Published March 26th, 2015 at 9:45 AM
Until the federal health insurance marketplace opened in late 2013, farmers and ranchers were more likely to be uninsured than many other occupational groups. The Affordable Care Act changed that by requiring them to buy insurance. But it also gave them coverage options they didn’t have before.
Jon Bailey, of the Nebraska-based Center for Rural Affairs, says it’s hard to make sweeping generalizations about how the health care law is working for farmers and ranchers.
“Depending where you live, what your individual circumstances are, how healthy you are, how old you are, it’s gonna make a lot of difference in what you pay for health insurance, or what you have available,” Bailey says.
But, he adds, there’s little doubt the Affordable Care Act has given farmers and ranchers — and rural people in general — more health insurance options than they had before.
Traditionally, there’s been less competition for their business — especially in the individual market. And since farmers and ranchers tend to be self-employed or to work for very small operations, that’s the market they rely on.
“Sixty to 70 per cent of farmers still purchase on the individual market,” Bailey says. “So how we can make the individual market affordable to them, and providing more options, is important because they’re so dependent on the individual market, more than the population in general.”
Bailey says farmers tend to be older — in their mid-to-upper 50s, on average. Along with the dangerous work they do, that makes farmers more likely to have health issues and more expensive to insure.
Studies done before the ACA’s enactment found that farmers were among the groups least likely to have health insurance. Donn Teske is a good example. Not that long ago, some health conditions he considers relatively minor made it virtually impossible for him to get insurance.
“…my hypertension, and I have a slight heart condition that was diagnosed 20 to 30 years ago, and is easily controlled with medication, but when that shows up on your history, then you’re uninsurable,” he says.
Teske has a cow-calf operation near Wheaton, Kan., in the Flint Hills northeast of Manhattan. He’s also the president of the Kansas Farmers Union. The only way he was able to get coverage before passage of the health reform law was through his wife’s policy.
Even then, adding him to the policy was very expensive, and he says the coverage left a lot to be desired. So Teske’s wife changed jobs to get a better deal on insurance—even though it meant driving 40 miles instead of eight. The ACA, Teske says, changed that.
“By God, for the first time in decades I’ve been able to buy my own health insurance, and I’m pretty proud of that,” Teske says. ”And I’m buying it from the same company that turned me down before. And so I’m very supportive of the Affordable Care Act.”
Others in farm and ranch country are less enthusiastic about the health care law. Kyle Baker manages a huge ranch for a landowner near Rosalia, in the Flint Hills east of El Dorado. He also has his own smaller herd of cattle. Baker is 28 years old and in good health.
“I go to the doctor maybe once a year or once every two or three years, and I just kind of want something there in case something, you know, catastrophic happens,” Baker says.
Eighty percent of Kansans who buy policies through the federal marketplace qualify for subsidies. But subsidies are based on income, and Baker says it’s hard to predict what his income will be because it depends on two factors beyond his control: weather and market prices.
“When I kind of filled out what I thought might be a decent year, I got an email that said ‘Congratulations! You’re qualified for a tax credit equal to zero or less dollars.’ And then the policies that they had on there were more expensive than the policies—and not as good—as the ones that I had,” Baker says.
So Baker opted to stay with the coverage he already had.
Farm Bureau Insurance agent Vernon Hurd says many farmers have done the same. Hurd’s agency is in the northwest Kansas town of St. Francis, and he does a lot of business with farmers. As a general rule, he says, they don’t like being told what to do.
“Yeah, they’re probably not excited about being told that they have to have health insurance, but by and large, I think they see the greater good in knowing that their neighbors, their friends and their family that weren’t able to get coverage in the past now can,” Hurd says.
He thinks that’s why he’s hearing fewer complaints about the health care law from his customers.
“Even some of the folks I’ve worked with that were the staunchest conservatives — probably haven’t voted for a Democrat in their lives — recognize the fact that there were so many people that weren’t able to obtain health insurance,” Hurd says. “And when you take that into consideration, I think most of my clients would tell you, overwhelmingly actually, that they think it’s a good thing that we’re finally able to give that opportunity to people that didn’t have it in the past.”
Hurd says some of his clients now have health insurance for the first time in 40 years. He calls that the “true blessing” of the Affordable Care Act.
Bryan Thompson is a reporter for KHI News Service in Topeka, a partner in the Heartland Health Monitor team.