Richard Shuman works the dairy with his father in the afternoons and spends his days in the family's corn fields. His two young kids have chores to do around their Mainville, Penn., farm; his 8-year-old son, Steven, even knows his way around a tractor, even if he can't quite drive one yet. It's a family operation in every sense of the word.
Well, almost. "Deb liked working on the farm. She wants to be on the farm," Richard says. Instead his wife, Deb, is teaching in town so the family of four can have health insurance.
Richard sits on the Pennsylvania Farm Bureau board, so he knows about the group insurance available through that channel. His father, Duane, purchases coverage through the dairy, but the out-of-pocket premiums are outrageous—"about $1,100 a month for him and my mom," says Richard. "Do the math on that. Our operation can't sustain that kind of expense."
Mainville is located in Columbia County, Penn., one of The Progressive Farmer's top 10 Best Places to Live in Rural America this year. There are two well-equipped hospitals inside its borders, and the world-class Geisinger Medical Center is one county over.
But the ticket to access is that insurance card, and it's one expensive ticket. That got the attention of The Access Project, a nonprofit group whose research mission is to improve access to health care. One of its recent studies showed that while 90% of farmers and ranchers surveyed had health insurance, often the policies didn't offer enough coverage. One in four said health care expenses cause financial problems for the family and the operation. The study surveyed more than 2,000 farmers in the Great Plains.
About one-third in the survey buy directly from an insurance agent, which means the 90% number is a little deceptive. While farm and ranch operators are much more likely to be insured than the general rural population, many are paying much higher premiums and have higher deductibles with fewer benefits.
Carol Pryor, The Access Project's senior policy analyst, says health insurance oversight is mostly in the hands of the state, and points to Massachusetts as having some possible solutions to ease the numbers crunch on small businessmen. There, "guaranteed-issue laws" mean health coverage can't be refused based on prior medical history. Rates also can't be set based on medical history alone, though age can play a role.
State-subsidized group coverage, such as Fishing Partnership Health Plan, bases insurance costs on income and helps lower premiums for owners and operators in the state's fishing industry.
These kinds of public and private partnerships might be the light at the end of the tunnel for farmers feeling the pinch, but they're rare.
Pryor says a good first step is to pay attention to health care plans from political candidates at all levels. "As proposals come out for health reform," she says, "look for protections for the self-employed."
Meanwhile, off-farm employment looks like the best option for most, just like the Shuman family. More than half of those surveyed said that's where their coverage comes from.
It's a symptom of the rising cost of health care and coverage across the board; a symptom that feels more like a disease to those paying for it right out of the pocket or right off the farm's balance sheet.