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'Job Lock Phenomena'

CENTER for RURAL AFFAIRS -

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--. - Values. 'Wofth. Action.

By Elishu Greeley Smith, elishas@cfru.org, Certterfi~r Rural Aflairs Someone once told mc that work is not fun, that's why it's called work.

This person was'stuck in an unsatisfactory job that they kept only because it provided health insurance. They aspired to start their own business, but it was too risky.

The lack of affordable, quality health insurance is the primary barrier to . .

entrepreneurship reaching its potential for rural people. The cost of health insurance prevents snlall businesses and entrepreneurs from expanding their businesses and creating jobs; the cost of health insurance makes it less likely for rural small businesses to provide health insurance to their employees, af- fecting the health of their employees and making it more likely they will seek employment in urban areas. Health insurance costs also affect the dreams of potential rural entrepreneurs, delaying or killing an idea by making it too risky for one to leave employer-provided insurance at a current job, the so- called "job lock" phenomena.

The rural economy is based on entrepreneurship, both agricultural and non-agricultural. Entrepreneurs add jobs and create wealth. Spurring inno- vation and job creation in rural communities through entrepreneurship is the key to revitalizing rural communities and ensuring rural America's long- - term future.

Properly developed and administered, a public health insurance plan could provide an affordable and quality choice to benefit the entrepreneurs of rural America. It would provide a coverage option that does not currently exist for rural small businesses to provide health care coverage for owners and employees, and for rural families that are pursuing their entrepreneurial dreams.

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Vitality of rural areas hinges on health-care reform Health-care reform is

crucia1,to rural economic revitalization. And rural Iowans know it. As Linus Solberg, a farmer from Cylinder, Ia., and my good friend, said recently, "Health care is killing rural America." Unless we act today, and act boldly, his observation will become truer each passing day.

Congress is embroiled in a debate over whether or not America will act boldlyi- a choice that will determine, in large part, whether or not we will revitalize Iowa's rural com- munities and rebuild Iowa's economy. America must choose whether or not we will reform our broken health-care system. Rural Iowans have the opportu- nity to ensure that Iowa's con- gressional delegates champion real reform that addresses the unique health-care challenges our rural communities face. In particular, the leadership roles of Sens. Tom Harkin and Charles Grassley make Iowa a pivotal battleground in the health-care debate.

JOHN CRABTREE is the media director for the Center for Rural Affairs, Lyons, Neb. Contact: johnc @cfra.org.

At the heart of that debate is this question: Whether or not Congress will create a public health-insurance plan that provides individuals, families and businesses affordable cover- age by giving them the option of choosing such a plan over private insurance.

Opponents of reform have said that private health-insur- ance companies simply c q o t compete with the efficiencies of a public health-insurance plan. However, we must remember the moral imperatives that under- lie the need for reform. Our first loyalty must lie with the American people, especially those that have suffered most under America's dysfunctional health-care system. Fifteen years ago, and many times since,

the health-insurance industry promised the American people who it would fix the problems in the health-care system. It did not. It has made the same prom- ise again this year, but every meaningful poll and survey and my own conversations with rural people have taught me that this time we're not buying what it's selling.

In 1982, when I graduated from high school, my hometown's main street boasted two grocery stores, two gas stations, a meat locker, a hardware store and myriad other businesses. Like most Iowa small towns, Sheffield has struggled to keep its main street viable. So far it has, while many other communities have not. Of course, one grocery store, one gas station, the meat locker and the hardware store are gone. Sheffield-Chapin High is also gone, replaced by a larger consolidated district that also includes Meservey, Thornton, Rockwell and Swaledale.

Sheffield has seen good days, along with the bad. The building that used to house one of the gro-

cery stores now contains a small software company, a quintes- sential example of the entrepre- neurship that holds such great hope for towns like Sheffield across Iowa and throughout rural America. But rural Iowa's family farmers, entrepreneurs and small businesses face stern economic challenges. First and foremost is the skyrocketing cost of adequate health insurance.

