Farming isn’t a career path for the faint of heart; along with fisheries and forestry, farming is one of the most dangerous jobs in the country. Just ask Darby Weaver who suffered a broken leg in 2015 as a result of an accident involving her cow.
While Weaver was insured, limited provider options and rising premiums only reinforce the importance of affordable health insurance options for farmers.
“I did have insurance through the marketplace at the time, but it was the cheapest available because as a farmer that’s all I could afford,” Weaver says. “Because of that, I had a lot of costs in addition to my monthly premium.”
According to the US Department of Labor, in 2011 the fatal occupational injuries for agricultural workers was the highest in the US (24.4 per 100,000 workers), and the rate of non-fatal on-farm injuries is even higher. Data from the Center for Disease Control (CDC) shows that in 2014 there were over 58,000 on-farm injuries, meaning over 150 agricultural workers suffered an on-farm injury daily. The Bureau of Labor Statistics estimated the rate of work-related injuries for agricultural workers to be 5.7 per 100 workers.
Families and children of farmers are also at risk of accident and injury. According to the CDC, in 2006 nearly 23,000 youth reported an on-farm injury and over 50 percent of these injuries were to youth living on the farm. Over one quarter of farming operations in the U.S. report having youth under 20 living on them. Because the Occupational Health and Safety Administration budget bill prevents tallying data on on-farm injuries on small farms, on-farm injuries are likely under-reported.
However, as Weaver can attest, work on the farm doesn’t stop because of an on-farm accident. “I kept working, which added to my recovery time, but it was the only way I could keep up,” she says. “I was on crutches for a while, which isn’t super effective, and eventually I got a boot. But the fact I wasn’t resting means my foot was injured longer than it should have been.”
On-farm accidents aren’t the only risk farmers face. While farmers may be healthier than the average population in some ways due to their active lifestyles, farmers face higher rates of melanoma and cancers of the lip likely due to high exposure of sunlight according to research out of the National Cancer Institute.
The cost of on-farm accidents and other major health concerns farmers face are significant, and according to research out of the University of Vermont 52 percent of farmers are not confident that could pay the costs of a major illness. In fact, according to Georgia Watch medical debt is the number one reason why people file bankruptcy. New research out of the University of Vermont also indicates that almost half of farmers and ranchers are concerned that they will have to sell some or all of their farm assets to address health related costs.
One important tool in addressing these costs and ensuring farmers receive the health care they need is access to affordable health insurance options. The National Center for Farmworker Health estimated about 32 percent of farmer workers in 2012 had health insurance and only 14 percent had employer provided health insurance. The largest barrier farmers point to in obtaining health insurance is cost. Because two out of three farmers and ranchers report having a pre-existing condition, the inherent dangers of the work, and narrow farm profit margins, the cost of health insurance can be prohibitive.
When Babe and Sage farming couple Bobby Jones and Chelsea Losh began farming, they were able to obtain health insurance through the ACA marketplace, which was made affordable through a premium subsidy. However, a growing business and growing family (Chelsea and Bobby’s son was born in 2014) changed their premium subsidy eligibility.
“We had a really great plan that we loved,” Jones says. “Our plan that was $50 per month in 2014 would have cost over $400 per month without the premium subsidy. So, we’ve been without health insurance since.” Although their son is covered through PeachCare for kids, Bobby and Chelsea remain uninsured and rely on supplemental insurance options and sliding scale clinics to meet their needs. Weaver, who was insured at the time of her accident, decided last fall not to re-enroll in the marketplace for similar reasons. “The plan I was on at the time was about $100 per month,” she says. “But now the premium would be $400 for the same plan, so I decided not to enroll and hope for the best.”
Rural Georgians in particular are hit hard by a lack of affordable health insurance options. According to a 2014 PEW Research Center survey, 81 percent of agricultural workers are self-employed or work for someone who is. Rural Americans are more likely to work in industries where self-employment is common, such as farming, where the median annual wages were $21,790 in 2015 according to the Bureau of Labor Statistics. According to Georgians for a Healthy Future, 76,000 rural Georgians are caught in the health insurance coverage gap, and based on self employment rates and average wages, it isn’t unreasonable to conclude this includes a significant number of farmers. Rural hospitals are also more likely to provide a greater share of uncompensated care, according to Georgian’s for a Healthy Future, and also have lower operating margins. In Georgia alone, six hospitals have shut their doors since 2012.
Weaver faced this obstacle in her own experience. “I was working in Sylvania at the time, but the only provider covered by my insurance was in Augusta, over an hour away,” she says. Georgia is also one of 19 states that has not expanded Medicaid, where the bulk of hospital closures (75 percent) have occurred.
“Ultimately, the Georgia legislature should expand Medicaid coverage to the nearly 1.4 million Georgians without health insurance who would be covered by Medicaid expansion, over 90% of which is funded by the federal government,” Jones says. “Otherwise, we’re going to see more entrepreneurs and small business owners in Georgia go out of business and more Georgians not getting the medical care they need.” Young and beginning farmers in particular have reported that Medicaid expansion has allowed health insurance coverage for their children and more time to invest in farm operations rather than seeking off-farm work with benefits.
Farmers face high risk of on-farm injury, higher risk of certain illness, live primarily in rural areas that are disproportionately impacted by lack of Medicaid and affordable healthcare options, and have a high uninsured rate. For these reasons, it’s important to advocate for improved healthcare access and affordability for farmers while exploring innovative options to decrease this burden.
Georgia Organics is unveiling it’s new Get Covered! initiative, which explores affordable health insurance options for Georgia farmers. To learn more, visit our healthcare page.