In all the post-election analysis, farmers might have missed one election consequence. The controversial and widely misunderstood health care reforms will now more than likely come to fruition.
The mandate has been upheld, the Senate is still Democratic, and the Wall Street Journal has thrown in the editorial towel. What awaits us? Brace yourself: In the next year or so, self-employed people like us will be able to buy health insurance just like General Motors. Instead of being "groupless" refugees, we will have the capability to buy whatever coverage we can pay for, even with an asthmatic child or a spouse with high cholesterol.
"A change in the insurance
market could bring many
weary women back home to
farm with their husbands,
enjoying the same perks."
Wait, there is more. The insidious practice of rescission—cancelling a policy because inspection of your original application revealed an error, however slight—will end. Policies and costs will be easily comparable online, just like auto insurance. No lifetime limits, and all will qualify for coverage, regardless of pre-existing conditions.
Since most farm operations already have insurance, full access to the health insurance market might not seem like a gain. It won’t until you lose your coverage or hit a limit during a major illness. Jan and I dealt with this when our insurance company was bought and informed us we had to reapply.
With diagnostic technology identifying more health risks than ever, getting an individual policy can be difficult after 40. Something as unremarkable as migraines might be disqualifying.
Once you are marked with the "Scarlet U" for uninsurable, forget it. One of the first questions on an application is "Have you ever been turned down for health insurance?" One strike and you’re out.
We got coverage, thanks to extraordinary effort by our agent; however, you never forget the fear and anger at a system so discriminatory even to those who can pay.
Farmers have worked around this problem. Curiously, it is often expected that the wife is somehow responsible for family healthcare coverage. Rural jobs with benefits, such as teaching, nursing and local government, are prized. But having to live within bearable commuting distance can complicate farm planning.
Another approach is seen in the part-timer who commits to a grueling schedule in order to farm and keep group insurance. Even if expansion opportunities arise, inability to get coverage prevents some from committing to full-time farming. Working for benefits is most noticeable in older families, especially now that farm profits are higher than ever. Even after the salary becomes unimportant, one spouse continues to work until Medicare kicks in.
Bringing It All Back Home. January 2014 brings change. Despite many features that have aroused anger, few consider universal access objectionable. Cost will be determined by community rating—where you live, family size, tobacco use and age—not by gender or history. Policy costs will be the same, whether for an individual or a group.
Guessing from comments, such a change in the insurance market could bring many weary women back home to farm with their husbands, enjoying the same perks—control of their time, no commute and a unified lifestyle. The same goes for part-timers. Younger families will have less hassle during child-rearing years. Older couples will enjoy identical schedules—"We’re rained out, let’s drive up to see the grandkids!"
Economists have urged separating access to the health insurance market from employment since its inadvertent linkage during World War II. It will increase labor mobility and make wages better reflect the value of the work. Full disclosure of insurance costs will also help consumers make better choices. Self-employment will undoubtedly become more attractive.
Just as the commodity boom brought sons and daughters back home, health insurance reform could let Mom join them.
John Phipps is a farmer from Chrisman, Ill. He is the TV host of "U.S. Farm Report." Contact him at firstname.lastname@example.org. For local station listings, log on to www.USFarmReport.com.
- December 2012