Ohio farmers often struggle with high levels of stress, poor mental health, and barriers to affordable health care.
The Ohio Farm Bureau wants to help bridge this gap by becoming the latest state to let the bureau offer health coverage sold directly to farmers and family's in their network.
Senate Bill 100 would let them do so, by letting the bureau directly sell coverage, outside of state health insurance regulations. It unanimously passed the Ohio Senate and is now in the House.
The bill, however, has been opposed by many health care interest groups, from American Diabetes Association to the American Lung Association and more.
They told the Ohio General Assembly that they oppose the bill because — without state insurance regulations — it could leave patients with thin coverage and without the same protections for pre-existing conditions.
Similar bills are under consideration in Missouri and Alabama and already approved in other states.
High needs, thin coverage
Farmers and their families have a need for better, affordable health coverage.
The Ohio Farm Bureau’s recent Farm Stress Survey found that 44% reported they would have benefitted from help coping with their daily stress.
And with many farmers lacking health coverage, mental health care often is left to the wayside. That’s part of the driving force for the bureau’s support for Senate Bill 100, which would also provide mental health care.
"What an opportunity it would be to open this up," said Whittney Bowers, Ohio Farm Bureau director of state policy and grassroots engagement. "To just say, 'You don't have to worry about this part, we have you covered. This is gonna take care of you. You can make your choices based on the needs of your farm and your family.'"
This would be a more stable form of health coverage for farmers who already live with a lot of uncertainty in their work, Bowers said.
"Once you're in, you're in and you're not reapplying every year, you're not re-evaluated every year, you don't have to pick a new level every year ,you can change at any time," she said. "There's no enrollment window. So you can kind of come in as you need and you're not forced to re- evaluate everything every single year. So it provides more stability for an industry that is not the most stable."
As part of a farm family herself, Bowers says she has seen how some have to choose between the growth of their business or health insurance.
“When I was working part time — when our children were little and my husband was full time off the farm — if he would have had the opportunity to come back full time on the farm, we would have to choose between full time on the farm, health care or child care," she said.
And the ebb and flow of farming can cause even more obstacles when turning to the marketplace. Bowers said farmers often pick plans based on the year they had, leaving them with more uncertainty.
"Do I sell this corn when it is this high of a price and risk jumping out of my income bracket because last year was a bad year or last year as an average year? And this year's a great year, but this year is a CAUV reevaluation, so we need that extra income?" she said. "So it's just like, you're punished almost for trying to have the best yield that you can."
Outside state regulations
But many health care trade groups said this kind of coverage could hurt, not help, because it wouldn't be under the same kind of regulations as health insurance that's now available.
"Plan administrators can reject people or charge them more due to their health status and treatment for pre-existing conditions, like diabetes, and these people may not be covered for up to six months," testified Gary Dougherty, with the American Diabetes Association. "ADA has concerns for those individuals with diabetes who are in need of robust, comprehensive coverage."
Bowers noted Tennessee Farm Bureau has had a similar offering since 1947.
"We are voluntarily complying with a lot of the standards. I haven't come across one yet that won't voluntarily comply with the ACA marketplace structure," she said.
While this bill would exempt Farm Bureau members from the oversight of the state Department of Insurance, the bureau's health plans must still abide by consumer protections enforced by the Ohio Attorney General’s Office.
"We're making sure that we have everything covered and with the reinsurance aspect, we're under the review of Department of Insurance to make sure that we have the financial structure," she said.
