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Co-op Is New Health Option

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

"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

"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,

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
  • New Medicare tax for high earners: $240,000 for couples
    who file jointly; a 3.8% Medicare tax on unearned income.

What's yet to come in 2014? To learn more, visit

  • Guaranteed issue (no preexisting condition denials).
  • Individual mandate. Everyone will be required to have
    health insurance or to pay a tax penalty. Private insurance, employer-provided,
    Medicare, Medicaid, CHIP, Veterans Affairs, or Tricare all qualify. Premium
    subsidies are available if you meet the criteria.
  • Employers with more than 50 employees will be required to
    provide them coverage.
  • Medicaid expansion.

Photography: ©Deryacelik & © Loredana ,

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