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Co-op Is New Health Option

CHERYL TEVIS 05/21/2013 @ 11:42am Cheryl has been an editor at Successful Farming since 1979.

As the Affordable Care Act (ACA) is fully implemented, key provisions are more likely to impact farmers than other Americans. "Nationally, about 36% of farmers and ranchers buy insurance as individuals," says Jon Bailey, Center for Rural Affairs, Lyons, Nebraska. "They're also self-employed small business owners and employers."

The new Health Insurance Marketplace is designed to assist Americans who are uninsured, self-employed, or do not have employer-based health insurance. Online enrollment will begin October 1, 2013, with coverage effective in January 2014.

The ACA creates state health insurance exchanges that allow individuals and small-business owners to study, compare, and buy private health plans. The American Health Benefits Exchange is aimed at individuals; the Small Business Health Options (SHOP) Exchange covers businesses with up to 100 employees.

"Many states elected to use the federal exchange, and the details are still being ironed out," Bailey says.

The Exchange will be online, but access also will be available by calling a toll-free phone number or through brokers.

One model that's emerging is a familiar fixture in rural communities: the cooperative. Montana Health Co-op is a new nonprofit, member-owned health insurance cooperative focusing on individuals and small businesses. It's one of 24 health insurance co-op plans that will be offered on the federal insurance exchange, with subsidies available for qualified individuals to offset monthly premium costs. It received a start-up loan from the Department of Health and Human Services.

CoOpportunity Health is a new co-op carrier offering individual health insurance policies in Iowa and Nebraska.

2014 final phase-in

Farmers Health Co-operative of Wisconsin (FHCW) was ahead of the health care insurance curve with the passage of a 2003 Wisconsin law allowing farmers and agribusinesses to form a health insurance program. AgriServices Agency and Anthem are the partners. Today FHCW covers 1,700 individuals.

"On average, our AgriPlan saves families about $4,000 in premiums and out-of-pocket costs per year," says FHCW executive director Tim Mahaffey.

The FHCW will be aligned with ACA.

Regardless of whether a co-op model is available in your state, Bailey says one thing is clear: "Outreach and education about the exchanges will be especially important in rural areas," he says. For more, visit cfra.org.

Here are a few of the key provisions that already are in effect under ACA.

  • Youth can stay on their parents' plans until they are 26 years old.
  • No lifetime limits in coverage.
  • Lower Medicare drug costs.
  • Expanded access to free preventive care (immunizations, Pap smears, screening colonoscopies).
  • Insurers required to spend at least 80% of premiums on medical care and quality improvements for individual and small-group policyholders.
  • New Medicare tax for high earners: $240,000 for couples who file jointly; a 3.8% Medicare tax on unearned income.

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