Article Summary –
Farmers are facing significant challenges as farming becomes more dangerous and financially risky, compounded by the looming expiration of ACA-enhanced premium tax credits, which could result in a doubling of health insurance premiums. This impending increase in costs, amid already tight profit margins due to factors like tariffs and extreme weather, forces farmers to make difficult decisions, such as paying higher premiums, opting for catastrophic coverage, or going uninsured, which could have adverse effects on their health and farming operations. The expiration of these subsidies also threatens rural communities and hospitals, potentially increasing overall healthcare costs and limiting access to necessary services, while the uncertain political landscape leaves the extension of these credits unresolved.
Farming is a high-risk profession, involving physical labor and dangerous machinery. Farmers often face accidents like falling into grain bins or getting trapped by equipment. They are also exposed to chemicals, dust, and gases.
Beyond physical risks, farmers deal with mental health challenges, including high stress from financial and natural disasters. Suicide rates in farmers are two to five times higher than the national average, reports the American Farm Bureau.
Most farmers struggle with limited health care access due to high self-employment costs.
The Affordable Care Act (ACA) helped lower premiums through tax credits, making healthcare more accessible for farmers. However, these credits under the Biden administration are set to expire, potentially doubling premiums unless Congress intervenes. Farmers on ACA plans have already received notices of rising costs.
Farmers face economic challenges from tariffs, funding freezes, and extreme weather, making premium hikes unaffordable. The loss of credits impacts not just individuals but also entire rural communities.
Gary Wertish, Minnesota Farmers Union president, stated, “The margins aren’t there for farming at all.”
Many farmers now face tough choices: pay more for premiums, opt for catastrophic policies, drop insurance, or relocate.
How the Affordable Care Act Impacts Farmers
Signed in 2010 by President Obama, the ACA introduced major health care reforms, including policies for private insurance. Enhanced tax credits by the Biden administration reduced upfront insurance costs.
The Inflation Reduction Act extended these credits through 2025, but their expiration could increase premiums.
Researcher Florence Becot from Penn State University has studied farmer access to health services for a decade. Affordable healthcare remains a persistent issue for farmers.
The ACA initially divided opinions, but recent additions have lowered plan costs. Many farmers use the ACA marketplace as a last resort, aided by the credits.
According to Kaiser Family Foundation and USDA data, 27% of farmers use marketplace healthcare, nearly triple the national average. This marks a 10% increase since 2015 in private insurance reliance.
Most farmers buy their own healthcare due to lack of large employer group plans. Average annual premiums are expected to rise from $888 in 2025 to $1,904 in 2026, according to Kaiser Family Foundation.
In states with high premiums, the expiration could hike individual costs significantly. Vermont residents could see costs rise to $10,000 for individuals and $32,000 for families. “It’s pretty much going to be out of reach,” said Graham Unangst-Rufenacht, policy director at Rural Vermont.
In 2025, over 30,000 Vermont residents saved an average of $946 monthly due to these credits. Their expiration is a concern for many farmers and small-business owners.
Dairy farmers, with higher uninsured rates, could be hit hardest. A 2015 USDA study found 41% of dairy farmers lacked insurance, compared to 10.7% of all farm households.
Credit expirations force farmers to consider difficult choices and alternatives.
Difficult Choices Ahead
Farmers might absorb increased premium costs, straining already thin margins. “Farming is taxing physically, emotionally, mentally,” said Maddie Kempner, policy director at Northeast Organic Farming Association of Vermont. “Affordable health care is critical.”
The farming community anticipated credit expirations since June. Farmers may turn to high-deductible catastrophic policies, which have lower premiums but require paying care costs until meeting higher deductibles.
Farmers in high-cost states consider relocating, says Unangst-Rufenacht.
Many farmers have off-farm jobs for healthcare access. Becot found 60% of farmers work in jobs like teaching or construction, though they prefer full-time farming.
Without credits, more farmers may take up off-farm jobs for insurance.
Farmers with inadequate coverage could split pills or delay surgeries until qualifying for Medicare, affecting their lives and farming ability. Becot noted, “Long-term treatment costs could increase as conditions worsen.”
Farmers may even consider going uninsured. Gary Wertish mentioned, “It’s going to have a huge ripple effect.”
How Farm Communities Will Feel the Effects
If many leave the marketplace, rural hospital incomes will be affected. National Rural Health Association reports 190 rural hospitals have closed since 2010, and another 432 are at risk.
The Republicans’ One Big Beautiful Bill could cut Medicaid, impacting rural hospitals relying heavily on those funds.
Expiration of ACA credits will worsen rural hospital issues, said Carrie Cochran-McClain, NRHA chief policy officer. If farmers drop ACA coverage, overall costs may rise.
A rural hospital’s vulnerability increases if more patients seek urgent care due to lack of insurance, also raising treatment costs.
Without subsidy extension, rural hospitals may reconsider services and investments, raising community health care prices.
Cochran-McClain emphasized, “A real rippling effect exists. Adequate coverage for many is beneficial.”
An Unclear Path to ACA Extensions
ACA credits were central to Senate Democrats during the government shutdown. Democrats sought credit extension, but Senate Republicans prioritized reopening the government.
While Republicans promised a vote on ACA credits, passage remains uncertain. Speaker Mike Johnson (R-LA) hasn’t committed to a vote, despite concerns raised by Republicans like Rep. Marjorie Taylor Greene (R-GA).
Timely congressional action is crucial. Farmers are selecting 2026 plans, with most needing coverage by Dec. 15, although deadlines vary by state.
Democrats proposed extending credits for three years, offering potential relief, but the situation is volatile.
Cochran-McClain stated, “Family farms face numerous challenges, and health insurance shouldn’t be another struggle. The potential non-renewal’s impact could be underestimated.”
This story was originally published by Public News Service.
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