As Donald Trump heads to Iowa to brag about his “strong economy,” he may want to step off the stage and onto an actual farm. Because for farmers across Iowa and the country, Trump’s economic record doesn’t look like prosperity. It looks like kitchen table math that doesn’t add up, health insurance premiums spiking by hundreds of dollars, and families forced to gamble that no one gets sick or hurt.
From Iowa to Wisconsin to Louisiana, farmers say it’s not drought or markets that could put them out of business — it’s health care. That isn’t an accident. It’s the direct result of Trump and Republicans ripping away the Affordable Care Act tax credits from nearly 22 million Americans, causing premium costs to more than double. Farmers are delaying care, downgrading coverage, taking off-farm jobs just to keep insurance, or going uninsured and hoping they don’t have a farm accident or medical emergency. One illness, one injury is all it would take to lose everything.
Iowa
Seth Watkins, Pinhook Farm, Clarinda
- “‘I really want people to understand, it’s not markets or weather that will put me as a farmer out of business,’ Watkins said. ‘It’s a catastrophic health issue.’ Watkins said his family’s premiums could jump from about $600 a month to more than $2,300, with total health care costs exceeding $40,000 a year once deductibles and out-of-pocket limits are factored in. ‘That’s $25,000 a year less that I’ve got to spend,’ he said, adding he and others wouldn’t be upgrading pickups or buying other equipment as a result.” [Progressive Farmer]
- “Our politicians talk about us being the backbone of our economy, and yet the people that are making these decisions have great benefits,” Watkins said. “I’d like them to put themselves in our shoes and understand what this is like.” [Iowa Capital Dispatch]
Aaron Lehman, Lehman Farm, President, Iowa Farmers Union, Polk County
- “‘The Affordable Care Act has allowed farmers and rural entrepreneurs to take risks,’ Lehman said. ‘To start businesses, expand farms, replace equipment, and bring the next generation into the operation.’”
- “Without affordable marketplace plans, he said, many families would again need off-farm jobs solely to secure insurance.”
- “Lehman also credited the ACA with protecting families with pre-existing conditions. His wife is a breast cancer survivor. ‘Without the Affordable Care Act, she likely wouldn’t have even been offered an insurance plan,’ he said.” [Progressive Farmer]
- “‘Our farmers right now are meeting with their lenders just to figure out how to get next year’s crop in the ground,’ Lehman said. ‘The last thing we need right now is an increase in health care costs.’” [KIOW]
- “This has a direct impact on our farm. We have to make choices if we have these huge increases in health care costs. We have to make decisions about what machinery needs to be repaired. We have to make decisions about the inputs that we purchase. We have to renegotiate with our vendors, because we have a real crisis in rural America right now,” he says. “So many farmers just cannot make ends meet, if they’re facing that decision.” [Protect Our Care interview]
- “We have the decision to support making health care affordable in this country, and this impacts our farms, it impacts all of our rural communities. We have a decision to make about whether that investment in our farms and rural communities is worth it, and it is.” [Protect Our Care interview]
Meghan, 42, and John Palmer, 45, Prairie Star Farm, Allamakee County
- “But going uninsured is not an option for the Palmers. During their first year of marriage, the couple recalled being uninsured and having to pay out-of-pocket for two unexpected health crises: Palmer had an appendectomy, and her husband John needed stitches after getting kicked in the face by one of his cows. ‘It was stupid of us,’ said Palmer of the decision to forgo coverage.”
- “Palmer has started to search for an off-farm job, though she anticipates that whatever she earns will mostly pay for additional insurance costs and there will be little left over. In addition, her absence would create a greater burden for her husband, which worries her. ‘John is working exhausted most of the time,’ she said. ‘That’s when mistakes get made and you end up in the ER.’” [NPR]
Matt Russel, Coyote Run Farm, Executive Director, Iowa Farmers Union, Lacona
- “The Affordable Care Act provided a path for small businesses, entrepreneurs and farmers to pursue livelihoods that didn’t require having someone work for a job for the health insurance benefits,” Russel said. “…Remember the days when the farming family had to have an off-farm job for health insurance? Because Republicans are letting these enhanced premium tax credits expire, we are headed back in that direction.” [Iowa Capital Dispatch]
- “This is a gut punch to working families. Raising health insurance premiums by thousands — sometimes tens of thousands — of dollars doesn’t fix what’s broken in health care. It just shifts the cost onto families and small businesses.”
