Farmers struggle with health care costs
About 90 percent of the more than 2,000 farmers and ranchers who were surveyed said they had some sort of health coverage. However, many complained of high premiums, and more than one-quarter said high out-of-pocket insurance costs were creating financial problems, according to the 2007 Health Insurance Survey of Farm and Ranch Operators.
The money problems included using up savings, being forced to take off-farm employment, delaying investments in their operation, and difficulty paying rent, mortgage and other bills.
Most of the 10 percent of respondents who reported that all, or at least one family member was not insured at some point in 2006, said they didn't have coverage because it was too expensive.
"Medical costs are way out of line," one respondent said. "Insurance company costs have gone way beyond affordable when income has stayed the same."
Alana Knudsen, a co-author of the study, said the survey shows that policy solutions are needed "to ensure that farm and ranch operators and other small business owners are able to pay for health care services in their rural communities."
The study found that about 20 percent of farmers and ranchers had outstanding medical debt. One-in-six put off doctor visits because they couldn't afford medical services, they were uncomfortable about their outstanding medical debt or their work demand was too great.
"The deductibles are too high, so you don't go to doctors as often as you should go," a respondent said.
The report was based on telephone surveys earlier this year with farmers and ranchers in Iowa, Minnesota, Missouri, Montana, Nebraska, North Dakota and South Dakota. Researchers at the University of North Dakota's Center for Rural Health, Brandeis University and The Access Project analyzed the results.
The study said the seven Great Plains states account for more than one-quarter of the total U.S. agricultural market.
"For farmers and ranchers, health care expenses have the potential to affect not only their families' economic security, but the financial viability of their businesses, which in turn may impact the larger economy," the report said.
Researchers pointed out that farmers and ranchers often must purchase more expensive insurance because they don't have an employer-sponsored plan to help offset costs.
"Those who purchase insurance in the non-group market are more likely to face financial strains due to medical costs than other insured people," the study said.
About 36 percent of the farmers and operators said they purchased insurance directly, while another 10 percent had some sort of public insurance coverage such as Medicaid and Medicare. More than half of those surveyed, or 54 percent, said they were getting health coverage through off-farm employment of their own or their spouse's.
"If I did not have to pay health insurance coverage, I could devote all my time to farming and make more money, but I have to work in town to afford health insurance coverage," a respondent said.
The study said that although farmers and ranchers may have higher incomes and net worth than average U.S. households, much of their cash is tied up their operations, and that farm incomes can vary greatly from year-to-year.
While farmers and ranchers have more financial resources than many other rural Americans, "it's clear that the middle class folks with health insurance are feeling the pinch of spiraling premiums and medical costs," said Bill Lottero, a co-author of the study.
Yvette Oloff, who raises cattle and row crops at a family farm in Persia, Iowa, said she lost health coverage when she left her job after suffering from lung problems in 2001. Since then, the family has gone $24,000 in debt to the local bank to pay insurance premiums and farm expenses.
Oloff said that the "premiums are outrageous," and she doesn't seek care for her continued breathing problems because her current plan won't cover it. She said the family has no savings and must cut back, stay home more and borrow money. "Instead of affording a new pickup, we go into debt for our health insurance," she said.