Rapidly rising health-insurance costs will determine whether many of rural Iowa's entrepre- neurs, farmers and small-busi- ness owners succeed or fail during our nation's economic recovery. As health-insurance premiums and out-of-pocket medical expenses rise, more small-business owners will drop unaffordable coverage for themselves and their employees. Health-insurance costs will con- tinue to burden family farmers and dampen efforts to help the next generation of family farm- ers get started. And rural eco- nomic-development efforts will grow increasingly difficult as the leap of faith that entrepreneurs

must take in leaving employ- ment with health-care benefits to start their own business comes to look more like a leap into an economic abyss.

A strong public health-insur- ance option would offer precisely what many rural Iowans need - affordability, stability and the ability to choose their medical provider and control the medical decisions that affect their lives.

In particular, small-business owners, their employees and the self-employed would benefit from having a choice between a public health-insurance plan and private insurance.

Real reform should create such a public health-insurance option while doing two other things: providing new incentives and support to help rural communi- ties attract and retain medical professionals and ending the practice of paying rural hospi- tals and doctors less than their urban counterparts for the same services.

That should be our vision for where health-care reform begins.

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= Nebraska guide breaks -down federal farm bill details

LYONS, Neb. (AP) - Nebraska farmers and ranchers can get some help understanding the farin bill

-- and finding government programs that can help their businesses.

The Center for Rural Affairs has published a guide to the federal farm bill to help people find pro- grams that might help them get started or succeed at farming and

-

ranching. The guide offers details on 23

different programs in the farin bill that are designed to help farmers, ranchers and other rura l resi- dents.

The guide is available online at www.cfra.org. The center also runs a farm bill hot line that farmers can call at (402) 687-2100.

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Families pinched by health care costs 1 By Center for Rural Affairs

A report released June 24 by The Access Project found that farm and ranch operators, like many self- employed Americans, can- not afford the cost of health insurance offered to small business owners, While family farmers and ranch- ers are insured at a rate higher than the general population, still one in ten (10%) was uninsured or had an uninsured family member, sometime during the previous year.

The report, 'Who is Uninsured?' is based on data gathered through the 2007 survey of farm and ranch operators in seven Great Plains states. The report found that uninsured farm and ranch operators were more likely to say that their principal occupation was farming or ranching than their insured counter- parts. They also had lower incomes and were more likely to live alone.

.- . "Those niost reliant on - - income derived from the

family farm or ranch are ~ .. least likely to be able to

afford private health insur- ance," said Carol Pryor,

- - . lead author of the-report and Policy Director at The Access Project. "This threatens both their health and their livelihoods. Washington must act to develop alternatives to a private market that is unwilling or unable to pro- vide affordable protection to the self employed and small business owners."

The survey found that more than one-third of the uninsured farni and ranch operators spent more than 10% of their inconie on health care costs. They were also four times more likely to have incomes under $20,000 than those with insurance.

The Access Project's report is the fifth in a series of issue briefs based on a

k 2007 survey of farm and

ranch operators in seven Great Plains states: Iowa, Minnesota, Missouri, Montana, Nebraska, North Dakota, and-.South Dakota._ The AccessProject iAd its" partners at Rrandeis University and the University of North L)akota School of Medicine's Center for Rural Health contracted with the USDA's National Agriculti~ral Statistics Service to survey more than 2,000 non-cor- porate farm and ranch operators (those operating as sole proprietors or part- nerships).

The report finds that uninsured farmers and ranchers face much greater barricrs to getting care and suffer higher levels of financial hardship than those with insurance. They delayed needed care niorc than twice as fi-equently as those with insiirance - niore than a third of the unin- sured delayed care (3456) versus 15% of 6 e insured. The uninsured were also .. - -more likely to:

* Draw down resources, such as withdrawing money from savings or tak- ing out loans. to pay for

rihealth care (40% vs. 25%)i; * Spend more than ten

percent of their income on health care (34% vs. 29%);

* Report that health care costs contributed to finan- cial problems (32% vs. 22%);

* Accrue medical debt (32% versus 16%).