- “‘This isn’t just a farmer problem,’ Russell said. ‘It’s a problem for millions of Americans who don’t have employer-based insurance. But farmers are right in the middle of it — and the cost is very real.’” [Progressive Farmer]
Beth Hoffman, Whippoorwill Creek Farm, Lovilia
- “‘If we make $84,999, we get the credit,’ Hoffman said. ‘If we make $85,000, we literally fall off this cliff. A $300-a-month premium turns into owing roughly $16,000 retroactively.’ Since at least 2021, subsidies tapered down gradually as income rose. With that protection gone, Hoffman said her family chose a bare-bones bronze plan with an $8,300 deductible for each adult — insurance she described as inadequate but financially safer than upgrading. ‘We decided to stay with really pretty crappy insurance,’ she said. ‘Because if we upgrade and make a little more money, suddenly we’re talking about paying $20,000 a year.’ [Progressive Farmer]
California
Justin Miller, Twin Peaks Orchards, Placer County
- “Most of the roughly 20 employees who work on Justin Miller’s 113-year-old family fruit farm in rural Northern California purchase coverage through the Obamacare marketplace. He’s agonizing over what it could mean if health insurance through the marketplace becomes unaffordable for his employees. He fears they might consider leaving his farm for a job that comes with health coverage.”
- “‘Being a small-business owner, especially in a field like ours, where it is tough work and we really understand how hard everybody works, we have to look everybody in the eyes every day,’ Miller said. ‘Knowing that they’re going to have to pay $4,000 or $5,000 more a year to stay on their insurance is a tough pill to swallow.’” [Fortune]
Connecticut
Kaitlyn Kimball, Sunset Farm, Naugatuck
- “‘I know a lot of people who don’t grow their business to try to keep their profits down so that they can keep them and their families on [health] insurance,’ Kaitlyn said. As first-generation farmers, the Kimballs are actively trying to grow their business, which is one of the only of its kind in the Naugatuck area and employs up to 12 people during the peak season. They’re bracing for an increase in their monthly expenses next year if the premium tax credits end. The $450 monthly premium they pay now is estimated to rise to $500 per month. ‘It’s really hard to budget for that increase because it’s so substantial,’ Kaitlyn said. ‘But we also can’t go without coverage.’” [Daily Yonder]
Louisiana
James Davis, 55, Davis Farms, Tensas Parish
- “James Davis, 55, who grows cotton, soybeans and corn in north Louisiana, said he doesn’t know how he and his wife will afford coverage next year, when their insurance premium will quadruple, jumping to about $2,700 a month. ‘You can’t afford it. Bottom line, there’s nothing to discuss. You can’t afford it without the subsidies,’ Davis said.” [NPR]
Kaden and Rachel Cable, Currant Farms, Farmerville
- “‘Cable says he and his wife Rachel, they depend on those subsidies in order to afford their health insurance. Rachel has medical conditions that require expensive prescriptions.’ ‘And if my wife gets sick, she may die, and we can’t afford it. If I get sick, I can’t go to the hospital because we can’t afford it.’”
- “‘It feels like to me, they’re putting a gun against my head and just saying, you don’t really have any choice if this bullet goes in your brain or not, where. Still gonna fire, and it’s just utter and complete heartbreak. I’m shaking now thinking about it, it’s it’s really hard.’” [WWNO]
Maine
Bethany Allen, Harvest Tide Organics, Bowdoinham
- “‘The ACA is really the only option for people,’ Allen said, explaining many of the farmers she knows are on the ACA if they aren’t working elsewhere part-time or on a spouse’s plan. ‘It being tied to income and being affordable basically allows people who are working on farms to have insurance as well.’”
