Rural America Loves Trump; But Pre-ACA, 20% Of Farmers Carried Medical Debt - Now What?

The ACA has been a mixed bag for agriculture. While many large farms balked at the requirement to ensure their employees (experts say it cost farm employers in California about $1 per hour per employee working in the field), most small-scale farmers often opted out of insurance all together before the ACA, or sought off-farm employment in order to get coverage through an employer’s plan. A 2015 USDA blog post notes that prior to the ACA, rural families struggled to find affordable healthcare, “paying an average of nearly half of their costs out of their own pockets” and that “one in five farmers is in debt because of medical bills.”

That lack of access to affordable health insurance often dissuades beginning farmers from entering the industry altogether. Andrew Bahrenburg, national policy director for the National Young Farmers Coalition, said that, in addition to such challenges as affording farmland and paying off student debt, young farmers often cite access to affordable health insurance as one of their biggest hurdles. “We’re talking about one of the most dangerous occupations in the U.S., so health coverage often forces young farmers to make incredibly difficult decisions and trade offs, like having to work an extra off-farm job, risking debt or disaster by going without health insurance and paying a fine, or deciding to quit farming altogether,” said Bahrenburg.

He also noted that many of today’s young farmers began their businesses once the ACA had already been put in place. “The expansion in Medicaid, the ability to remain on their parents’ plans until their mid-20s, and coverage for pre-existing conditions were critical for many of these young entrepreneurs and their businesses.”

Under the ACA, health insurance plans were required to offer 10 “essential benefits,” including emergency services, hospitalization, laboratory services, and maternity and newborn care. Depression screening and mental health services were also included under the ACA—particularly relevant, as suicide rates for farmers are now higher than for any other occupational group in the United States.

EDIT

http://civileats.com/2017/05/04/how-aca-repeal-would-hurt-farmers-and-rural-communities/