Jsa Kirk, who owns a horse ranch in South Dakota with her husband Jack, was uninsured when she was diagnosed with cervical cancer. It was only because she was able to get coverage from All Women Count, a program run by the South Dakota Department of Health, and from Medicaid, that she was able to afford care.

She said, ''If not for All Women Count, Jack and 1 might have lost our home,

ranch and livelihood clue to i

medical bills." But now that she no longer qualifies for those programs, she is once i

again uninsured.. She said, =

"We are determined to con- tinue to livc a healthy :

-lifestyle and have faith, since it seems very unlikely for me to obtain health cov- erage."

Jon Bailey, Director of Rural Research and Analysis at the Center for Rural Affairs in Lyons, noted that plans to reform :

the health care system nationally niust take into account the needs of rural businesses and communi- ties. "Hcalth reform that continues to rely solely on the private insurance mar- ket and attempts to strengthen elnployer-pro- vided insurance, no matter how regulateci or reformed will be irrelevant to a large

. .- -number 'of rural people. If!

you want farmers to contin- ue growing the food for our families, and if you want rural communities to thrive, theri axailability of a

affordable and quality, health insurance must be effectively addressed."

The findings f r o m this refioi-t c. r$ise que&iotis b regarding the availability and affordability of health -- , Insurance coverage, espe- cially for those families without access to employ- er-based coverage. Their lack of insurance may not only put their health at risk, but also their businesses. The Access Project urges policymakers, as they work to reform our nation's health care system, to con- sider options for expanding the availability of compre- hensive insurance coverage and ensuring that this cov- erage is affordable for lower income families.

The full report is avail- able online at: www.cfra.org/fileslAccess P r o j e c t - 2 0 0 7 - H e a l t h - . J n s u r a n c e , - FarrnRanchSurvey.pdf

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~ u r a l America needs a public health insurance plan 1 ,The current health insurance

system does not work well for many rural people and businesses. They pay too much for too little coverage and too little peace of mind. Health care reform that is based on the current system does little to address the unique issues faced by many rural people.

Why should rural people be sat- isfied with maintaining a system that does not work for millions of them without significant reforms? A public health insurance plan option is simply that - a choice that addresses many of the health insurance issues and barriers faced by rural people, families and -businesses.

Whether or not to include a public health, insurance plan in health care reform legislation as an option for individuals, families and businesses is a crucial deci- sion. With the many health care challenges facing rural people, Congress' decision will have sig- nificant consequences for rural America, and we have much to gain or lose.

The potential strengths of public health insurance plans are what many rural people and businesses need-stability and cost, controls while providing health insurance access to vulnerable populations like low and moderate-income families, small business employ- ers and employees and the self- employed.

A recent e n t e r for Rural Af-

fairs report examines some of ' the arguments for a public health insurance plan, how the plan would address the health care challenges that exist for rural areas, and, ultimately, why the choice of a public health insur- ance plan option is needed for rural America.

View the report at: http://files. cfra.org/pdf/publicglan.

The Center for Rural Affairs was established in 1973 as an un- affiliated nonprofit corporation under IRS code 501(c)3. The Cen- ter for Rural Affairs was formed by rural Nebraskans concerned about family farms and rural communities, and we work to strengthen small businesses, fam- ily farms and ranches, and rural communities.

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www.Nebraskafarmer.com - August 2009 9

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i I . Incentives

Young farm family gets its start wlth a state incentive program. : Tax credit goes to asset owner who rents to beginning farmer. Financial management course i is a program requirement. s

I T was a bit challenging for Josh Andersen a year ago when he r e t u r ~ e d to help rhn

the family farm after his father, r Carl, became ill. How would he

get established? How could the operation at its current size support two families?

Before leaving his engineer- ? ing job in Oklahoma to return to I Edgar, Josh researched young B farmer incentive programs 5 on the Web. On the Genter for : Rural Affairs site, he found a 4 link to the Nebraska Beginning

Farmer Tax Credit Program. Today, with the help of the tax incentives in that program, c r e ated by the Legislature 10 years

[How does tax I /,credit work? I

ago, Josh leases his dad's entire crop ground and several hun- dred more acres from a corpo- ration, aland trust and another area landowner.

