay them at all. In nine of the other countries, less than one in 10 rural residents reported the same thing. The survey noted that the 10 other countries looked at all had a universal health care system, which the U.S. does not have. The survey also pointed to census data that showed about 12 percent of the American rural population does not have health insurance as a reason why the U.S. fell short of what the other countries reported."

The study report says, "With affordability problems preventing Americans from seeing their doctor, it is no surprise that rural Americans also are more likely to have higher rates of chronic conditions and some of the highest rates of mental health conditions." The Commonweath Fund says its mission is "to promote a high-performing, equitable health care system that achieves better access, improved quality, and greater efficiency, particularly for society’s most vulnerable."

Western states asking counties to lead the charge to get federal land transferred to state control

Western states that have failed to have federal land transferred to state control and are reluctant to spend state money on federal land management are trying a more local approach, Rebecca Beitsch reports for Stateline. States such as Colorado and Utah are "arming counties with money and expertise to help them convince federal officials to hew more closely to residents’ interests."

This year in Colorado, state lawmakers "approved $1 million in grants for counties that want to influence federal land use decisions," Beitsch writes. "County leaders can use the money to hire consultants to evaluate data, provide scientific research or attend Bureau of Land Management coordination meetings. The law authorizing the grants also requires state agencies to provide additional expertise and assistance to counties when they ask for it."

Utah this year "passed a law requiring every county in the state to develop a resource management plan," Beitsch writes. "State Senate Republican Majority Leader Ralph Okerlund, who sponsored the legislation, said the new requirement not only helps create a statewide plan but it also prepares counties to deal with the federal government and argue that federal plans should be consistent with theirs."

In 2012 the state passed a law "calling on the federal government to transfer to the state all public land that is not designated as a national park or wilderness area or owned by Native American tribes—about 30 million acres in total," Beitsch writes. "State Rep. Ken Ivory, a Republican, said because the federal government did not comply with the 2012 law, the state has set aside $4 million for a lawsuit challenging federal control of the land and is assembling a legal team." (Stateline map: For an interactive version, click here)

Farm Bill winners, losers, and plenty of opinions

Now that the Farm Bill has passed the House and is expected to pass the Senate and be signed into law by President Obama, here's a look at some of the stories being written about the bill.

Dairy farmers welcome the bill's subsidy overhaul, reports M.L Johnson for The Associated Press. "Farmers expressed relief this week that a long fight over federal dairy subsidies had ended with an overhaul that most thought would be fair and effective in keeping farms from going under during hard times." (Read more)

One provision, "tucked into page 735 of the 949-page farm bill, could make it more difficult for gasoline blended with higher concentrations of ethanol to find its way to rural areas, where demand for the fuel is greatest," Cezary Podkul reports for Reuters. "That, in turn, could make it more difficult for the United States to implement a program known as the renewable fuel standard, or RFS, which mandates increasing amounts of biofuels like corn-based ethanol be blended into the nation's fuel supply." (Read more)

"Soybean and catfish farmers, dairy food manufacturers, U.S. cattlemen and the organic food industry all counted themselves among the big winners," Bill Tomson and Tarini Parti report for Politico. "Much less pleased are meat processors, champions of the food stamp program and Rep. Steve King (R-Iowa)," who sponsored an amendment "that would have prohibited states from regulating other states’ means of agricultural production." (Read more)

The Supplemental Nutrition Assistance Program, or food stamps, took a major hit, with $8 billion in cuts, Alan Bjera reports for Bloomberg. "The bill would cut food-stamp spending by $8.6 billion over 10 years, though additions to other programs bring nutrition-aid cuts down to $8 billion—one-fifth of the $40 billion sought by Republicans and fought by Democrats and food retailers." (Read more)

Passage of the farm bill is a huge victory for House Agriculture Committee Chairman Frank Lucas (R-Okla.), "who was whipsawed by his own party throughout much of 2013 over the costs of the bill and demands for more spending cuts," writes Chris Clayton for DTN The Progressive Farmer. "Nonetheless, he was able to successfully navigate a compromise bill through the chamber." (Read more)

Katie Valentine, of Think Progress, takes a look at what the bill means for energy and the environment, writing that it "has been heralded as a win for conservationists, but it’s got some pitfalls, too." (Read more)

President Obama should veto the bill, opines The Washington Post. "We hope Mr. Obama will pick up the phone, call Congress—and tell them he’s preparing his veto pen for the 2014 farm bill. It is only a slight exaggeration to say that this legislative grotesquerie gives to the rich and takes from the poor." (Read more)

The bill "makes some of the most significant reforms to wasteful agriculture subsidies in many years, and it contains dozens of important provisions designed to increase employment in rural areas and save lives with farsighted crop research," reports The New York Times. "It preserves some important environmental protections, while cutting others. And though its food-stamp provisions were saved from being much worse, they will still reduce benefits for too many poor people. On balance, the bill is clearly worthy of support, particularly because it will prevent austerity fanatics in future Congresses from gutting food stamps for the next five years." (Read more)

Backers of the farm bill "are patting themselves on the back for saving billions by eliminating a huge wasteful farm subsidy program. Don't believe the hype," Michael Hiltzik writes for The Economy Hub. "The conservative American Enterprise Institute says the measure could cost taxpayers $15 billion more per year than do existing crop programs, much of it going to the wealthiest farmers and the crop insurance industry." (Read more)

Farm Policy has a copy of the farm bill debate transcript, which can be accessed by clicking here.

