Farmworkers and the ACA

The deadline for enrolling in the Health Insurance Marketplace came and went at the end of January. Though the ACA open enrollment period has passed, those experiencing certain life events – including marriage, moving, or a change in immigration status – may be eligible for a special enrollment period. While these life events may seem obvious to some, others may not realize that they are eligible for coverage.

For H2-A workers who enter this country to work for a specific period of time, once their visas are stamped and they enter the US, they gain lawful immigration status and become eligible for a special enrollment period (SEP) to enroll in health care coverage. However, in North Carolina 90% of all farmworkers do not have health insurance for a variety of reasons. Farmworkers must enroll within 60 days of arriving in North Carolina, and there is a limited number of in-person assisters to help them with their applications, especially since farmworkers work long hours. Finally, growers or workers themselves simply do not realize that H2-A workers are eligible. Likewise, farmworkers require frequent follow-up to help them after the enrollment process to translate mail and troubleshoot errors, such as​ missing tax credits or misplaced insurance payments.

Agricultural labor is one of the most dangerous lines of work. Farmworkers do particularly grueling jobs that involve repetitive motions, exposure to the heat and pesticides,​ and working with heavy machinery. For these reasons, farmworkers need access to health care. With the Affordable Care Act their health plans cover basic care – doctor’s visits, physicals and hospital stays. The average cost for health insurance is $20 to $80 a month. Farmworkers and their families are a particularly vulnerable group and are greatly​ in need of the peace of mind that they will be able to afford health care and be able to continue doing farm labor if they are hurt on the job.

There are many health organizations in North Carolina working hard to improve access to health care for farmworkers. One such group is the North Carolina Farmworkers Project, located in Benson, a nonprofit organization dedicated to helping farmworkers improve their living conditions and increasing access to health care. Last year, they enrolled more than 200 workers through collaborations with other organizations at enrollment events in May and July timed to meet workers when they arrive in the state. They have many success stories, one being a farmworker whose insurance coverage started on July 1 and who suffered a broken leg on July 4, but thanks to his health insurance he was able to go to a local hospital and physical therapy was covered when he got out. If he had not had health insurance,​ his bills would have been more than $30,000, and he would have had limited access to local, affordable physical therapy without his insurance.

The NC Farmworkers Project proves that local organizations are needed to do the work of expanding health care coverage to people who require​ it the most, especially in rural areas. Through specialized outreach strategies and community partnerships, we can improve the lives of those who desperately need access to health care and are able to sign up for marketplace coverage.