He qualified for the program, which grants a refundable state

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income tax credit to the asset owner annually for three years,

-equal to 10%. of the cash rent the owner receives or 15% of the value of the owner's portion in a share agreement. That's on top of the rental payments. .

In return, Josh and other Aeligible beginning farmers in the Nebraska Department of Agricyltureadministered pro-

T HE Nebraska Department of Agriculture's Web site

provides two examples of how the tax credit on land leases works, using 100 acres in both cases.

A cash rent agreement, ,with rent at $250 an acre, equals $25,000 for the owner. At lo%, the program pro- vides an income tax credit of $2,500 each year for three years, or a total of $7,500.

On a share arrangement, 1 with 100 acres producing 200 . bushels of corn per acre, the ' owner's 50% share would be ' 10,000 bushels. At $3.50 per bushel, that's $35,000 for the owner. At 15% that's $5,250

year for three years, or a total of $1 5,750.

'This is a true tax credit," - says Dave Goeller, University of Nebraska-Lincoln transition

: specialist. "If the owner does . not pay state income tax, they will receive a tax credit."

!* Goeller says a strategy some families are considering is to simply make the son or daughter the operator and

. to pay the parents' rent, thus creating a three-year income through the state tax credit program to help with tight cash flow.

gram get a minimum threeyear lease of the qualified assets to get started and improve their chances of stability.

"Every bit of ground I farm, including all of Dad's, is involved in the tax credit program," he says. "Two-thirds of it is on a share agreement. With the 15% tax credit to the owner, the state is recognizing that share leases help beginning farmers by the owner sharing the risks."

Josh also leases his dad's equipment, another eligible asset in the program. In all, the assets allowable under the pro- gram are farm or ranch land, cattle, grain storage, irrigation equipment and others. "Leasing the equipment helps spread out his tax liability during retire- ment," Josh says of his father.

While Josh hasn't used it yet, the program allows the begin- ning farmer to apply for a tax exemption of personal property valued up to $100,000.

As part of the eligibility re- quirementF,-Josh_ and his wife, Teryl, had to take "anancial management class, but were eligible for a reimbursement of up to $500 of their costs. Community colleges with ag programs and the University of Nebraska-Lincoln offer finan- cial management classes, says Marian Beethe, coordinator of the program at NDA.

Program improvements It's a more attractive program today with amendments made by state senators the past two years. In 2008, "related partiesn were permitted for the first time as eligible asset owners, thus allowing Carl to-rent land and equipment to his own son.

"That was a huge deal," says Beethe. "It was a big factor for the 137 beginning farmers who qualified from July 2008 to the

ALL IN THE FAMILY: Josh and Teryl Andersen rent land from Josh's parents, Carl and Karen (right). The younger couple's children are (left to right) Leif, Elsa (held by Teryl) and Ingelise. Josh and Teryl are expecting their fourth child in mid-January.

end of June this year." Without these changes, Josh

says the only qualified asset owner would have been one neighbor, leaving him with only 20% of the land he now farms eligible for the tax-credit.

The Legislature made two changes in 2009. It modified the $200,000 net worth threshold for beginning farmers by ad- justing that amount annually based on the producer price index, and it permitted those

outside the state who own land in Nebraska to be an eligible asset owner, Beethe says.

Succession planning When qualified beginning farmers lease assets from closely related family members, such as parents or grandpar- ents, the families must develop a succession, or transition. The idea is to give beginning farmers security that the land will be there for them over the

long haul. "It eliminates a lot of uncertainty for us," Josh says.

Adds Carl, "I like it that the program rewards the asset owner and that it gives the young farmer security."

