As crops come in, farmers turn eye toward health insurance

Sept. 14--With fall fast approaching, it is time for farmers across the region to concern themselves with something important: health insurance.

Since 2013, the average annual premium through the federal exchange has risen 105 percent for the 39 states utilizing the federal exchange under the Affordable Care Act, according to the U.S. Department of Health and Human Services. That includes states such as Iowa, which has seen a 110 percent increase from 2013 to 2017, Wisconsin (93 percent) and Illinois (120 percent).

Those increases, said Nick Gerhart, chief administrative officer of Farm Bureau Financial Services in West Des Moines, Iowa, are likely to keep climbing.

"Right now we're getting ready. It's two months to open enrollment," Gerhart said. "When people look at the rates, they'll be very shocked and disheartened."

With enrollment dates less than two months away -- ACA enrollment begins Nov. 1 -- Sen. Al Franken, D-Minn., said, "There are things we can do to make the exchanges more competitive."

He added that the Minnesota Legislature's work to make the MnSure exchange more competitive should help Minnesotans.

"The state Legislature has done some good things on that," he said. "I hope the federal government grants their waiver."

For individuals or families with access to employer-based health insurance, he said, none of this matters. Those plans, while generally increasing, are not part of the federal exchange under which Iowans live, nor the state exchanges for states, like Minnesota, that run their own individual health insurance markets.

But for anyone who owns a small business -- and most in agriculture fit that description -- the individual health insurance marketplace has become a financial burden. "We've heard stories from farm families where a spouse is getting a job just for health benefits.

About 7 percent of Iowans, he said, are purchasing insurance through the federal exchange. That amounts to roughly 77,000 people that will again be facing increases for 2018. For example, two 55-year-old individuals in Iowa City with no tax-credit assistance would be paying premiums plus deductibles of around $45,000. A family of four with two parents at age 28 and two young children would pay $27,000 annually in premium plus deductible.

With prices going that high, Gerhart said, the current 5 percent of uninsured Iowans will likely increase. "I think that number goes up," he said.

Mike Orbeck, president of the Sterns County Minnesota Farmers Union, said a switch to MinnesotaCare in 2017 saved him money. His plan, which costs $71 a month for just himself has no deductibles and modest copays. "I've never had better health insurance than I have right now," he said.

Orbeck said he hit the sweet spot with his income, making enough that he was not put on Medical Assistance but not making little enough from his dairy and crop operation to qualify for a $400 monthly subsidy.

Not everyone in Minnesota is so lucky. At a Minnesota Farmers Union meeting in Oronoco in March, farmer Mike Frost said the premium on the plan he could get through Minnesota's health insurance exchange for his family of three rose 73 percent from 2016 to 2017. His monthly premium for a high-deductible plan is $2,143.

Orbeck said he would have been in the same boat without a subsidy and a new plan. His Blue Cross Blue Shield plan in 2016 was $444 a month for just himself with a $6,700 deductible. For 2017, that same plan would have climbed to $560 monthly and a $6,800 deductible. "If I ended up in the hospital, everything I made in the year would be gone," he said.

The answer in Minnesota, according to Orbeck, is to expand MinnesotaCare.

"I have a friend who was on Minnesota Care," he said. "Last year, he was in the hospital for six days total. The bill was around $140,000. His portion was $1,400."

Eric Walker, who grows corn on 1,500 acres near Zumbro Falls, said his family is fortunate to have health insurance through his wife's employer. But he said farm families that do not have someone working off the farm for insurance are not as fortunate.

"I've got a lot of friends who have problems," he said. "One of my friends who has a dairy farm, by the time you take a family plan, the $20,000 premium puts their family in the negative."

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