America’s farmers have been hit especially hard with the Jan. 1 expiration of the tax credits that made the Affordable Care Act’s health insurance plans more affordable. Senate negotiations this month over reviving the subsidies have fizzled out, and local farmers — most of whom don’t have access to employer-sponsored health care plans — are being forced to find other ways to make a living.
“We don’t have a corporate job,” Liz Krug, the owner of Endless Roots Farm in Waverly, Pennsylvania, told MS NOW. “Both my husband and I work full time on the farm. This is how we make our income, and the ACA tax credits made that possible.”
Krug and her husband run one of nearly two million small family-owned farms in the country. They love what they do, and see their work as essential to the survival of the communities around them. Now, as their affordable health care options dwindle, they face tough questions about their own well-being.
“Community by community, we are feeding our nation,” Krug said of small farms. At the moment, her family’s health care costs add up to about 8% of their income. She said that without subsidies, the new costs could increase to as much as 50% of her family’s income.
“We have two kids,” she said. “If we don’t have health insurance, it makes me very nervous.”
Congress allowed the ACA tax credits to expire on Jan. 1 following a historic 43-day government shutdown. Days later, the House passed a bill to extend the tax credits — but there’s been little to no action in the Senate on solidifying the extension. Earlier this month, Sen. Bernie Moreno, R-Ohio, said negotiations on a bipartisan deal are “effectively over,” according to The Wall Street Journal.
There’s already a dwindling number of farmers in the U.S., but Vanessa Garcia Polanco, the director of government relations for the National Young Farmers Coalition, told MS NOW that Congress’ failure to restore the tax credits would push even more farmers away.
“Farmers are more likely to get injured, and they need more resources to stay healthy because their job is so physically demanding and so active,” Garcia Polanco said. “So by just removing that layer of safety net that the cost of that Affordable Care Act was providing, it definitely undermines their operations, their livelihoods and their ability to stay farming.”
Farmers are not the only Americans struggling since Jan. 1. An estimated 24 million Americans received health care coverage through the ACA’s health insurance marketplace in 2025, and most of them were able to afford those plans because of the subsidies.
According to a Jan. 29 KFF poll, 67% of Americans think Congress was wrong not to extend the tax credits, and 66% reported worry over rising costs of health care.
Sisile Maruzzelli, the head chef at Bailey’s Cafe in Dalton, Pennsylvania, sources many of her ingredients from local farmers, including Krug’s Endless Roots Farm.
She told MS NOW that she hates to imagine those farmers quitting because they can’t afford health care.
“It’s scary honestly because we rely on those people, and they are the foundation of everything that we do here. So without them, we aren’t able to do what we need to,” Maruzzelli said.
Krug said leaving the industry would be heartbreaking, but the concept remains on the table.
“Our options were not having health insurance, getting catastrophic health insurance — which is really not covering any sort of proactive health care — and then one of us getting an off-farm job,” she told MS NOW.
She went on to say, “We got into this knowing that this is not a big income job, but it was enough to sustain our family, enough to make a living off of. But we want to make sure that we can still feed our community, make sure that we’re stewarding this land, and really one of the only options to do that is through the ACA tax credits.”
CORRECTION (Feb. 11, 2025, 8:04 p.m. ET): A previous version of this article misspelled the name of the head chef at Bailey’s Cafe in Dalton, Pennsylvania. The head chef’s name is Sisile Maruzzelli.
Maya Eaglin is a reporter for MS NOW.