American farmers are bracing for a severe blow to their finances in 2026, with health insurance premiums under the Affordable Care Act (ACA) set to double or even triple for many due to the expiration of enhanced federal subsidies. While low commodity prices, rising input costs, and trade uncertainties already strain farm budgets, this impending cost surge adds another layer of hardship. Yet Congress has taken no meaningful action to prevent it, leaving farmers to make painful choices between coverage and survival.
The enhanced premium tax credits, introduced during the pandemic and extended through 2025, have made ACA marketplace plans affordable for millions, including a significant portion of farmers who lack employer-sponsored insurance. According to estimates, about 27 percent of farmers, ranchers, and agricultural managers relied on individual ACA coverage in recent years. With these subsidies expiring at the end of 2025, premiums are poised to spike dramatically. For some families, monthly costs could jump from around $600 to more than $2,300, pushing annual health expenses over $40,000 when deductibles and out-of-pocket limits are included.
Iowa beef and sheep farmer Seth Watkins described the impact vividly: “I really want people to understand, it’s not markets or weather that will put me as a farmer out of business. It’s a catastrophic health issue,” DTNPF reports. His family’s potential increase would leave them with $25,000 less each year for other needs, such as equipment upgrades or farm inputs.
Similarly, Aaron Lehman, president of the Iowa Farmers Union and a corn and soybean grower, noted that costs for his family could double. “That is an incredible cost for our family budget and for our farm budget,” he said in reports from AgWeb. Lehman highlighted broader pressures: “Farmers right now are trying to make all sorts of decisions because commodity prices are low, because of the chaotic trade situation that we’re in and higher input prices. All these things have made a real crisis for a lot of our farmers.”
The expiration also revives the so-called “400 percent poverty cliff,” where subsidies vanish entirely if income slightly exceeds the threshold. Beth Hoffman, who raises grass-finished beef and goats in Iowa, explained the dilemma: “If we make $84,999, we get the credit. If we make $85,000, we literally fall off this cliff. A $300-a-month premium turns into owing roughly $16,000 retroactively.” Many farmers are opting for bare-bones plans with high deductibles to mitigate risks, but this leaves them vulnerable to major medical events.
Matt Russell, executive director of the Iowa Farmers Union, called it “a gut punch to working families,” emphasizing that the spikes shift costs onto small businesses without addressing underlying issues, as reported in DTNPF.
Congressional efforts to extend the credits or find alternatives have stalled. Proposals from both parties failed in the Senate, with no agreement reached before the ACA open enrollment deadline passed. This inaction affects not just individual farmers but the future of agriculture. Lehman stressed that “the Affordable Care Act has allowed farmers and rural entrepreneurs to take risks, to start businesses, expand farms, replace equipment, and bring the next generation into the operation.”
Without relief, some farmers are turning to alternatives like Farm Bureau health plans in certain states, which offer lower premiums but often exclude pre-existing conditions and provide limited coverage. Interest in these has surged, with applications doubling in places like Nebraska amid ACA uncertainties.
As rural America grapples with these rising costs, the lack of congressional action exacerbates an already tough environment. Farmers, who feed the nation, deserve policies that support their health and viability rather than forcing impossible tradeoffs. Extending support for affordable insurance would be a clear win for rural communities, yet lawmakers have let the deadline approach without resolution.