For information, go to the Nebraska Department of Agriculture Web site at www. agr.state.ne.us, select "Choose a Division" and then click on "Beginning Farmer." You can also call the Beginning Farmer Hot Line at 800-466-4071.

cw - l**ma*-^i-rr an->-* * i , t q i a r s v r r x srk,ev= i ~ r m - ~ i s ~ - ~ &. e. - i ... - x n s i =WWT ii--*ms- 7k--E-w* *ij*c* svwa r M S ~ find: v01. 151 NO. 8 Contact US:

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Visioning presentation to be How can a website enhance Web Team Lead and Project

community development ef- Management Consultant, will forts in northeast Nebraska? . , present information on as-

The Center for Rural A- sisting th& communities in believes that perhaps a new development of a web site that websitewill bringnew~ustom- wiil. offer business presence ers for area businesses, entice and the opportunity to sell new residents toour comrnuni- their products/se~ices online. ties,andsolidify tieswiththose Examples of the benefits of interested in the future of the developing and having astrong Logan Vailey. web prtsence wili be demon-

The community is invited strated at the.meeting. to "Find the answers to those This will be aregional website questions and more" at awhat available to Lyons, Decatur, the Center is calling a visioning Bancroft, Rosalie, Pender and presentation in Lyons, Thurston with further devel-

Nebraska, on August 11, opment to incorporate other brought to you by a partner- communities in Northeast ship between the Center for Nebraska in.the near future. Rural Affairs and Nebraska "We will be looking for Business Development Center schools and businesses from (NBDC). Bancroft, Rosalie, Pcnder,

Jennifer Metzler, NBDC Thurston, Lyons and Decatur Training Director of Marketing who would' like to participate and Sales and Beth Giesbrecht. in development of an e-com-

heta in Lyons merce web site.

This is a wonderful oppor- tunity for area businesses and schools to consider, and we encourage them to attend," commented Stephanie Fritz, Center -.

'This is an activity we are providing through the'Bufding Entrepreneurial Communities Act Grant.

We will alsoconsider offering classes to individuals wanting to be actively involved in main- taining this site andlor their community web site if there is interest expressed." The presentation will be held

at 6:30 p.m. on August 1 lth at the Center for l t w L U a h located at 145 Main Street in Lyons.

For more infomationcontact Stephanie Fritz at stephanief8 cfra.org, or (402) 270-1070.

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Rural America needs a - -

CFRA guest opinion The current health insurance as an o w n for individuals, -income families, small busi-

system does not work wellfor families and businesses is a nessemployersandemployees many rural peap1e and busi- crucial decision. and the self-employed. A nesses. With the many health care recentCenterforRuralAffairs

They pay too much for too little coverage and too litfie peace of mind. Health care reform that is based on the current system does little to address the unique issues faced by many rural people.

Why should rural people be satisfied with maintaining a system that does not w d for millions of them without significant reforms?

A public health insurance pIan option is simply that - a choice that addresses many of the health insurance issues and

challenges fac- ing m d peo- ple, Congress' decision will have significant consequences for nual Amer- ica, and we have much to gain or lose.

The potential strengths of public health insurance plans a what many rural people

By Elid* W k y Smith Medi.urd Oumrh

report exam- ines some of the arguments for a public hedth insurance plan, how the plan w d d address the health care challenges that exist for rival areas, and, ul- timately, the choice why of

a public health insurance plan option is need-

barriers faced by rural people, and businesses ed for rurat families and businesses. need-stability and cqtcontroIs America

Whether or not to include a while providing health insur- View the report at: http:// public hedth insurance plan in anceaccess to vulnerable popu- fdes.cfra.m~public-plan. health care reform legislation lations like low and maderate- pdf.

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Our current health care sys- tem is crushing farmers. And the proposals under considera- tion in Congress won't give us the relief we need. Farmers often depend on off - h jobs to provide health insuance, if we can find them. But this takes us away from our calling. And anyway, those jobs are vanishing, and those that remain are cutting their health care benefits.

Oh, we can try to find indi- vidual coverage, but the price is exorbitant, with extremely high deductibles.

Farmers have few options for health insurance, yet we des- perately need comprehemsive coverage. Farming is one of the most dangerous occupations in America: heavy machinery, laxge animals, long hours in the sun and exposure to hazardous pesticides can all take their toll. Many of us have pre-existing

conditions and we are nearing an average age of 9 years. Rural residents are twice as

likely to be uninsured as urban Americans, while farmers and ranchers are four times as likely to be underinsured, notes the Center for Rutal Affairs.

