Mid-Missourians Face Limited HealthCare Options 

In addition to threats of ACA eradication, a single provider dominated market means higher rates and less access to health care providers and specialists.  

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Mid-Missouri farmers’ health care improves with the Affordable Care Act


By DJ Pointer, Rachel Thomas and Meiying Wu



In early February outside the Boone County Courthouse, fifth-generation livestock farmer Rhonda Perry stood in unison with farmers and activists at the Columbia Health Care Bus Rally event, chanting “When ACA is under attack, what do we do? Stand up fight back!”


Perry and the rest of the crowd had arrived on a charter bus that read “Save My Care” in bold letters. They made their message clear; that farmers want affordable health care. The event was coordinated by the Missouri Rural Crisis Center, a non-profit organization that caters to the needs of family farmers.


Those needs are apparent when farmers like Perry have pre-existing conditions, and could never pay the bills required for hospitalization and medication.


“For several years I did not have any insurance at all, and then I was able to get insurance through MRCC and thank God I had, because I was diagnosed with a really rare cancer,” Perry said.


She was hired at the crisis center as the program director. She remembers how lucky she was to find an off-farm job that provides quality health insurance. But she said other farmers who rely on the private marketplace for health care aren’t so fortunate.


According to a health insurance survey done in 2007 by the crisis center and the U.S. Department of Agriculture, 91 percent of Missouri farmers reported having individual insurance plans provided by private insurance companies instead of on the market. This resulted in farmers on average spending $2,117 more on health care than those insured through off-farm employment. The survey concluded that farmers’ insurance expenses affected their ability to pay rent 40 percent of the time and other bills 80 percent of the time. Most importantly, it caused them to delay farm or ranch investments 40 percent and increased the need to take off-farm jobs to help pay medical bills.


Perry is concerned for her neighborhood farm community who cannot afford private insurance plans.


“One of the things that I wonder is does everyone get the same treatment if you don’t have insurance? The amount of stress that, that creates in rural communities is pretty incredible,” Perry said.


When the Affordable Care Act was implemented in 2010, the situation for these farmers changed significantly. Now, farmers who have pre-existing conditions can no longer be charged for it. Some farmers under the health care law even qualify for a tax credit from the government that can help pay toward their monthly premium.  


Health law professor Sidney Watson of Saint Louis University works on behalf of low-income people and she teaches her classes about the regulations of the health care law.


“What the Affordable Care Act did was make it illegal to charge farmers more for their hard work, so they can’t be charged more,” Watson said.


She said if there were to be a current survey about family farmers and their health insurance, the premiums and deductibles would be much lower now with the health care law into play.


Audrain County farmer Paul Harter agrees. He said that before the health care law, he could only afford to put his wife and his daughter under their insurance, leaving him to go without coverage.


“When the ACA came in, we went ahead and got health care coverage because now it was affordable adding me on. So it's been a good thing as far as that's concerned in the beginning,” Harter said.


Since its enactment, the health care law has made it accessible for farmers to get affordable health insurance. But, some farmers are facing another hurdle. They fall into what is called the coverage gap.


The Kaiser Family Foundation defines the coverage gap as a space where adults have incomes above Medicaid eligibility limits but fall short to make enough to qualify for Marketplace premium tax credits.


According to Healthinsurance.org, Missouri is a state that has not accepted federal Medicaid expansion and in 2016, there were about 109,000 people who had no realistic access to health insurance without the expansion.


Crisis center communications director Tim Gibbons partners with other non-profit organizations to allow its members to testify at House and Senate Medicaid Expansion interim committee hearings about why Medicaid expansion is a priority for mid-Missouri farmers.


“Medicaid expansion is vital for rural people. Farmers and rural people have less access to employer sponsored health care, they have less providers, insurance is more expensive, and there is less competition within the insurance marketplace for rural people,” Gibbons said.


Gibbons said lack of competition in the marketplace has been bad for consumers and producers alike.