Missouri Farm Bureau launches new health plans, raising concerns about coverage limits

The Missouri Farm Bureau is partnering with UnitedHealthcare to offer new health coverage plans that could save farmers between 30 and 50 percent compared to other insurance options. Consumers may choose from four plans, with optional dental and vision coverage.

The plans are the result of legislation passed in July after four years of debate. Missouri Farm Bureau President Garett Hawkins said the organization felt compelled to pursue its own coverage options because many self-employed farmers have gone uninsured or faced expensive plans that offer limited benefits.

"It is heartbreaking to hear the individual stories of our members and to think that they are one major medical emergency away from losing the farm," Hawkins said. "That's why we pursued this effort. Our members were relentless in having these conversations."

The launch comes as enhanced Affordable Care Act subsidies are set to expire this year, which could increase premiums for many individual-market customers.

Hawkins said one of the goals of the program is to make health insurance more accessible for young farmers, who often leave or hesitate to join family operations because of insurance costs.

Bryant Kagee, a fourth-generation farmer in northwest Missouri, returned to his family farm after eight years in corporate work. His farm now pays about $3,000 a month for a small-group plan through a private insurer. He said the Farm Bureau's plans may offer a more affordable alternative.

"Ours is a fairly sizable farming operation, and sometimes our income looks better than it feels," Kagee said. "The biggest hang-up with health insurance is that there are a lot of government mandates on what needs to be included, and we didn't qualify for the ACA subsidies."

Missouri joins a handful of states that offer health coverage through their Farm Bureaus, including Tennessee, which has run a similar program for about 75 years. A key difference between Farm Bureau plans and ACA marketplace plans is that Farm Bureau policies are medically underwritten. That means the organization can review an applicant's full medical history and decide whether to accept or deny coverage. ACA-compliant plans must accept all applicants regardless of pre-existing conditions and cannot charge higher premiums based on health status.

Sarah Lueck, vice president at the Center on Budget and Policy Priorities, said that while Farm Bureau plans may cost less, they lack many consumer protections.

"People may be required to submit medical records, especially if they're over 40 or enrolling a new baby," Lueck said. "That's an old-school way of doing things. In the regular individual market, you don't wait for benefits to start, you don't have conditions excluded, and you don't have to answer invasive medical questions because that information can't be used against you."

Lueck said Farm Bureau plans represent "going back in time to when consumers had far fewer protections," adding that "there are a lot more opportunities for things to go wrong."

Hawkins said the organization expects approval rates similar to Tennessee's, where about 90 percent of applicants qualify. He said Missouri's plans will not exclude all applicants with medical conditions.

"Bottom line, there are people accepted onto the plan who have pre-existing health conditions," Hawkins said. "There may be a six-month or one-year waiting period before coverage begins for certain conditions, but we are taking all sorts of members. It is not accurate to say we cherry-pick."

Enrollment opens Jan. 1 and will be available year-round to Farm Bureau members.