PEOSTA, Iowa — Health insurance is an important consideration for every family — including farmers and ranchers in rural areas, where options may be limited.
Insurance coverage and research are discussed during the AgriSafe Talking Total Farmer Health Podcast on November 1.
Florence Picotte, a rural sociologist and research scientist with the National Center for Farm Medicine, and Maria Bipedes, a collaborative extension educator at the University of Delaware, shared their insights during the podcast.
What trends have you seen in rural health care?
Pequot: There is research dating back to the early 2000s that the cost of health insurance and access to farmers was a challenge. To give you an idea, one of our colleagues, Shoshanna Inwood, asked farmers what the biggest serious problem with agribusiness was, and lo and behold, the first problem was not related to the cost of production, it was not related to the cost of land, but for 65% of the farmers, it was the cost of health insurance.
And also what we need to remember is that prior to the major Medicare health insurance reforms in the early 2010s, there were specific rules about pre-existing conditions that made it more difficult for people to get coverage.
So, what we’ve known is that since changes brought about by the law in the early 2000s, people can no longer be excluded as a result of their pre-existing conditions.
And what we also know is that accessing the market and health insurance plans through private insurance is getting easier.
But the last thing I will say is that for farmers also an important source of health insurance is their own off-farm work or the off-farm work of their partners.
Why is it important to seek out rural health care?
Pequot: There are many reasons. First, farming is one of the most dangerous occupations. So it’s no wonder that health insurance is so important to farmers.
And when we’ve asked them in the past, more than three-quarters of farmers said it’s an important risk management strategy.
What we also know is that there are direct links between the ability to offer health insurance, health care, and agricultural businesses.
We already have some evidence that higher healthcare expenses and higher health insurance can lead to bankruptcy and can lead to an early exit from the farm.
And so we also know that the cost of health insurance and health care has direct effects on the day-to-day decisions of a farm business.
This is related to the type of agricultural investments that I can make on the farm or that I make on the farm, including around the level of income – which has direct implications not only for the development of the agricultural business, the vitality of the farm, but also in the long term on potential retirement savings.
So, time and time again, health insurance is really an issue that affects not only farmers’ daily ability to see a doctor, but also the development of their farming business.
What has some research shown?
Pequot: So, what we know from research on farmers, is that on average and even before the 2010 health insurance reform, farmers were insured at a higher rate than the general population.
What we do know, from our research and from the USDA, is that we’re looking at the lower 90s, 92%.
However, what we also know from our research is that having health insurance does not mean that the coverage is sufficient nor does it mean that people feel well protected should they need it.
We found that a large percentage of farmers were what we call “uninsured.” And with that, we looked at what people said if they felt confident they could pay for major health care expenses, and to pay for expenses in the event of a major health emergency, half of the farmers told us they didn’t. We are confident they can pay – and that’s despite the coverage.
And what we found was that the biggest difference was related to coverage quality. So, the level of out-of-pocket expenses, the level of how their plan covers it.
How can farmers sign up for healthcare, is there a deadline?
Pippidis: Therefore, some of them get health insurance because their spouse works for an employer who provides insurance through that workplace. And so to answer your question when to register? Well, that will be paid for by your employer and that enrollment period.
Then there’s Medicare, right? So, there may be farmers who are older, 65 or older and have access to Medicare. So the enrollment period is the seven months around the month of their birthday.
Thus, for example, if my birthday is in March, I have three months before my 65th birthday and three months after that to enroll in Medicare.
And then at the end of the year, there’s the Medicare open enrollment period where people can select or change the Medicare plan that they’re on or the supplement that they might choose.
There is a program in every state called SHIP for short. They are trained volunteers who can sit with you and help you understand Medicare better.
Also Medicare Advantage plans as well as Supplemental Health Insurance Plan options available in your community.
For the market for people under the age of 65, who want access to market plans offered either by their state or by the federal market. This registration period is from November 1st to January 15th.
There are also programs like Medicaid and CHIP. So, Medicaid is for really low-income families. And CHIP is coverage for children in low-income families. Indeed, this registration period is any time.
And having said all that, if you have an insurance plan and something changes, maybe you lose your job or get married or have a baby or there is some type of life event – that opens the window to change your plan.
What advice would you give people?
Pippidis: I really encourage people to look at last year or what you should have done, because there are a lot of people who don’t go because of the cost. But you should have gone. So, do the math and compare that with your plans.
And there are some really great resources on the University of Maryland Extension’s Health Insurance Literacy page that can help you work out these numbers.
We have a really great post called Estimating Your Healthcare Costs, and it’ll give you a kind of comparison shop. Make two plans. Let’s crunch the numbers, and see which one works. This will help you choose the right plan.
What are some resources to help people with healthcare?
Pippidis: Healthcare.gov He did a really great job of helping people understand healthcare and health insurance and also kind of how to connect with the market.
Why is it important to continue this kind of conversation within the farming community?
Pequot: I think there are several reasons. First, navigating the health insurance landscape is difficult and confusing. We have spoken to several farmers who have explained their frustration with not even understanding how it works.
And so it’s important that the conversation continues about what can be done to make it easier for people to take out health insurance.
The other thing also is that what we’ve found through our research is really the connections between health insurance and agribusiness.
We’ve spoken to countless farmers who’ve told us the thing that would make a huge difference is if I didn’t have to spend $20,000 on health insurance a year.
And so I think health insurance is one of those things that, as individuals, there’s not much we can do. But talking with farming organisations, commodity groups — really talking about the kind of solutions that can be deployed, but also reaching out and talking to policy makers about what’s going to make it easier to have a vibrant and resilient farming business.