Fifteen years ago, Jamie and Kristen Walter paid just under $400 a month for health insurance, for a high-deductible policy for themselves and one baby. They added two more babies and it went up to $600. Just before the Affordable Care Act passed, it was $700.
Today, they pay $2,000 a month, for the same policy — nearly three times as much as before the ACA. If they meet their deductible in a given year, that means they’ll pay nearly $30,000 before insurance kicks in.
Not a single farmer reading this is surprised by this scenario.
“I don’t have the answer, but this isn’t sustainable,” says Walter, who farms near DeKalb, Ill., and runs Whiskey Acres Distillery with his family. “And, we have not found a better solution.”
To be sure, he’s looked. Local health clinics and hospitals wouldn’t take alternative insurances. That meant either switching insurance and driving to the Chicago suburbs for health care (“that’s not palatable”) or sticking with Blue Cross Blue Shield and paying more … and more. The Walters stuck with BCBS and their local doctors.
“In Illinois, on an individual policy, the only way to turn is Blue Cross,” he concludes.
The ACA, which expanded coverage for Americans six years ago, has largely meant increased premiums for Illinois farmers, many of whom have seen their rates jump by as much as 40% a year. And while Republicans promised to “repeal and replace” the ACA, Americans are two years into the Trump administration and a Republican Congress with little change to the ACA, minus extensions to short-term coverage. No surprise, farmers were looking for a big overhaul.
“Even when they were talking repealing and replacing, I wasn’t hearing monumental changes to insurance premiums,” Walter says. “They’d maybe go down 10% — but they went up 40% every year for a while there.”
Sharing the costs
Brian Duncan and his wife, Kelly, recently ditched their $24,000-a-year policy for a $6,000-a-year plan through Liberty Healthshare, a faith-based health-sharing group. They farm near Polo, Ill., and Duncan is vice president of the Illinois Farm Bureau. Duncan says Liberty functions like other health-sharing programs (think Samaritan Ministries, Medi-Share and Christian Healthcare Ministries), but it negotiates payments with doctors, pays the bills, and then turns bills in to the group for sharing — effectively sharing the bills among the group, instead of paying for insurance. Duncan likes that Liberty deals with doctors and negotiating, so he doesn’t have to.
Drawbacks: Health share plans aren’t for people with pre-existing conditions. They underwrite, just like old-fashioned insurance plans. But if you’re healthy and willing to accept the lower-risk standards they require? Duncan says it’s a very good option.
“At Liberty, you have to agree to a certain lifestyle. You’re a Christian, and you agree to Christian values, and if you get drunk and plow your car into a tree, they’re not going cover it. If your daughter gets pregnant out of wedlock, they’re not going to cover it,” he explains.
Walter looks at high medical costs as the real problem — and discounted rates for insurers. When one of his children recently visited the doctor and had a throat culture, the bill came to $500-plus. The discounted rate? $165.
“This is crazy,” he says. “You have to have negotiated rates, or you’re bankrupt before you get there.”
Walter and his family are served by the Kishwaukee Community Hospital in DeKalb, a regional hospital that was recently bought out by nonprofit Northwestern Healthcare System. He’s observed that for a nonprofit, Northwestern “charges incredible rates and pays some of the highest salaries in the county — and builds new buildings.”
When Duncan convened Illinois Farm Bureau’s health care working group last spring, he and many of the members had big ideas about what they could do to fix health care options for farmers. Namely, they wanted what Jamie Walter would like: a catastrophic insurance policy, with a $10,000 to 12,000 deductible. They quickly learned, however, that’s not allowed under the ACA and is unlikely to be granted special permit in Illinois.
Currently, Tennessee Farm Bureau is able to offer a big discount because it was grandfathered into the ACA, and Iowa Farm Bureau is able to do the same because Iowa legislators wrote in a special permit for it to do so. Nebraska Farm Bureau offers its members a discount on an ACA-compliant plan, through an insurer in Minnesota.
And while the Illinois Farm Bureau is working on various options, through this working group, Duncan says his best advice today is to work the current system.
“Work the ACA. If you’re young and healthy, look at a health share plan. Find a Country agent to help you navigate the ACA options,” he says.
Back in DeKalb, Walter is becoming resolved to the idea that the government lacks the political will to fix health care — and that if enough people come to believe health care is a right, the U.S. is headed for a single-payer system and, effectively, socialized medicine.
Either way, he’s pretty sure he’ll still be paying for it — either in premiums or taxes.
“If you receive more than you’re paying in, it’s not sustainable for sure,” Walter concludes.
FBN launches health care options
Farmers Business Network this week announced it has teamed up with Lifestyle Health Plans to offer group coverage for its farmer-members, with options for vision and dental. The idea is to reduce overhead by forming a group and taking advantage of economies of scale, and FBN claims to save 5% to 15% from traditional plans. Its plans are available to FBN members with at least two full-time employees.
FBN is offering four plans: HealthyChoice, Healthy100, HealthyValue and Healthy Consumer. Deductible options range from $1,500 to $6,850. Family rates vary from $876 to $1,110 a month.
FBN Health is available in Illinois and 10 other states: Arkansas, Indiana, Iowa, Kansas, Missouri, Nebraska, North Dakota, Ohio, Oklahoma and South Dakota.