California’s farmers and ranchers are struggling with health care bills that, in some instances, threaten the viability of their family businesses, according to a report Wednesday by the Access Project and funded by the California Endowment.

The report finds that while almost all farm and ranch operators have health insurance, one in five says that California insurance premiums and other out-of-pocket health care costs are causing financial difficulties for themselves and their families.

These families report spending 37 percent of their income on health care coverage and medical costs.

“A better term for health insurance that leaves nearly one in five purchasers in financial jeopardy might be called ‘product failure’,” says Carol Pryor, a report author and policy director for the Access Project.

The survey also found that more than three in 10 farmers and ranchers (31 percent) are spending at least 10 percent of their annual income on health insurance premiums, prescriptions and other out-of-pocket medical costs. Spending this much on health care is a commonly used indicator of financially burdensome health care costs, the report’s authors say.

Farm and ranch operators are especially hard hit because they are often forced to buy insurance on the individual, non-group market, where insurance generally costs more and covers less, says the report.

The study shows that on average, those farmers and ranchers purchasing insurance in the non-group market spent almost twice as much on health care as those who got their health care coverage through off-farm or off-ranch employment. The median amount spent by farmers and ranchers who got insurance on the non-group market was $8,500 a year (including premiums and out-of-pocket costs), compared to $4,630 spent by people who got insurance through employment off the farm or ranch.

Three in 10 of the study’s respondents purchased health coverage directly on the open market. Nationally, only 8 percent of Americans obtain their health insurance this way.

“Right now farmers are faced with increasing costs for everything – fuel, feed, fertilizer. Adding exorbitant health care costs on top of these expenses is simply not sustainable and threatens the viability of family farm operations,” says Lynn McBride, director of the California Farmer’s Union.

One-fourth of those surveyed (26 percent) report having to draw on other financial resources to cover the costs of care. Of these respondents, 70 percent dipped into family savings and nearly one in three (29 percent) incurred credit card debt or increased existing debt. Others took out a loan, borrowed against their farm, withdrew money from a retirement account or turned to friends and family for help.