Kansas City Star
Written by Julius Karash

Health Insurance Pinch Hits Rural America

Sep. 11-- Every day, a farmer or rancher must deal with the vagaries of commodity prices, fuel costs, foreign trade talks and the rain gauge.

Then there's health care.

Even if a farmer or rancher makes a good living and has health insurance, he or she may have a tough time paying for doctor visits or hospital stays.

This situation was spelled out in a report issued last week by the Access Project, a Boston-based research affiliate of the Schneider Institute for Health Policy at Brandeis University.

The Access Project and the University of North Dakota School of Medicine's Center for Rural Health contracted with the U.S. Department of Agriculture's National Agricultural Statistics Service to survey more than 2,000 noncorporate farm and ranch operators in Iowa, Minnesota, Missouri, Montana, Nebraska, North Dakota and South Dakota.

The good news from the survey was that the vast majority of the farm and ranch families had health coverage. Only 5 percent of those surveyed said the entire household lacked coverage, while 5
percent said some member of the family lacked insurance at some point during 2006.

Nevertheless, one out of five respondents said they had taken ondebt to pay for health-care expenses.
"Farmers and ranchers have more financial resources than many other rural Americans," Bill Lottero of the Access Project said in a statement accompanying the report. "It's clear that middle-class folks with health insurance are feeling the pinch of spiraling premiums and medical costs."

The reports points a finger at high out-of-pocket health-care expenses, even for those with insurance. The surveyors noted that about one-third of respondents had purchased individual health-insurance policies, which typically offer less comprehensive coverage than group health plans. By comparison, only 8 percent of Americans as a whole arecovered by individual policies, the report said.

More than half of the respondents said they received coverage from employment off the farm or ranch, frequently through a spouse.

A July 2006 Access Project report found 36 percent of Kansas farm households with three or more members contending with medical debt.

Such findings come as no surprise to Alan Morgan, chief executive officer of the Kansas City-based National Rural Health Association, a nonprofit advocacy group.