Heartland Regional Medical Center

The emergency room at Heartland Regional Medical Center in Marion, Ill., in Williamson County.

For Illinois farmers, affordable health care coverage is as elusive as ever.

A two-year push by Illinois Farm Bureau to offer the association’s members a group plan fell victim to red tape and the inability to land an underwriter.

“We have made health care coverage a major priority,” said IFB Vice President Brian Duncan, who spearheaded the effort. “We worked at it for two years. At the end of the day, the regulations from the Department of Labor were just too hard.”

The Illinois Farm Bureau membership is a microcosm of the dearth of health-insurance options for the nation’s farmers.

The association recently surveyed 55,000 members of the 389,000-strong group to determine if there is enough interest to put together an association plan.

“We’ve taken this a step at a time. (We) wanted to survey members to show providers what the potential is,” said Chris Magnuson, IFB’s executive director of operations, who directed the survey.

It was aimed largely at the group’s farmer members, estimated at about 75,000.

“We’re thinking they are more likely to be self-employed,” Magnuson said. “The task force is looking at various ways to help our members. This is one of the top concerns they have addressed.”

During the 2018 legislative session, the Iowa legislature passed a law signed by Governor Kim Reynolds which enabled the Iowa Farm Bureau Federation to provide an underwritten health benefit plan to its members.

“When we talk to members, it’s one of their biggest issues,” said Duncan, who farms near Polo, Illinois. “We spent a lot of time trying to craft a solution. But when you can’t get a carrier, you can’t get a carrier.”

The initiative has been an educational experience for IFB executives.

“That’s one of the things we’ve learned — how regulated and how complicated the health care industry is,” Duncan said.

One issue for association-led health care plans is that recipients must have employees in order to be eligible, which in a way defeats the purpose. Federal rules require that farmers or others involved in such plans have at least two full-time employees, including the farmer.

“The rules have gotten complex,” Magnuson said. “The Department of Labor had issued a ruling about how self-employed farmers could be considered both employee and employer. A judge overturned that ruling, which is now being appealed.”

The Trump administration submitted a change in those rules that would have allowed sole proprietors to participate, but that was blocked by a judge.

The Affordable Care Act is one option for farmers. Magnuson noted that subsidies are available, and may be more generous than many farmers realize.

“One of the things we are trying to do is make our membership aware of what is available,” he said. “Affordable Care Act options do offer subsidies if your income is at certain level. If you’re a family of three and have an income of $100,000, you can still qualify for a subsidy.”

Subsidies may be even bigger for many farmers who are suffering from the struggling agricultural economy.

One option many farmers have embraced is coverage through an off-farm job.

“Most employee plans have provision for spousal coverage,” Duncan said.

Magnuson said that may be the principal reason for farm family members to get jobs off the farm.

“We didn’t ask about it in our survey, but anecdotally, some farmers certainly have spouses who work,” Magnuson said. “In some cases, that’s the reason the spouse works — to have access to health insurance.”

Many farmers depend on faith-based health care cost-sharing associations, such as Medishare and Liberty. Gravie is a secular company that also offers health care plans to individuals. Duncan said his family is covered by Liberty.

“I’ve talked to a lot of farmers who are doing that, as well,” he said.

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Nat Williams is Southern Illinois field editor, writing for Illinois Farmer Today, Iowa Farmer Today and Missouri Farmer Today.