Each morning, Sarah Ison greets a coop of talkative chicks at her farm in southwest Ohio’s Clermont County. They strut in excitement as she pours feed into bright red bowls.
“There's about 550 chickens in here and they'll go through a couple hundred pounds of
feed a day right now,” Ison said, amid a cacophony of chirping.
Ison loves this simple farm work. She and her husband work full time on their ranch to support their family of five. It’s flexible and rewarding, but there’s one major hurdle: affordable health insurance.
“Our plan tripled in price for what we had to pay out of pocket with no notification of what that payment was going to be,” Ison said.
Her children do not qualify for Medicaid and the cost of private health insurance accounts for nearly 20% of her ranch’s profits, leaving her with little sustainable solutions, she said.
Around 700,000 Ohioans are uninsured, according to 2023 data from the U.S. Census Bureau. Many farm families are among them, citing high premiums and a lack of employer-sponsored plans as barriers to coverage.
An Ohio law that goes into effect this month will offer an alternative health coverage option that operates outside of standard insurance regulations. SB100, introduced by Rep. Susan Manchester (R-Waynesfield), allows the Ohio Farm Bureau, a non-governmental, private nonprofit, to offer personalized health coverage plans to its members.
Fluctuation on the farm
At Ison’s ranch, the revenue from beef, pork, chicken and lamb sales is mostly steady. Still, navigating the insurance market is complex for her family.
Insurance costs can be even harder for produce growers, like corn and soybean farmers, whose profit margins are as unpredictable as the weather, said Whittney Bowers, policy director with the Ohio Farm Bureau.
“You might've had a really good year the year prior, and then you have a drought, and you have not so great a year, or you have to sell off all of your cattle,” she explained. “You have very little control over what your income is.”
That means very little control of what income bracket you fall under for health coverage. Many farm families shift in and out of eligibility for Affordable Care Act subsidies, making insurance affordable one year and seemingly impossible the next.
Trevor Kirkpatrick with the Ohio Farm Bureau said it hurts producers’ ability to farm full-time.
“We've been hearing for many years that health coverage is a huge issue,” he said. “We want farmers to keep farming. We don't want to have one spouse go ‘in town’ to get a part-time job just to get that employer benefit coverage.”
Outside-the-box coverage
The Ohio Farm Bureau believes its new health plans offer an alternative that works for agricultural producers.
The plans are medically underwritten, meaning it’s not income but health status that determines eligibility. Unlike traditional insurance, the farm bureau can deny coverage to those with higher health risks.
The bureau can only do so because it’s not technically insurance, and therefore doesn't have to follow standard marketplace rules. For that reason, some health organizations, like the American Lung Association in Ohio, mounted opposition to the law change.
“We don’t encourage anyone to rely on this,” said Kezia Ofosu Atta, director of advocacy with the ALA in Ohio.
The nonprofit was one of eight health organizations that testified against SB100. Together, they argued that these sorts of health plans lack oversight and only provide thin coverage for those with conditions like asthma, diabetes or cancer.
“It’s quite misleading and it can put a lot of families in more irreparable financial harm because they thought they could depend on these health plans, but they're actually not going to cover it,” she said.
Helping farm families
Bowers disagrees. She says these kinds of plans are working for families in 10 other states, including Tennessee which has been offering farm health benefits plans since 1947.
“They would not be highly regarded in those states as a great alternative if they weren't delivering what they're supposed to deliver,” she said.
Participants won’t be dropped if their circumstances change. Still, Bowers admits, the health coverage plans aren’t suitable for every Ohio farm family.
“You may be told this isn't the right plan for you,” she said.
But she says it could fill a gap that families like Ison’s face. Application delays and short enrollment windows have left Ison’s children without health care coverage, she said.
“I didn't have anything as a mom in my hand that said this is their health insurance,” Ison said. “It’s gonna be truly life changing even just for peace of mind.”
Governor DeWine signed the bill into law in July and the plans are expected to take effect at the start of next year. But opponents caution that farm families need to read the fine print.
