Farming is a profession rife with the risk of bodily harm. Unfortunately, many farmers lack the sufficient health insurance to protect themselves and their family in the event of a medical crisis. In a world where tractors, animals, and exposure to the elements compound the potential health challenges any of us face, this means that many farmers are one injury away from financial collapse.
The adoption of the Affordable Care Act has opened up new possibilities for farmers to access insurance, but despite the national mandate, many farmers remain uninsured or underinsured.
Researchers at the University of Vermont are hoping to help. The Health Insurance, Rural Economic Development and Agriculture (HIREDnAg) project, a USDA-funded collaboration between UVM and the Walsh Center for Rural Health Policy at the University of Chicago, aims to understand how health insurance influences farm family decision making, quality of life, and economic development.
“When we surveyed farmers, 65% of them identified the cost of health insurance as a serious problem for their business—above the cost of inputs and other potential economic threats,” says Shoshanah Inwood, Assistant Professor in the UVM Department of Community Development and Applied Economics. “Like any small business, farmers are making health insurance decisions for their family and their employees. We’re hoping to provide them with tools to navigate those decisions.”
The HIREDnAg project is tackling the issue from multiple perspectives: interviewing farmers and ranchers to understand their needs, talking to extension and tax experts to take advantage of their unique access to farmers, analyzing the impact of state and national policies, and developing educational tools to aid service providers as they help farm families make smart health insurance decisions.
Inwood and her collaborators recently convened a Summit on Health, Agriculture and Rural Economic Development in Vermont, the first event nationwide to bring together the health and agricultural sectors. Participants at the one-day event represented a wide range of stakeholders: state and health service agencies, farming and agriculture organizations, University of Vermont researchers and Extension professionals, and financial institutions.
The stated goal for the day was to discuss how to improve health insurance information and enrollment processes for Vermont farm families, with the goal of identifying concrete next steps for meeting the unique health insurance needs of farmers and their families.
Participants at the Summit discussed the complicating factors that can affect farmer access to health insurance at different life stages. Young families often need childcare at the same time that they are growing their businesses and reinvesting in the farm—yet many rural areas lack affordable childcare options.
Because eligibility depends on the previous year’s tax filings, fluctuating farm incomes can mean that families may be eligible for federal subsidies one year, but lose them the next year—despite being in the middle of another bad year.
To mitigate these challenges, many families utilize off-farm jobs to gain access to benefits. But even this can pose challenging, if the off-farm partner is needed on the farm, but cannot leave their job because their family would lose health insurance benefits.
With the average age of farmers nationwide 58 years old, a growing population of elderly farmers are approaching retirement. However, many of them have been paying low taxes for their entire careers, and won’t receive much from their social security benefits.
When farmers do decide to go out and purchase their own insurance, they enter the complicated health insurance world, which often struggles to understand their complex income streams and unique business situations. The average time it takes for a farmer to enroll is twice that of the general population.
“Navigating the marketplace can be a very confusing and frustrating process,” says Alana Knudson, Co-Director of the Walsh Center for Rural Health Policy located at NORC at the University of Chicago. “We’re hoping to streamline that process by making sure tax and health insurance professionals have the tools they need to accurately assess farmer eligibility.”
Knudson says she and others outside Vermont see the state as an opportune place to innovate and test some of the solutions the HIREDnAg researchers are developing, because of its history of leadership in healthcare policy.
“We’ve been watching Vermont for years. Even 20 years ago, we were looking at what Vermont was doing. You’ve helped shape health policy that has gone forward to the national level.”