LOS ANGELES, Jan. 25 (Xinhua) -- For James Davis, a 55-year-old farmer in the U.S. state of Louisiana, the start of 2026 brought a major financial shock: His monthly health insurance premium surged to 2,700 U.S. dollars after federal assistance under the Affordable Care Act (ACA) expired.
"You can't afford it," Davis stated in a recent interview with the non-profit research organization Kaiser Family Foundation (KFF). "Bottom line, there's nothing to discuss."
The increase followed the end of enhanced ACA subsidies, which had effectively capped insurance costs at 8.5 percent of household income. Those subsidies were not renewed and expired at the end of 2025, following the enactment of the One Big Beautiful Bill Act, a sweeping tax and spending law.
The Act also reduces support for Medicaid and the ACA marketplace, and brings back the so-called "subsidy cliff," under which families earning just above the income threshold lose all financial assistance.
For farmers whose revenues can be high but profits thin, the changes have created an immediate crisis. During an Iowa Farmers Union (IFU) event last month, farmer Seth Watkins said that his monthly premiums were set to rise from about 600 dollars to more than 2,300 dollars, according to a report by Radio Iowa.
He noted that while farmers are used to dealing with volatile markets and unpredictable weather, a single catastrophic health issue is now the most likely factor to put them out of business.
The new legislation also introduced a "repayment trap" that punishes successful harvests. Beth Hoffman, who raises grass-finished beef and goats in Monroe County, Iowa, noted during the IFU event that earning just one dollar over the limit could trigger thousands of dollars in retroactive charges, an obstacle she said prevents farmers from expanding their operations.
Extensive data from health and economic researchers support these individual stories. An analysis by the KFF last September indicated that 27 percent of the U.S. agricultural workforce relies on the individual marketplace for insurance, a rate significantly higher than the 6 percent found in the general adult population.
Meanwhile, a joint study by the Urban Institute and the Commonwealth Fund from September 2025 projected that 4.8 million Americans would lose coverage in 2026, while for those remaining in the marketplace, the study found that annual net premiums for families just above the poverty limit would nearly double.
The consequences of these rising costs are already rippling through the rural economy. Matt Russell, executive director of the IFU, described the spike as a "gut punch" that shifts systemic healthcare failures onto the shoulders of small businesses.
There are growing fears among American farmers that the next generation will be driven away from the land. Aaron Lehman, president of the IFU, warned at a Senate Democratic press conference last December in Washington that now inviting young people to become farmers is a "far riskier proposition" without a healthcare safety net.
"Too many in Washington live in a bubble. But in reality, the anticipated health care cost increases will cave in the budgets of farm families, and the damage will reverberate throughout our rural communities. We need to demand action now to extend support to keep health care prices affordable for ordinary Iowans," he said. ■