- “‘The people that work on Maine farms that are being impacted by this are people that work in the local economy and that are providing really healthy food to our neighbors and our friends and our communities,’ she said. ‘If Maine and the Maine delegation, Collins, King, Pingree and Golden, want to support Maine farmers and the people that work on Maine farms, like this is how you do it. There’s lots of things, I think, that farms provide for our community, and Maine really values them, but we can’t do it if we’re at risk for health insurance.’” [WMTW]
Missouri
Joe Maxwell, Maxwell Farms, President, Farm Action Fund, Audrain County
- “You know, the plight of the middle-size and family farmer – because of the financial stress that they’ve been under for a number of years, many have begun to rely on the subsidies that support health care under the ACA. And that’s how they receive their health care. I think it’s also important to know the average age of a farmer is about 58 years old. So they’re several years away from Medicare, they’re getting into where health is an issue and are strongly reliant upon those subsidies.”
- “And to be without insurance, you know, you’re literally, you know, one farm accident – it’s a very dangerous profession – one illness, and you could lose the farm. So, you know, you just struggle to try to justify how you can go without insurance, but then you look at your bank account, and you don’t know how you’re going to afford it.” [NPR]
Pennsylvania
Liz Krug, Endless Roots Farm, Waverly
- ““Without the ACA, my family’s healthcare costs will rise over 80%,’ said Liz Krug of Endless Roots Farm in Pennsylvania. ‘To keep our business going, my husband or I may have to find off-farm employment that provides more affordable benefits. We built this farm together, and now only one of us might be able to continue on. With two children, not having healthcare coverage is not an option for us.’” [Quality Assurance Magazine]
- “‘Access to affordable healthcare through the Affordable Care Act has been critical. Without it, I wouldn’t be able to continue farming and serving my community.’” [National Young Farmers Association]
Virginia
PJ Haynie, Haynie Family Farms, Chairman, National Black Growers Council
- “‘We all have to eat, whether you’re Republican, whether you’re Democrat, whether you’re independent, we all have to eat. And that’s the most important thing that we have to recognize, is that we’ve got to support farmers.’” [WWNO]
Wisconsin
Kat Becker, Cattail Organics, Marathon County
- “Becker employs just three to six people depending on the season. Last year she paid $4,000 for health insurance for her employees. But now with the expiring tax credits she’s projected to pay between $7,000 to $8,000 in 2026. ‘We have to put aside extra money for insurance because the costs have gone up,’ Becker said. ‘But the more money we put aside to cover health care the more income it shows, which means our health care is more expensive.’”
- “‘I think it’s bad for the economy,’ Becker said. ‘Instability is bad for small businesses and small businesses are really the engine of small communities and the growth of the economy.’” [WJFW]
Danielle Endvick, Runamuck Ranch, Executive Director, Wisconsin Farmers Union, Chippewa County
- “‘Farmers as small business owners don’t have employer-provided coverage, so they depend heavily on those premium tax credits (for marketplace plans),’ Endvick said. ‘It’s already a profession that’s filled with so much uncertainty. I’m really worried about what’s going to happen when these letters hit mailboxes.’”
- “‘Health insurance costs directly affect the financial stability of farms. Even a few hundred dollars more for health care premiums is going to tip the balance from barely affordable to not being in the long run.’”[Wisconsin State Farmer]
Tommy Stauffer, Vitruvian Farms, McFarland
- “The rising costs and uncertainty might also affect young farmers’ willingness to stay in the industry. ‘They want to start farms one day, they want to have a family farm. And they are looking at the future looks like when they turn 26, and they’re concerned that life choice might not be feasible financially.’” [WJFW]
Experts
John Hansen, Nebraska Farmers Union President
- “Whether it’s commodity prices, whether it’s insurance costs, whether it’s input costs, all the different things we work with, they’re all in the problem area. The yellow light or the red light is flashing in all those areas.”
- “And so, if we have a medical condition that hits, and if that condition’s not covered, we see time and time again that a medical situation is the number one driver of farm bankruptcies.” [Public News Service]
Maddie Kempner, Policy and Organizing Director, Northeast Organic Farming Association of Vermont
- “‘Farming can be an incredibly taxing job, physically, emotionally, mentally. So, having high quality and affordable healthcare is really critical to farmers and people who work on farms.’” [North Central PA]