As farmers prepare for spring planting, a growing number are faced with some difficult choices - a poor farm economy and a health insurance industry in upheaval.

Gary Wertish, the recently elected president of the Minnesota Farmers Union, is traveling the state, conducting listening sessions to hear the concerns of rural Minnesotans, including a stop in Alexandria on Thursday.

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He said health care has been the No. 1 theme at the meetings, both for farmers and non-farmers.

The farm economy has been weak the past couple of years and for those with no off-farm employment to provide access to group insurance, it is especially problematic.

"The bank tells you to cut expenses," Wertish said in an interview after the meeting. But when farmers look at their operations, not willing or able to cut back on inputs such as fuel, fertilizer or herbicide, "the only thing left not giving a positive return is health care insurance."

Health insurance has gotten more expensive and harder to find in Minnesota, especially after Blue Cross and Blue Shield dropped out of the individual policy market through MNsure.

"The individual marketplace is the one that got hit so hard," Wertish said.

That is leaving some farmers running at the risk of dropping insurance and hoping they don't get sick in order to keep farming.

But Wertish, who farms in Renville County, said farmers tend to be optimistic people.

"We're still going to plant that crop."

He added, however, that the ag industry is "very close to being a serious crisis."

With a surplus of supply and access to operating loans getting harder to come by, "it all doesn't look very good right now."

"Some people are going to be forced out."

The meeting drew about 40 people from around the region and included Emily Piper, Minnesota's commissioner of human services and representatives from Minnesota's U.S. senators and Congressman Collin Peterson.

People asked questions or expressed concerns about a variety of issues, including long-term care insurance, the challenges facing young farmers, the bureaucracy involved in signing up for medical assistance and providing rides for patients on medical assistance.

Wertish said other issues that have come up around the state include ditch mowing, buffer strips along waterways, broadband internet access and property taxes.

"It's been a really broad spectrum of issues."