Food & Climate
More than a quarter of U.S. farmers rely on the Affordable Care Act, but Biden-era tax credits expire at the end of the year.
Over the years, tax credits and other subsidies included in the Affordable Care Act (ACA) have helped lower premiums and made it easier for U.S. farmers to access reliable care.
Now, though, farmers across the country are bracing for new difficulties ahead.
That’s because tax credits created under the Biden administration are set to expire at the end of the year; without congressional intervention that will mean, on average, a doubling of premiums.
At the start of November, farmers on ACA subsidized plans began getting notices that premiums are increasing, according to a report seen by Food & Climate.
Those higher premiums will come at a time when farmers can least afford them: tariffs, federal funding freezes, and extreme weather are making farming more expensive, with margins tighter than ever.
The loss of tax credits for U.S. farmers affect entire communities
The loss of credits for U.S. farmers poses a threat not only to individuals, but will also affect entire communities in all agricultural regions.
And the loss of credits isn’t just a threat to individuals. It will also impact entire communities across farm country.
“That’s just not sustainable, because right now the margins aren’t there for farming at all,” said Gary Wertish, president of the Minnesota Farmers Union.
Taken together, this has left farmers across the country with a number of bad options: pay premiums at the expense of operations; take only catastrophic policies; drop insurance completely; or move somewhere cheaper.
The ACA was signed into law in 2010 by then-President Barack Obama. Among other major reforms to U.S. healthcare, the ACA established new policies and protections for private insurance purchased from the marketplace.
Later, the Biden administration implemented ACA-enhanced premium tax credits that limited the amount a person must pay for upfront costs of insurance.
These enhanced credits were extended by the Inflation Reduction Act through 2025. If they are not extended, the original ACA premium caps will return, and that is expected to raise premiums.
Florence Becot, a researcher with Penn State University, has focused on farmer access to services like healthcare, child care, and mental health services for the past decade. She said access to affordable healthcare has been a persistent issue year over year.
When the ACA was first adopted, Becot said, farmers were split on the package. For some it was life changing, while others lost access to coverage plans they’d had for years. But more recently, with the passage of the credits and other additions to the ACA, the cost for plans have dropped.
Getting insurance from the ACA marketplace has often been the last resort for many farmers, she said, but many have found it easier because of the ACA credits.
A triple of the national average for the rest of the population
Now approximately 27 of U.S. farmers rely on healthcare from the marketplace, which is about triple the national average for the rest of the population, according to a Kaiser Family Foundation analysis of the 2023 American Community Survey. This also represents a nearly 10 percent increase among farm households that relied on private direct-purchase insurance in 2015, according to data from the U.S. Department of Agriculture (USDA).
The bulk of farmers are buying their own healthcare because they are not under a group plan from a large employer. The out-of-pocket premium payment for ACA marketplace enrollees across income levels was an annual average of $888 in 2025, but that is expected to increase to $1,904 in 2026, according to a Kaiser Family Foundation study.
The costs are amplified in states with above-average healthcare premiums.
If the ACA credits expire, Vermont residents using marketplace insurance and making about $63,000 in annual income could see premiums increase to $10,000 per year for an individual and $32,000 for a family of four, according to Public Assets Institute, according to “civil eats”.