Like all others, the changes and potential challenges farmers and ranchers face as a result of the Affordable Care Act are underway.
John Reeves III, a specialist and regional broker with Aflac, spent last year touring Colorado, discussing with ag producers the approaching healthcare changes.
As he did then, he took time out of his schedule again this week to talk to The Fence Post about what he’s seen in rural America under the changes so far.
Below are portions of that conversation:
Q: Now that we’re seeing some of the changes going into effect, what good do you see taking place among your clients?
A: The one thing that is making a big difference, is that if someone has a chronic illness, it’s taken away some of the prejudice that was once out there ... what we call the “guarantee issue.”
For example, I have one client, who’s a farmer in northeast Colorado, who has diabetes, and who was previously paying about $1,600 per month, and with his family on the plan, it was close to about $2,200-$2,300 per month.
Now, with the changes that have been made, he has a policy ... which is a tremendous policy, low-deductible, etc., etc. ... that’s about $1,400 per month, with his family on it. It’s saving him six, seven, $800 per month.
That’s made a big difference, not only for him but many others.
It was something that needed to be fixed.
Q: I’m sure there’s also been some problems. What have those been?
A: The issues in rural areas have long been in place ... but they seem to have been exacerbated under the new rules.
As an example, someone else I’ve worked with — a husband and wife in Steamboat (Springs), who are ranch managers ... don’t own the ranch, but make pretty good money managing it — are on a plan that’s costing them $1,200-$1,300 per month. That same plan for someone in Denver is about $700.
This couple is being penalized for where they live. We’re seeing a lot of that all around eastern Colorado as well.
The issues of fewer medical facilities, fewer medical professionals and a lack of competition among insurance providers in rural areas has long driven up costs for rural residents, compared to urban areas, and caused issues. On top of that, what we have now, with the changes, is doctors simply saying “no” to the insurance companies. They won’t accept the amount of money insurance companies are paying ... and instead are just working with wealthier patients who can pay cash ... what we call “concierge doctors.”
We’ve seen a growing number of those. It’s been disheartening.
Q: As far as agriculture goes, those who hire migrant workers seem to still have a lot of questions surrounding health insurance for those employees. Is there any advice you have for them?
A: No. 1, get with your accountant, and No. 2, learn about and get used to using an FTE (full-time equivalent) calculator, which are all over the internet, by the way.
Pretty much if producers are running 50 FTE ... for four months, I believe ... you’re going to be required to have insurance for those workers.
Now, the changes made have said that for 2014 there won’t be a penalty, and for 2015 there won’t be a penalty. However, you’re still required to report what you’re doing. That still needs to be done ... there’s just no penalty going to be in place for a while.
Still the biggest question, is how do you calculate an FTE, and that’s a decision employers and their accountants need to make together.
Having said all of that, it could soon change.
Q: Compared to when you were going around and having discussions with farmers in advance several months ago, do farmers and ranchers seem to be grasping the changes better today? Or are they still confused ... and is it understandable for them to be confused?
A: Yeah, but they’re going to have to get their arms around it at some point. That’s just how it is.
Read everything you can on healthcare.
Aflac has pretty good information on their website ... as does the Kaiser Family Foundation site.
Keep researching and keep up with the changes.
Q: Are you still expecting a lot of things to change?
A: There are certainly going to be some changes.
There’s a lot of Democrats talking about tweaking this and tweaking that. How soon will that happen? Probably not this year ... too many political problems.
At the same time, though, the bill isn’t going away, no matter what Republicans say.
Best thing to hope for is to get it tweaked to look a little better.
I think something had to be done.
Is this the first step? Yeah.
Is it an ending point? God, I hope not. ❖