Mefhbers of Congress are expending plenty of energy but have little of substance to show for it. House Democrats exulted

over their 1,018-page health care reform bill. "It is really his- toric. It's transformation. It's momentous:, Speaker Nancy Pelosi said.

The best part of the bill is an

amendment by Rep. Dennis Kucinich, D-Ohio, that would allow states to experiment with their own single-payer health care plans without being penal- ized by the federal government for doing so.

But that's not likely to fly in the Senate.

There, single payer is a non- starter, probably even at the . m e n t a l state level.

Sen. Max,Baucus, D- Mont., says single-sayer health care "is off the table!' It is especially galling that Baucus, from such a rural state, one that would ben- efit most from a single-payer plan, is opposed to any discus - sion.

It's also distressing that President Obarna has distanced himself from single payer as fast as he could, even though a February CNN poll showed 72 percent favored a government - controlled plan. Any issue with that much across-the-board support should be "on the table!' The insurance cornpa- nies, in hopes of killing single payer, say they are willing to cover those with "pre-existing conditions" - provided every- one buys their health insurance.

They're licking their chops at signing up an additional 46 mil- lion people, under orders of the government. Of course, they could still deny payment of claims; they're very good at that.

Still, they say, "Tntst us!' Trust an industry that emplays an army of claims deniers and other administrative personnel whose numbers have grown 25 times faster than the number of physicians in the United States

- - - - - - -I

aver the past 30 years? Despite the House action, we are no closer to health care reform today.

The Senate may strip the public option from the bill.

Without a public option, muchlesswithoutsinglepayer, hmers and the self-employed would be, at best, underinsured - or fined for not having private insurance.

Some Americans lack d- dence in the government's abili- ty to administer a public health insurance plan. But it's been doing a pretty good job with Medicare and Medicaid.

Just ask an elde~ly person. Or someone with a disability.

We can't keep falling for that same old line from the insurance industry and the pharmaceuti- cal industry. They peddle it for a reason: It keeps them mlliug in profits - and keeps us at their mercy.

There are roughly 46 million uninsured and 25 million under- insured in America, many of whom are farmers.

We know when we're being swindled.

And we're being swindled right now.

Jim Goodman is a fanner from Wonewoc, Wis., and a WK ~ellogg7L47TJ~ood and Society Policy Fellow. The writer wrote thls for Progressive Media hoject; it is aftllhted with The Progressive magazine. Readers may write to the author at: Progressive Media Project, 409 East Main Street, Madison, Wis. 53703; e- mail: pmproj@progTessive.org; Web site: www.progressive. org.

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The Date Tuesday, August 04,2009 L ~ ~ a t ~ ~ n FOSSTON, MN C,rculat~on (OMA) 9.000 (1 19) Type (~re~uency) : . ~ e w s ~ a ~ & r (W)

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Rural America Needs A Public Health Insurance pian

Ehsho G I w I ~ .Y///i/h, rlish~~.~@!frt~.o~;q, C > ~ ~ / r r / i , r & ~ n ~ l . ~ ! f i ~ i r s Thc current he:tltli iiisur- decision will Iiarc sipificant

ancc systcm does not \vork consequences for rural hmer- ncll for mnny rural peoplc and ica, and \vc haw rnucli ro gain busincsscs. Thcy ply too rnucli or losc. for too littlc coverage and too The potential strengths of littIe p;acc o f mind. Health puhlic licnlth insurance plans carc reform that is bascd on arc \vh:tt rn;tn!. rural people the currcnt system does Little and b u s ~ c s s c s nc-ctl-stability to address thc unique issues nnd cost controls while pro- faced by many ructl pcople. viding health insurancc nccrss W h y should rural people be t o vulncr;iblc populations like satisfied with maintaining a lo\\- i~ntl moder:lte-income system that does not \wrk fnmilies, small business for millions o f them \x-ithout cmploycrs and employees and significant reforms? A public the self-t-mployed. 11 rcccnt hcalth insurancc plan option is siinpl!* that - a choicc that report esamines somc of thc- addresses man!. of the health arguments for a public health insurancc issues and barriers insurnnce plnn, how thc plan faced by rural pec)pIe, families \vould addrcss the Iienlth and busincsscs care clinllcnges that csist for