Farm Bill compromise passes House by 251-166 vote; Senate is expected to pass it

"The House approved the five-year Farm Bill today, with a 251-166 vote, sending the nearly $1 trillion agricultural policy package to the Senate," Derrick Cain reports for Agri-Pulse, a Washington newsletter. "The bill would eliminate direct payments in favor of enhanced crop insurance, revise commodity supports, create a new dairy program and make several other changes to agricultural policy, including an approximate $8 billion cut to the Supplemental Nutrition Assistance Program," better known as food stamps.

Rep. Frank Lucas

The Senate is expected to approve the legislation—possibly as early as next week—and President Obama to sign it into law, Cain writes. House Agriculture Committee Frank Lucas (R-Okla.) said, "It may not have everything my friends on the right may and it may not have everything my friends on the left may want. But, it's a compromise.”

"The Congressional Budget Office released a score for the bill Tuesday estimating that direct spending for authorized programs would total $956 billion over 10 years, of which $756 billion would be for nutrition programsm," Cain writes. "Relative to spending and revenues projected under CBO's May 2013 baseline, CBO said it estimates that enacting the legislation would lower budget deficits by $16.6 billion and increase revenues by $100 million over 10 years. This came in below the $23 billion in possible savings being touted by bill supporters, but they noted that the Farm Bill baseline had already been reduced by $6.6 billion" through budget sequesters. (Read more)

The bill includes "a new revenue insurance subsidy that would pay farmers in the event of 'shallow losses' or revenue losses incurred before their paid crop insurance kicks in. That program might kick in sooner than previously thought as some crop prices have dropped in recent months," The Associated Press reports. Also, "a separate subsidy program would trigger payments when crop prices drop. This is similar to current subsidies, though the new programs would kick in sooner, especially for cotton and rice, the crops that depend the most on the direct payments that would be phased out. Producers would have to choose between these subsidies or the revenue insurance." (Read more)

Farm Bill ends 'direct payments' and sets limits, but not what reformers wanted

The five-year Farm Bill, which passed the House Wednesday by a vote of 251-166, and now heads to the Senate, ends direct payments to farmers, whether they farm or not, that cost around $4.5 billion a year, reports The Associated Press. However, "Reformers came away frustrated by the bill’s failure to rein in crop insurance subsidies and impose a more meaningful cap on what any single farm can receive in government aid," David Rogers reports for Politico.

The bill includes "stricter limits on how much money an individual farmer can receive—$125,000 annually on all payments and loans, when some were previously unrestricted," the AP reports. "The agreement is less strict than either the House or Senate bills, which had put limits on how much a farmer could receive from individual programs. Language that would limit how many people in a farm operation may receive such payments was also passed by both chambers but taken out of the compromise bill, which would kick the issue to the Agriculture Department."

The bill also includes "a new revenue insurance subsidy that would pay farmers in the event of 'shallow losses' or revenue losses incurred before their paid crop insurance kicks in. That program might kick in sooner than previously thought as some crop prices have dropped in recent months," AP reports. Also, "a separate subsidy program would trigger payments when crop prices drop. This is similar to current subsidies, though the new programs would kick in sooner, especially for cotton and rice, the crops that depend the most on the direct payments that would be phased out. Producers would have to choose between these subsidies or the revenue insurance." (Read more)

New measuring stick gives clearer picture of how size of farms in U.S. is increasing

An August report from the U.S. Department of Agriculture could be one of the keys to solving the continued debate over limits on farm payments, a contentious subject in the struggle to pass a new Farm Bill, David Rogers reports for Politico. But beyond that, it gives a clearer picture of how farm size is increasing, says USDA's Economic Research Service, which did the work.

The ERS report "introduces a measure of midpoint acreage in which half of all cropland acres are on farms with more cropland than the midpoint, and half are on farms with less. Midpoint acreage is revealed to be a more informative measure of cropland consolidation than either a simple median (in which half of all farms are either larger or smaller) or the simple mean (which is average cropland per farm)," the study's authors write. (ERS graphic: Measures of average farm size)

Researchers found that "the midpoint acreage for U.S. cropland nearly doubled between 1982 and 2007, from 589 acres to 1,105, and midpoint acreages increased in 45 of 50 States and more than doubled in 16," according to the report. "The largest increases occurred in a contiguous group of 12 Corn Belt and Northern Plains states; midpoint acreages more than doubled in each of 5 major field crops (corn, cotton, rice, soybeans, and wheat) and increased in 35 of 39 fruit and vegetable crops, where the average increase was 107 percent; the shifts were persistent, with a general pattern of increase between each Census of Agriculture conducted between 1982 and 2007."

