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Affordable Care Act’s Impact On Hoosier Farmers Uncertain

Paul Nord pets one of the horses he keeps on his farm.

Paul Nord walks through rows of kale on his farm in rural Orange County.

“As all of the times that I’ve ever injured myself, I was rushing,” Nord says, recalling a day two summers ago when a normally routine task went terribly wrong.

He was preparing to attach a 600-pound mower called a bush hog to his tractor.

“Although I normally keep an eye on where my toes are and don’t trust implements, had it under the bush hog, and it dropped and came right down across my big toe and my next toe,” he says. “It pretty well crushed the big toe and took the tip of the next toe off, and as a person without health insurance my first thought was, ‘great, I’m bankrupt!’ My second thought was, well, maybe I should take this little bit of toe with me.”

Nord ended up owing about $60,000 in medical bills. He was not sure how he was going to pay. He does not own the land he farms. He had carried catastrophic coverage in the past, but he had dropped it in the hopes of qualifying for the more comprehensive Healthy Indiana Plan, a state-run program providing medical insurance to certain low-income individuals and families.

Healthcare Overhaul Could Change Farmers’ Insurance

Nord’s story is similar to that of many Americans who do not receive health insurance through their jobs try to fashion medical coverage out of a patchwork of sometimes-inadequate options. The stakes are especially high for one group – farmers, whose work exposes them to a range of potential dangers.

Their situation might improve as the Affordable Care Act takes effect, but how much depends in part on the State of Indiana, which is still deciding how to implement the new health care laws within its borders.

“It just made sense to all be covered, especially farming, because it’s pretty dangerous what we do,” says Sean Breeden-Ost, who grows basil and oregano at his farm on the top of a hill in rural Monroe County.

Hickory smoke wafts from his chimney as he explains that he and his wife have been insured through Healthy Indiana for about eight years. They pay a fee that’s scaled to their income. It is coverage they would not be able to afford otherwise.

“Farming is not very lucrative,” he says. “It’s sort of a way of life rather than a way of making money. So, we choose to live this way because we want to.”

Breeden-Ost says he has been lucky so far. He has never had to use his insurance to cover a major health crisis, and while Nord was unfortunate to have lost his toe, in the end his finances survived the ordeal more or less intact.

The hospitals that treated him allowed him to apply for aid and eventually write off nearly his entire bill.

“Just the way of the insurance companies, I actually think in the end I was probably better off not having insurance – that fighting with an insurance company over having really poor insurance probably would have been worse for me in the end,” he says.

Insurance Options

Purdue professor and farm safety expert Bill Field says farmers without insurance cannot count on such an outcome. For one thing, some health crises cost far more than Nord’s.  A spinal cord injury might run into the millions, and uninsured farmers who do own property risk losing it.

“I know that there have been cases of severe injuries where the farm has been sold, because the financial pressure was so insurmountable,” Field says.

That can leave growers in a tough situation. Many buy coverage through groups like Farmers Union or the Farm Bureau, but the rates can be really high. Field says he knows of one family with a $16,000 per year deductible.

The Affordable Care Act has an entire section devoted to improving health care policies for rural Americans. But the state of Indiana is still working out how it will implement the new law. Family Social Services Administration officials declined to comment on the state’s plans, except to say the incoming administration and General Assembly will make those decisions

Still, Field says he is concerned when the new laws are in place, they will not do enough to encourage farmers to make their habits safer. He says it would be easier for farmers to get insurance in the first place if they could lower their risk.

“If you’re an insurance company, and you know that you’re four times more apt to be fatally injured in a farm accident than someone who works in general industry, do you want to jump – run right out and see that as a great audience to sell insurance to?” he says.

Back in Orange County, Paul Nord says he is looking forward to the Affordable Care Act taking effect.

“I mean being a poor farmer I will qualify for subsidies, so I can get a better insurance coverage for the cost of bad insurance coverage,” he says.

In the meantime, Nord is still uninsured.

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