Whethcr o r not to inclutle rural arcas, and, ultirnatrl!; a public health insurancc plan \vhy the choice of n public in health carc reform legisla- health insurance plan option tion as an option for individu- is nredecl for rural America. als, familics and businesses is ir\r the report at: http:// a crucial dccision. \\'it11 the filcs.cfra.org/pdf/publicplnn. many hcnlth care chalIcnges pdf facing rural people, Congress'

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Fight for us by passing

health reform this vear

E very Nebraskan knows someone who fights for their life while fighting insur- Jim, a Nebraskan who has farmed his entire ante, or who a small business and life; needs Sens. Nelson and Mike Johanns to fights to pay insurance prem,ums, or fight for him. Jim is already spending half of his

who sim,,lv fights to get insurance coverage. income . - on health insurance for himself and his ~ebraaganLhave hLard from

both of our U.S. senators about the critical need to fix the bro- ken system. Recent reports doc- ument the urgency to pass health care reform and what the cost of

Nebraska View

wife. Bonnie and her husband, two professionals

who were laid off, kave been denied coverage by private insurance because of their pre-exist- ing conditions. They cannot afford the state's CHIP insurance program of last resort. They are

- ....

keeping the status quo represents: now uninsured.

Families USA reports more than 220 Rodney, a fork-lift operator from Omaha, was

Nebraskans are losing health insurance every diagnosed with cancer.

week because of rising premiums, and ended his health insurance a year after he was diagnosed, leading to significant out-of-pocket

Nebraokms die every year do bills. Unfonunualy, R e y lost his have 'Overage. This is On top of the more battle with and the debt from his treat- than 200*000 who have ment remains a burden for his wife and s,,+ ance.

The Center issued a report from Small Business Majority, which found that 63 percent of Nebraska's small businesses. including our farms and ranches. believe reform is important to getting the economy back on track. Additionally, 82 percent of businesses not offering health insurance say they can't afford to or are really struggling to do so.

SEIU and Nebraska Appleseed report your average Nebraska family spends more than $14,000 on health insurance and that cost goes up at least $1.500 each year.

AARP reports that 31.534 Nebraskans

ter. Affordable health insurance must cover what

Nebraskans need to keep them healthy, provide adequate coverage when they need it, and pro- tect them from out-of-control costs.

Several committees in Congress have been working to find the most helpful and productive policies for reform. The House reform bill con- tains several significant policy reforms that will bring us closer to a system that works for ail Nebraskans.

It's time to get gtmd policy in place for Nebraska's farmers. ranchers, families and busi- ..h.."a"

between 50-64 are uninsured. and people on """=" We urge Johanns and Nelson to work toward Medicare are spending about 30 percent of their comprehensive that ensures all incomes On health Nebraskans have the health care they need and If we do nothing to reform. the Robert Wood can afford. It.s time to pass health cate Johnson Foundation estimates health costs for +,.:- ..---

families, individuais and businesses doubling ""' yGa'

Commentary submitted by: AARP Nebraska, American Over the and the rate of the Cancer Society, Cancer Action Neiwork, Nebraska Center for sured going up to 40 percent of Americans. Rural Affairs, Nebraska Appleseed, Center for Law in the

Ail of these are critical numbers, but we also Public Interest Nebraska Alliance for Healthcare Reform, have stories from our neighbors who make this Nebraska Heallh Care for America Now and SElU Change

issue real and who remind us why it's time for That Works Nebraska.

Universal Information Services , Inc. http://news.universaI-info.com Profih: Ill - Center for Rurd A l t s i Recipimt: John Crsbbw

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GRAND ISLAND. Nebraska

Thursday, August 6,2009 , ,. Date: Frequency: DAILY Circulation: 22792 Clip Size: 48.48 sq. inches 1 +g&jj *TI *

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c C o ~ n & t 2009 \All RngMsRes~~sd

Nebraskans show why health By Jane Kkeb and David Holmquirt

This oped was submitted by the following organizations and repre- sents their position on the health care refom issue: AARP Nebraska, American Cancer Soctety Cancer Action Network Nebrasku, Center or f i~ml&kirs , Nebraska App 4 Center for Law in the Public Interest, Nebmska Alliance for Haalthcare Re-, Nebmka Health Care for Americu Now, Sh'IU Change That Works Nebraska.

