It's a time of year that ranks up there on the stress-o-meter with spring planting and fall harvest: Open enrollment for health insurance. 

"We were pushed out of the individual market with Blue Cross a few years ago," said Jamie Beyer, a grain farmer who lives near Wheaton in Traverse County in far western Minnesota. "We actually have an employee, so we can do a group plan, but that means we can go back to Blue Cross Blue Shield."

Beyer, who is also the president of the Minnesota Soybean Growers Association, said health care has grown to become a topic of great importance to Minnesota farmers – farmers everywhere, really – as they look to meet their family's needs while keeping costs in line. 

Health care goals

Across the state, both goals are difficult for farmers to meet. 

"In western Minnesota, our options are pretty limited," Beyer said. Those limits mean that for a family of five, Beyer is paying $1,578 a month in premiums for a plan with a $13,500 deductible. That's a total of more than $32,000 before full coverage kicks in.

"In Wheaton, you can buy a small house every year for $32,000," Beyer said.

And while small business entrepreneurs across the state are often in the same boat as farmers, most of those other businesses are not part of a global marketplace where their competitors don't face the same regulations and costs for their health care. 

Believe it or not, Minnesota farmers are the lucky ones, said Pam Grove, senior director of member and corporate benefits for Land O'Lakes. 

Beyond Minnesota's borders

The Twin Cities-based ag and food conglomerate jumped into the Minnesota individual market in 2018 with its Gravie cooperative insurance for member farmers. In 2019, the company expanded into Nebraska, but the state's lawsuit against the federal government over associated health plans has led to Land O'Lakes needing to pull out of the Cornhusker State.

"Because of the lawsuits pending, we have to rely on state legislation, not the federal AHP laws," Grove said. "That means Nebraska couldn't approve us for 2020."

Land O'Lakes has been working to get its health insurance cooperative into other states – and will be able to offer plans in Kansas in 2020 – by lobbying state legislatures to pass their own associated health plan laws, similar to the cooperative law that exists in Minnesota. 

Grove said losing Nebraska for 2020 is a shame because Nebraska farmers generally have a single option for health insurance, and it's incredibly expensive. 

Creating options for farmers

Minnesota, meanwhile, with its agriculture health care cooperatives such as Land O'Lakes' Gravie plans, 40 Square Cooperative and the state's MNsure health care marketplace, most farmers have at least two if not three options. 

All those options – and Minnesota's low rate of uninsured individuals – make it a hard state in which to expand. 

It makes Land O'Lakes and 40 Square something of a team as they work in states outside Minnesota to get laws changed that would allow health care cooperatives there, said Char Vrieze, executive director at 40 Square.

"We're focusing on other states where there are people in the ag industry, where they have boots on the ground working on this," Vrieze said. 

And the AHP lawsuits in several states along with what Land O'Lakes is going through show the interest from farmers is out there. 

"Those people who were in the Land O'Lakes plan in Nebraska, we felt really bad for them," Vrieze said. 

Vrieze said while Land O'Lakes can offer insurance in Minnesota to its suppliers and associated farmers, 40 Square's niche is all those people in the agriculture industry that Land O'Lakes can't cover, including people who provide service to farmers like a drain tiler, soil tester or large-animal vet. 

"The market is more open for us," Vrieze said. 

Right now, she said, the goal for 40 Square is to compete against MNsure. But with the ag economy's continued depression, more farm families qualify for federal subsidies and can get their plans subsidized through the state exchange. 

"It's great they'll receive health care, but not great for the ag economy in general," she said. 

Costs and other factors

But it's not always about cost. 

Cole Trebesch, who farms near Sleepy Eye in Brown County, said 40 Square, with its access to the Preferred One Network of health care providers, made more sense for him and his family. 

"If you stayed with Blue Cross, you're forced to go more toward the (Twin) Cities and less toward Mayo," he said. "We've got the Preferred One Network, so we can go where we need to go."

Trebesch said he talks with other farmers and hears their health care nightmares. 

"I've got a landlord," he said. "Health care was his biggest input cost. It's a major stressor and a major issue for a lot of farmers."

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