The report, though, states that  "less comprehensive evidence from annual surveys suggests that the pace of consolidation slowed between 2007 and 2011, the last year for which data are available. Data from the 2012 Census will provide more definitive evidence of recent trends; and larger crop farms continue to realize better financial performance: average rates of return on equity increased with farm size in five major commodity categories analyzed in this report (corn, soybeans, wheat, fruits, and vegetables). In turn, larger farms utilize labor and capital more intensively, which provide them with the primary source of their financial advantage."

Rogers writes, "The new midpoint index is a more telling measurement than simply averaging the size of all farms nationally." He also says Mississippi "stands out, going from 950 acres to 1,950 acres. But the Midwest saw the greatest change. The weighted median values for harvested acres in North Dakota went from 882 acres to 2,240 in the same 25-year period. Illinois, Iowa, Minnesota and South Dakota all saw a better-than-100-percent jump. Government commodity payments appear to have had less to do with this consolidation than other factors — the search for higher profits, greater efficiencies of scale and an abundance of flat land making it easier to merge farms." (Read more) (ERS graphic: Changes in midpoint acreage for cropland from 1982-2007)

Publication collecting compensation figures from ag non-profit CEOS sees recent rise in salaries

The compensation for most nonprofit chief executive officers in the U.S. dropped along with the economy in recent years, but those numbers are starting to climb again, Agri-Pulse reports. The online publication has compiled a list of CEO compensations at nonprofit organizations that try to shape farm and rural policy from the recently released 2012 GuideStar Nonprofit Compensation Report.

GuideStar vice-president of research Chuck McLean told Agri-Pulse that "long established compensation patterns turned upside down" between 2008 and 2010. Over that period, compensation for 41 percent of incumbent CEOs was static or declined. Washington, D.C., had the highest overall median salary of the top 20 metropolitan statistical areas studied, likely because most of the big agriculture group are based in Washington. Median compensation of women continued to lag behind men when comparing similar organizations, and very few women are CEOs. But Pamela Bailey, head of Grocery Manufacturers Association, had the highest base salary in 2011 of all groups surveyed: just more than $1.1 million.

This compensation report is a service provided by Agri-Pulse, and a lot of work goes into it. That's why the publication makes this request: "We’ve invested a lot of time in collecting this data in conjunction with GuideStar, and hope you will continue to respect our copyright by not forwarding the information to those who do not subscribe. We offer a four-week free trial for those who are interested in investing in our content." That free trial can be accessed here.

Environmental Working Group expands farm-subsidy database

As the new five-year Farm Bill is being debated and much more than usual attention is focused on government programs for agriculture, a major critic of such programs, the Environmental Working Group, has posted an expanded database that it says "provides nearly full disclosure of federal farm subsidy beneficiaries for the first time."

Reporters who used the database to do stories about the top beneficiaries in their counties, regions or states need to check it again, because "just about every one of those rankings has changed, particularly in rice and cotton country," EWG President Ken Cook says. Click here for the new rankings.

The database "includes 350,000 new individuals who have never had a specific dollar amount attributed to them -- until now," Cook says. "For the first time, using new USDA data, we identify individuals whose subsidy benefits 'pass through' one or more plantation-scale farm business that produces vast quantities or subsidized rice, cotton, or other crops." People listed in the system for the first time "received $9.8 billion in crop subsidy benefits alone between 2003 and 2005," EWG says on its MulchBlog.

Cook says the data confirm what EWG calls "the inequitable distribution of farm program payments, in which the top 10 percent of beneficiaries get 66 percent of the payments in Title 1 of the Farm Bill, while the bottom 80 percent got only 16 percent of such payments, averaging $4,508 over years. "EWG’s database shows that family farmers are getting peanuts from today’s subsidy system, while corporate agriculture is living high on the hog," Taxpayers for Common Sense, a spending-watchdog group, said in a press release.

"The original EWG database, released more than five years ago, had a significant impact on the 2002 farm bill debate," reports Brownfield's Peter Shinn. "It provided documentary evidence that the bulk of commodity payments went to a relatively small minority of ag producers, and helped Senate supporters of payment limits successfully attach a more stringent payment limits provision in their version of the 2002 Farm Bill. Lawmakers ultimately stripped that provision in conference. But the expanded version of the EWG database is expected to have a similarly bracing effect on efforts to tighten payment limits in the 2007 Farm Bill." (Read more)

The Nebraska-based Center for Rural Affairs says the new database "can and should be used to examine how large, aggressively expanding operations utilize loopholes in current law to evade statutory limits. Those loopholes allow such operations to obtain the unlimited payments that they use to bid up land costs and, in the process, drive their smaller neighbors out of business."