Healthcare insurance plans for some U.S. farmers could double in 2026, as enhanced federal subsidies under the Affordable Care Act (ACA) are scheduled to expire.
The impending cost surge could affect thousands of U.S. farmers who currently rely on the ACA marketplace for their health insurance, according to the non-partisan KFF (formerly Kaiser Family Foundation), a health policy organization.
KFF estimated in 2023 that 27% of “farmers, ranchers, and other agriculture managers” relied on individual ACA market coverage. Nationally, more than 22 million Americans rely on the ACA marketplace for insurance options.
Farmers ‘Don’t Have Many Options’
Iowa farmer Aaron Lehman, who testified before Congress last week, highlighted the severity of the potential cost increase on his family. He said he expects to pay double to purchase an insurance plan for 2026 that would be comparable to what his family had this year.
“That is an incredible cost for our family budget and for our farm budget,” Lehman stated. The fifth-generation farmer and president of the Iowa Farmers Union described how rising healthcare costs are colliding with already harsh economic realities in agriculture.
“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,” said Lehman.
“Finding ways to deal with that, we just don’t have too many options. Farmers will buy less equipment or not make the necessary upgrades and equipment that they need to,” he added. “They’ll look at their input suppliers, and they’ll decide, ‘what can we do to get through just this year … to get a plan to put the crop in the ground?’”
Read the testimony of Aaron Lehman here. A portion of his testimony and discussion is also featured on a posting to YouTube.
Signup Deadlines For Coverage
The challenge for farmers trying to decide on what insurance policy to purchase is compounded by the deadline to enroll in ACA marketplace plans: People needed to choose their ACA plan by Monday for coverage to begin Jan. 1. Open enrollment continues in most states until Jan. 15 for coverage beginning Feb. 1.
Despite broad public support for an extension to the ACA tax credits — a KFF poll said 74% of Americans favor continuing the enhanced credits — a congressional standoff has so far failed to produce a solution:
- Failed Votes: Both a Democratic plan to extend the enhanced tax credits for three years and a Republican proposal to replace them with Health Savings Accounts (HSAs) failed to pass the Senate last week.
- Impending Crisis: Nearly six in 10 enrollees (across all categories) told KFF they could not afford even a $300 annual increase in 2026 without significantly disrupting household finances.
- Political Fallout: The issue of healthcare costs and expiring subsidies is highly polarizing, with some Republicans warning that a failure to address the problem could cost them legislative majorities in next year’s mid-term elections.
As the deadline for open enrollment closes and the Dec. 31 subsidy expiration date approaches, farmers must prepare for substantially higher health insurance costs in 2026 unless Congress acts to reach a last-minute agreement.
Young Farmers Need Better Options
During his testimony and ensuing discussion, Lehman stressed that healthcare isn’t just a personal household issue; it’s central to the future of American farming. With the average age of an Iowa farmer at 57, he said the sector desperately needs young and beginning farmers to return to the land. But without affordable, reliable health coverage, inviting the next generation back onto the farm becomes a far riskier proposition.
“You have to be very smart to figure out the plan that can bring the next generation on the farm,” he said, adding that many talented, innovative young people want to farm, but face daunting financial barriers — healthcare high among them. He noted that one of his sons works with him on their family operation, which is based in Polk County, Iowa.
Lehman framed affordable healthcare for farm families as an investment, not a handout: a way to make it possible for young farmers to feed their communities, support local and regional food systems, or continue larger family commodity operations.
“Extending the federal support for lowering the cost of health insurance is a true win for farmers and for all of rural America,” he said.
