Add health insurance costs to problems facing American farmers : Shots

It has been a difficult year for farmers. Between falling prices for cash crops like corn and soybeans, rising input costs for supplies such as fertilizers and seedsTrump tariffs and USAID dismantlingMany agricultural sectors will not be profitable this year.

Expanded subsidies that many Americans, including farmers, rely on to buy health insurance, validity period set at the end of this month.

James Davis, 55, who farms cotton, soybeans and corn in northern Louisiana, said he doesn't know how he and his wife will be able to afford insurance next year when their premiums quadruple, jumping to about $2,700 a month.

“You can't afford it. In general, there is nothing to discuss. You can’t afford that without subsidies,” Davis said.

More than a quarter of the farm workforce purchases health insurance through the individual marketplace, study finds analysis from KFF, a nonprofit health policy research organization.

This figure of 27% is much higher than the general population – only 6% of US adults have non-group coverage.

Farmers are used to dealing with challenges such as unpredictable weather and fluctuating commodity prices. But the loss of expanded subsidies, coupled with difficult economic conditions, will make coverage unaffordable for many.

Without serious intervention from Washington, farmers say they will have to choose between not having insurance or giving up farm work for jobs that offer health insurance.

Waiver of Insurance Is a Bad Game for Farmers

Farming is a dangerous job. Farm workers spend most of their time outdoors, exposed to the elements. Many of their duties can result in injury or illness: they drive and operate heavy equipment, handle toxic chemicals, and handle large animals.

Work-related deaths seven times higher for farmers than the national average.

The financial toll from non-fatal farm injuries is also significant. A study from the University of Nebraska Medical Center found that the average cost of an injury in agriculture was $10,878 for medical care and $4,735 for job loss.

It's important that farmers can purchase comprehensive insurance, he said. Florence Becot is a rural sociologist and assistant professor of agricultural health and safety at Pennsylvania State University, where she studies the social and economic needs of farm households.

IN 2022 studyBecot found that more than 20% of American farmers had medical debt exceeding $1,000, and more than half were unsure they would be able to cover the costs of a serious illness or injury.

“This shows the level of vulnerability and challenges farmers face,” she said.

Mental health is also a concern. Farmers approximately double are just as likely to die by suicide compared to the general population. Mental health hotlines serving rural communities seeing A splash in calls this year.

These concerns about farmers increased emotional stress in combination with increase in bankruptcies evokes memories of the 1980s farm crisis, according to Michael Klein industry group USA Rice. During this decade, there were many foreclosures and hundreds of farmers committed suicide.

“We're really afraid of what's going to happen,” Klein said.

Farmers may be reluctant to admit they rely on government-subsidized insurance, said Megan Palmer, 42, who runs a dairy farm in northeast Iowa with her husband, John, 45.

“We don’t collect handouts,” Palmer said.

Among dairy farmers, more than 40% do not have health insurance. one of the highest uninsured rates of any agricultural industry sectors.

However, Palmers cannot go uninsured.

The couple recalls that in their first year of marriage, they had no insurance and had to pay out of pocket for two unexpected health crises: Palmer had an appendectomy and her husband, John, needed stitches after one of the cows kicked him in the face.

“It was stupid of us,” Palmer said of the decision to withdraw from coverage.

But next year, the combined monthly cost of their plans will increase by more than 90% to $368.18. For both, their deductible in 2026 will be $7,200.

Palmer has started looking for off-farm work, although she expects that whatever she earns will mostly go toward covering additional insurance costs, leaving her with little left over. Also, her absence would put more strain on her husband, which worries her.

“John works tired most of the time,” she said. “That’s when mistakes are made and you end up in the emergency room.”

Political consequences

Even after the expanded subsidies are eliminated in 2026, the Palmers estimate their income will still be low enough that they will qualify for some tax credits to purchase coverage.

However, another change in healthcare is that repayment limits are canceledso if the Palmers have a surprisingly profitable 2026, they'll be forced to pay some, if not all, of that subsidy back at tax time.

A farmer's income can vary greatly from year to year, in part because commodity prices can fluctuate quickly, Becot said.

Some farmers may deliberately choose not to grow their business because too much profit could lead to them losing access to health care subsidies.

Farmers covered by Medicaid have similar concerns, Becot said. Prioritizing access to health care by suppressing operational growth will have long-term consequences for the success of the farm.

Palmer of Iowa and Davis of Louisiana are upset that lawmakers have not been more sensitive to the economic needs of agriculture and how they have coincided with rising health care costs.

Trump recently pledged $12 billion in one-time funding. interim payments farmers growing crops, but this will not stop rising health care costs.

Republicans recognize that health care is an issue and have put forward proposals, Donna Hoffman, a political scientist at the University of Northern Iowa, said in an email. But most do not support extending the expanded ACA subsidies because they do not believe subsidies are a good solution to rising health care costs.

This story comes from NPR's health reporting partnership with KFF health news.