Residents living in more than half of the nation’s counties have only one insurer to choose from on their state’s Affordable Care Act health insurance exchange. This lack of options is most prevalent in rural areas: 41 percent of enrollees in non-metro counties vs. the overall rate of 21 percent, according to the Kaiser Family Foundation.Could the creation of agricultural cooperative health plans help fill insurance gaps, offer more choices for consumers and lower costs? Minnesota lawmakers hope so, and their passage of SF 1 in 2017 marked the start of that state’s policy experiment with this type of health insurance option. “Farmers can join together in self-insured plans like those used by large employers,” explains Rep. Tim Miller, who helped guide the legislation through the House. By the start of this year, two agriculture cooperatives, 40 Square and Land O’ Lakes, had jumped into the market and enrolled more than 1,700 people.