1. Short title This Act may be cited as the Rural Health Insurance Act of 2018 . 2. Supporting agricultural association health plans (a) In general The Secretary of Agriculture may establish a loan program and a grant program to assist in the establishment of agricultural association health plans, in order to help bring new health options and lower priced health care coverage to rural Americans. (b) Loans (1) In general With respect to plan years 2019 through 2022, the Secretary of Agriculture, in consultation with the Secretary of Labor, may make not more than 10 loans under this section, for purposes of establishing agricultural association health plans, to qualified agricultural associations that have not received a loan under this section. (2) Use of funds The proceeds of a loan made under this section may only be used to finance costs associated with establishing and carrying out an agricultural association health plan. (3) Loan terms A loan made under this section shall— (A) bear interest at an annual rate equivalent to the cost of borrowing to the Department of the Treasury for obligations of comparable maturities; (B) have a term of such length, not exceeding 20 years, as the borrower may request; (C) be in an amount not to exceed $15,000,000; (D) require that the borrower submit annual audited financial statements to the Secretary