ALEX COHEN, host:
Finding inexpensive healthcare isn't quite as easy as snatching fashion bargains at the Snooty Fox. Many families are struggling with rising healthcare costs, especially farming families. A survey from the non-profit Access Project found that farmers paid twice as much for healthcare than non-farmers do. From member station KXJZ in Sacramento, Kelley Weiss reports.
(Soundbite of an engine starting)
KELLEY WEISS: Meet Paula Floriano.
Ms. PAULA FLORIANO (Dairy Farmer): Fixing this, fixing that, doing this, doing that.
WEISS: She's a 43-year-old dairy farmer. She lives in the California central valley town of Atwater. Today, she's raking hay near the calves' pen. Her blond hair is firmly clipped up, and a cigarette dangles from her mouth.
Ms. FLORIANO: Well, usually, like I said, I'm the clean-up crew, and then, when the milker's off, I feed the heifers, the dry cows...
WEISS: Floriano has two teenage kids and runs a modest farm with her husband, Paul. They work seven days a week starting at the crack of dawn tending to their 125 cows. She says health insurance costs eat into their limited income, and she says her coverage pays for only a few doctor visits a year. Beyond that, it's out of pocket.
Ms. FLORIANO: About a year and a half ago, my husband got stung by some bees that were out here. And he had an allergic reaction to them. So, we went over here to the clinic, and that bill was $1,900 after the insurance picked up. And he got a shot, you know, for the reaction, and that was basically it. So, you know, we try not to go unless we really - we really have to.
WEISS: Right now, she pays about $1,000 a month for her family's health insurance. She says that doesn't include dental or vision coverage, and on top of the monthly premium, Floriano has a $10,000 deductible for medical care. With all of these costs, she says, sometimes, other bills have to wait.
Many small business owners like the Florianos buy their insurance as individuals. Scott Leavitt works with the insurance industry. He says there's a reason individual coverage is so expensive. First of all, he says, it's a small pool of people, and that makes it harder for the insurer to spread out risk, and...
Mr. SCOTT LEAVITT (President, National Association of Health Underwriters): When you work with an employer, the employer's paying the lion's share of the premium, typically 50 percent plus. When you do buy individual policies, there's nobody else paying any other share of the premium. You do pay the entire cost.
WEISS: Regardless of why it's so expensive, a professor at the Health Policy Institute at Georgetown University, Karen Pollitz, says the bottom line is, the individual market is a mess.
Dr. KAREN POLLITZ: (Public Policy Institute, Georgetown University): Nobody would design a system for financing healthcare like the individual market that we have today. It's volatile, it's unstable, it's expensive, it's dangerous, and people can really get hurt.
WEISS: And Pollitz says there's one area in particular that worries her. She says small business owners, like so many farmers who buy their insurance as individuals, are at risk of paying higher prices when they have pre-existing conditions like cancer or diabetes. She says a few states, including Massachusetts and New York, guarantee that everyone can get health insurance and pay similar prices for it, but Pollitz says most states don't have these rules.
Dr. POLLITZ: So, your protections in this market are much less compared to group plans, where federal law says, it's just not allowed to discriminate against people based on their health status. In this market, you always get discriminated against based on your health status.
Mr. RICH MATTEIS (Administrator, California Farm Bureau Federation): It's disconcerting, that's for sure, and we'd certainly like to find ways for them not to do that.
WEISS: That's Rich Matteis with the California Farm Bureau Federation, an advocacy group for farmers. He says he'd like to see his members pay less for healthcare. However, he's not in favor of major insurance industry regulation. Instead, he says, farmers should have the choice of more health plans with higher deductibles and lower premiums.
But back at the dairy farm, Paula Floriano says it's going to take more than that. She says lawmakers need to change the healthcare system that she believes punishes small business owners.
Ms. FLORIANO: Tell the insurance companies that, hey, these small businesses need their insurance, and you will work with them. And regulate it, not that they can charge outrageous prices and, you know, really stick it to you.
WEISS: But for now, Floriano will have to wait. There's no significant movement at the federal or state level to restructure the individual market. So, all eyes are on the new administration to see what will come of its plans to change healthcare. For NPR News, I'm Kelley Weiss in Sacramento.
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.