Appendix 7: Case Studies 2018/2019 - Linking Farm Vital ity and Health Forum
Scenario 1 - Sara is a young part-time farmer producing leafy greens for local restaurants. She does have health insurance through her other employment, but it has a deductible of $6,000. She broke her arm working on the farm an d now she can’t harvest crops, will lose income, and doesn’t have the funds to pay for care. She doesn’t have a primary care physician because she doesn’t think she can afford it. Her current annual income is about $35,000. She has student loans as well as other beginning farmer start-up costs. Scenario 2 – Tom has been working the family farm for over 50 years. Children, John and Katie, work on the farm and assist their dad. Tom has Medicare but no supplemental insurance. He and his spouse are trying to manage a chronic respiratory health care issue that impacts his ability to work on the farm. He is thinking that he will need to sell some or all of the farm in order to cover health care expenses and medical debt. John and Katie would like to take over the farm, but Dad won’t transition the farm to them. He believes the farm is an asset that will help cover the medical bills. If he and his wife sell the farm to get cash, the livelihood of both generations will be diminished, and the community character could change. Scenario 3 – Dairy farmer, Dave , has 200 cows which are milked at 5 am and 4 pm. Getting away from the farm is very difficult. Milk prices are very low, and income is not meeting expenses. Dave also grows soybeans. He is concerned about recent tariffs that will impact sales of the soybean crop. Dave is feeling very depressed. Debbie, Dave’s wife, doesn’t know what to do because the household and farm bills are piling up, including her medical insurance premium and a business loan. The medical insurance has a large deductible. Debbie knows Dave needs professional help but there are other priority bills to pay. In addition, another family member is struggling with addiction. Debbie is also concerned about how to get and pay for medical care. Scenario 4 – Frank and Frannie are poultry farmers. They have three poultry houses, and both work off farm at jobs that don’t provide health insurance. The poultry houses help to supplement their income and they net about $10,000 as they are still paying on the loans for the poultry houses. Their total adjusted gross personal income is about $51,000/year. It has been cheaper to pay the ACA tax penalty in the past. They have three children. The seven-year-old child has asthma and has been to the doctor and Emergency Department (ER) many times resulting in $20,000 in medical debt. Recently, Frank was diagnosed with diabetes. The couple realizes now that health insurance may be an important risk management strategy. Between the farm loans, student loans, home loan, living expenses and daycare, they are living paycheck to paycheck, and they are not sure how to cover health care premiums and medical debt costs. Scenario 5 – The Lorenzo family are farmers who grow a variety of crops on 250 acres. They include lima beans, corn, soybeans, peas, and small grains. The family consists of Mark and Sophia and two grown children and their spouses. There are four grandchildren. The business is a Limited Liability Corp (LLC) that provides income for these three households. Currently, the LLC pays health insurance premiums for the family members as a business expense, but family members are responsible for the out-of-pocket costs and the $3,000/per person deductible. In addition to family members working the farm, there are 4 seasonal helpers who assist with farm operations. The weather and pest issues have impacted the health of the plants; they are concerned about yields and revenues this year. On top of that, two of their hired staff have left, citing they need jobs with ben efits. The farm doesn’t make enough to pay for health and other benefits of the seasonal staff. Now they are looking for new staff and are concerned about their ability to operate adequately while they are in search of knowledgeable and skilled seasonal staff replacements.
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