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You think your health insurance costs too much. Try being a farmer.

Crains Chicago Business reports:

“John Kiefner, who farms 500 acres of hay in exurban Will County, has had health insurance from five companies in the past four years. One of them wouldn’t allow his wife and him to visit any of their own doctors. Another wouldn’t cover visits to the nearest hospital because it was out of network. All of them kept raising his premiums by 20 percent and more annually.

Kiefner will be lucky to net $75,000 on his farm this year. His last policy with Blue Cross & Blue Shield of Illinois was priced at $22,000 for annual premiums, plus a deductible of $5,000 apiece. That meant that he and his wife, Sherri, were investing $32,000, or 43 percent of their income, in health care before their insurer picked up any expenses.

Stretched too far, the Kiefners took out a deep-discount health policy earlier this year offered by Golden Rule ​ Insurance that doesn’t cover pre-existing conditions and is not compliant with the Affordable Care Act, better known as Obamacare. But at $6,000 for both of them, it was affordable.

“If my wife has a heart attack tomorrow and the insurance company finds out she had high cholesterol two years ago, I suppose they’ll argue that was a pre-existing condition and won’t cover us,” says Kiefner, 53, who lives in Manhattan, roughly 50 miles southwest of the Loop. “But we farmers need some kind of protection. For now, most farm families are holding their noses as they pay up.”

Small businesses everywhere are scrambling to acquire affordable health insurance as Congress argues over the repeal of Obamacare, a repeal that isn’t likely to reduce costs for anybody. But for many self-employed farmers, obtaining coverage is becoming nearly unbearable.​

Annual premiums for even high-deductible plans for farm families can top $40,000. Net farm income in Illinois, meantime, plunged to an average of $77,000 last year from over $105,000 in 2013, according to the Illinois Farm Business Farm Management Association and the University of Illinois at Urbana-Champaign. The reason: Farm commodity prices have tumbled, with corn dropping from more than $7 a bushel three years ago to $3.25 and less. Average living expenses in 2016 came to $82,300, with health insurance costs representing a giant slice of that.

Farming also is the most dangerous industry, based on workplace fatalities, according to the Bureau of Labor Statistics. “This is an industry that generally doesn’t want to chance the risk of having no health insurance,” says Carrie Echols, an accountant in Mendota, about 120 miles west of the Loop, who grew up on a farm and counts many farmers today as clients.

The squeeze is forcing more and more farm wives to leave home for work in local schools and government that can guarantee family coverage, and farmers to take part-time jobs to qualify for employer-based plans. In fact, a recent survey by the University of Vermont and NORC at the University of Chicago found that 72 percent of farm families have off-the-farm jobs, often to obtain health insurance. The same study, funded by the U.S. Department of Agriculture, found that 2 out of 3 farmers have pre-existing conditions.

“One of the biggest worries that farmers have concerns the volatility of their incomes,” says Alana Knudson, a project director of the survey. “One in 2 told us that they aren’t confident they could pay for a major medical procedure.”

“Health insurance clearly is becoming a financial burden for our farmers. Somehow we have got to find a fix,” agrees Adam Nielsen, national legislative director for the Illinois Farm Bureau, which officially endorses the repeal of Obamacare. He adds that farmers are just as concerned about the well-chronicled flight of medical practitioners from small towns. “We support the concept of more scholarships to attract nurses and physicians to practice in rural Illinois,” Nielsen says.

SEEING NEW DOCTORS

Joe White, a third-generation farmer in west suburban Kane County, near Elburn, has been through his own parade of insurers in recent years. His current policy with Blue Cross for him and his wife is priced at $24,000 a year, with a $7,500 deductible. He’s had to give up his out-of-network doctors and the closest hospital to travel farther for treatment.

“More of us might consider going without insurance altogether, but we’ve got too many assets to protect, and we’re afraid that one big illness could wipe us out,” White says. His plan, at age 62, is to bite the bullet three more years, when he’ll be old enough to qualify for Medicare.

Rob Sharkey, 43, who farms 2,200 acres of corn and soybeans downstate in Bradford, a town of 400 with limited employment prospects, started up a farm podcast a year ago discussing issues like weather and fertilizer with sponsors such as Farmers Edge, which sells satellite imagery, paying for commercial time. He was desperate for new income, he explains, after his annual Blue Cross premiums soared to $42,000 for coverage of him and his wife and four children.

“That is easily a third of my farm income. We’ve got farmers around here who have seen their incomes go down so drastically that they now qualify for Medicaid,” says Sharkey, referring to the federal program for low-income people. His best hope, he says, is to store corn this fall, betting that prices will rise eventually.

Steve Pitstick, a farmer for 40 years on 2,500 acres in Maple Park, 50 miles west of Chicago, remembers paying $300 a month for health insurance for his family of five two decades ago. Now he spends $850 a month for just himself, and he makes do with a $7,000 deductible.

Pitstick, 58, has made sacrifices at every turn in recent years. He hires only part-time workers who are retired and already on Medicare. “Farmers have quit buying new machinery—their health insurance budgets won’t allow it,” Pitstick says. “Some have cut back on their fertilizer to grow crops, and others are considering selling off acreage to pay their bills. And the troubling part of all this is that premiums keep increasing exponentially. This is only getting worse.”

Though no longer in a farm family, Echols is struggling to obtain insurance for herself, with premiums from Blue Cross currently running $24,000 a year for coverage of herself and three children. “That’s a third of my income,” she says. “Farmers are in the same predicament. All of us in small towns, where the economy isn’t exactly growing, are suffering right now.”

One other option for farmers is switching away from Blue Cross and other mainline carriers to so-called health care sharing organizations, which typically are set up as religion-based cooperatives of sorts. Brad Hahn, CEO of Phoenix-based Solidarity HealthShare, heads one of 200 such groups and is attracting a growing customer base in Illinois. Hahn, a 49-year-old attorney, advertises on Christian radio stations and says his own family of four is covered for $449 per month, a quarter of what he used to pay.

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