As our Senators prepare to come back home for the August recess, we ask them to fight for us-every Nebraskan knows someone who fights for their life while fighting insurance, or someone who runs a small business and fights to pay the increasing premiums, or someone who simply fights to get insurance coverage. It's time our Senators fight for Nebraskans; it's time to pass healthcare reform this year.

Over the past few months. ~ebraskans-have heard fkom both Senators about the critical need to fix the broken system, including Senator Nelson's bi- artisan letter this month stating & is 'Wmly committed to enactment of compre hensive reform this year."

We want to remind our Senators that we need their leadership to pass healthcare reform this year. We need them to fight for us.

Recent reports document the urgency to pass healthcare reform and what the cost of keeping the status quo represents:

Families USA reports over 220 Nebraskans are losing health insurance every week because of the rising cost of health insurance premiums, and 100 Nebraskans die every year because they do not have health coverage-this is on top of the

over 200,000 Nebraskans who currently have no insurance.

H The Cen- issued a report fkom Small Business Majority which found that 63% of Nebraska's small businesses- including our farms and ranches- believe healthcare reform is impor- tant to getting the economy back on track. Additional& 82% of busi- nesses not offering health insurance say they can't afford to or are really struggling to do so.

SEIU an NE Appleseed report W your average ebraskan family currently spends more than $14,000 on health insurance and that cost goes up at least $1,500 each year.

H AARP reports that 31.534 Nebraskans between 50-64 are uninsured and people on Medicare are spending about 30% of their incomes on out-of-pocket health care expenses.

If we do nothing to reform the system, the Robert Wood Johnson Foundation estimates, health costs for families, individuals and busi- nesses doubling over the next 10 years and the rate of the uninsured going up to 40% of Americans.

W of these are critical num- bers-but we atso-Im- storks 5 m our neighbors who make this issue real and who remind us why it's time for reform now.

Jim, a fellow Nebraskan who has farmed his entire life needs Senator Nelson and Johanns to fight for him. Jim is already spending half of his income on health insurance for himself and his wife.

Bonnie and her husband, two professionals who were laid off, have been denied coverage by private insurance because of their pre- existing cdnditions, nor can they afford the state's CHIP insurance program of last resort. They are now among the state's uninsured

reform needed population.

Rodney, a fork-lift operator from Omaha, was diagnosed with cancer. Rodney's employer ended his health insurance a year after he was diagnosed leading to significant out- of-pocket medical bills. Unfortu- nately, Rodney lost his battle with cancer and the debt from his treat- ment still remains a burden for his wife and sister. The American Cancer Society Cancer Action Network al l too often hears stories like Rodney's demonstrating the need for health care reform.

Affordable health insurance must cover what Nebraskans need to keep them healthy, provide adequate coverage when they need it, and protect them from out of control costs.

Several committees in Congress have been working diligently for over a year to find the most helpful and productive policies for reform. The House health care reform bill contains several significant policy reforms that will bring us closer to a health care system that works for all Nebraskans.

It's time to put good politics to work to get good policy .in place for Nebraska's-farmers, ranchers. families, and businesses throughout our rural and urban communities.

We urge both Senators Johanns and Nelson to work towards compre- hensive reform that ensures all Nebraskans have the health care they need at a cost they can afford. Above al l else, we ask the Senators to fight for us. It's time to pass health care reform this year.

Jane Kleeb Is the Hebraska state director for the Sewlce Employees International Union. DavM Holmqubt is the Nebraska govermnent relations director for the Amerkan Cancer Soclety.

Universal Information Services , Inc. http://news.universaI-info.com P r o k Ill - Center for R u d AMis Recipbnt: John CmWw

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