An ObamaCare repeal will leave American farmers without options

Ask a farmer what her primary concerns are, and you’ll almost certainly get “healthcare costs” among the answers. As their health insurance premiums rise and the marketplace becomes more unstable, farmers need Congress to make fixes to the current system. 

What they don’t understand is how some in Congress have chosen to support policies that would pull their healthcare out from under them. So when lawmakers head home for their July 4 recess, they are sure to hear from family farmers and ranchers about the healthcare debacle happening on Capitol Hill.

{mosads}Before the Affordable Care Act (ACA) was passed in 2010, farmers were just as concerned about the state of healthcare as they are today. Many were looking for full time, off-farm jobs just to access health insurance. And as time went on, single-family policies, which farmers almost always had to buy, became increasingly unaffordable. In fact, health coverage became so unaffordable that more and more farmers were left with no choice but to go without it.

The ACA changed that — and while the system has not been without its problems — the legislation helped more than 13 million Americans gain coverage through Medicaid, the health insurance marketplace, non-marketplace individual plans and other sources.

The Medicaid expansion has proven especially beneficial to rural communities, where the rate of enrollment is higher than in urban America, and the ACA’s system of tax credits and premium subsidies helps young farmers access insurance while enabling established farmers to maintain consistent coverage.

Recognizing these benefits, and at the same time, the need for improvements to the system, Congress should be focused on making meaningful changes to the ACA, not throwing the whole thing out. But the proposed “repeal and replace” bills in the House and Senate, the American Health Care Act and the Better Care Reconciliation Act, would only make matters worse.

For months, we’ve watched as congressional leadership negotiates these bills behind closed doors. And apart from the underhandedness of this opaque governing process, they have repeatedly come up with legislation that will worsen access to healthcare and affordable health insurance premiums for millions of Americans. 

The impacts on farming and rural communities would be disproportionately harmful.

Both the House and Senate bills propose enormous cuts to Medicaid that would have devastating impacts on rural communities, where rural hospitals rely heavily on Medicaid payments. The rural hospital closure crisis shows the strong correlation between the Medicaid program and financial success of rural hospitals. More than 80 percent of the 79 rural hospitals that have closed in the last seven years were located in states that opted not to participate in Medicaid expansion.

For many rural hospitals, the vast majority of their income comes from Medicaid payments. Remove that, and they are destined to go broke. With another 673 hospitals at risk of closure, we should be increasing — not decreasing — support for rural hospitals. 

The House and Senate proposals also include varying systems of tax credits that would have disastrous impacts on farmers and ranchers. Despite their differences, both bills allow insurance companies to charge older customers five times what they charge younger customers, and neither offers enough of a tax credit to offset premium increases of thousands of dollars. Both bills would also make healthcare unaffordable for young farm families. The Senate version dramatically reduces the tax credits and cuts premium subsidies, while the House bill’s age-based credit cuts tax credits for young customers altogether.

On top of all of this, both bills contain provisions that would have serious consequences for individuals with pre-existing conditions. Rural Americans have higher rates of obesity, diabetes, cancer and traumatic injuries. Given the dangers of a career in agriculture, and that farmers are much older on average than other Americans, many farmers would face increased premiums and higher deductibles.

Despite all of these shortcomings, the few that are running the show in Congress seem intent on scoring political points through a “repeal and replace” measure. Hopefully, they’ll use this recess to publicly discuss their healthcare proposals with farmers, ranchers and rural residents. They’ll find that these constituents cannot afford more partisan rhetoric and legislative inaction on healthcare.

When Congress returns to Washington, they need to write bi-partisan legislation that fixes the parts of the ACA that need to be fixed. The end result should be affordable, effective health insurance coverage for more Americans — not fewer.

Roger Johnson is president of the National Farmers Union (NFU), a grassroots organization that represents nearly 200,000 family farmers, ranchers, fisherman and rural communities across the United States. Johnson is a third generation farmer from Turtle Lake, North Dakota, and previously served as North Dakota Agriculture Commissioner. Follow NFU on Twitter at @NFUDC. 

The views expressed by contributors are their own and are not the views of The Hill.