We estimate farmers' health care consumption given their insurance status, explicitly taking into account the possible endogeneity of insurance. Data come from the 1996–2001 waves of the Medical Expenditure Panel Survey conducted by the Agency for Healthcare Research and Quality. Results show that farmers have problems accessing affordable health insurance coverage, and these access problems lead to an overall reduction in the utilization of health care services by uninsured farmers. After controlling for selection, we observe quantitatively large and statistically significant direct effects of uninsurance on the utilization of health care services.