DUNN, N.C. — Some seasonal agricultural workers were finishing a meal after a long day of planting sweet potato seeds when Julie Pittman pulled into their camp.

Up since dawn, they had worked through an 80-degree day that was just beginning to cool off. Now, Pittman, a paralegal with the Farmworker Unit of Legal Aid of North Carolina, wanted to get their attention.

The health care law passed in 2010 requires you to have health insurance, she told them in Spanish. If you don't get it, she said, you could be fined.

“Cuanto cuesta?” said one worker, wanting to know the cost.

These farmworkers, living in the United States legally through the H-2A visa program, must be insured, like most U.S. citizens and legal residents. But reaching them is an uphill battle. They live in cinder block homes built by employers in isolated areas. They work long days and often a full week.

The majority of them come from Mexico to work in Florida, Georgia and North Carolina. The countdown clock starts when they enter the country. They have 60 days to learn about coinsurance and copayments and decide whether to purchase a high- or low-deductible plan.

Alexis Guild, a migrant health policy analyst at Farmworker Justice, an advocacy group based in Washington, D.C., said North Carolina has been “very successful” in enrolling H-2A farmworkers, thanks to a yearslong partnership among various nonprofits and health centers.

In the camp near Dunn, about one-third of the 31 residents showed up for Pittman's presentation, gathering in a small dining room with two picnic tables and cement floors.

The cost of health insurance depends on the type purchased, income and family size, Pittman told them. Some people don't have monthly payments; others could pay $40 per month. Consider, she added, that this year's fine is $695 or 2 percent of wages, whichever is greater.

Antonio Flores, of Veracruz, said he worried about the cost. He is in the U.S. for six months and has a wife and son to support. Like other farmworkers based in North Carolina, he makes $10.72 per hour

“Would I need to pay the fine?” said Flores, 29.

It's a difficult question because some workers qualify for an exemption or are offered insurance through their employers.

Mackenzie Mann, a health educator with the North Carolina Farmworkers' Project, said the only way to be sure is to fill out a form.

On a recent Wednesday, Mann and a co-worker traveled through a narrow road to a camp in Angier, where workers were waiting for them with insurance letters and payment questions.

On its way to surpass last year's enrollment totals, the group has signed up about 150 workers since February with two months left to go.

Workers under the H-2A visa program are a small minority of the nation's more than 2.4 million farmworkers, many of whom are in the country illegally and don't have access to health insurance.

Agriculture ranks among the most dangerous industries, according to the Occupational Safety and Health Administration. Farmworkers face exposure to pesticides, and they risk heat exhaustion and heatstroke.

Outside of emergencies, farmworkers can use community health centers, which receive federal funding to care for the poor and uninsured. In North Carolina, about 10 percent of the centers' more than 450,000 patients in 2014 were agricultural workers.

Dr. Eugene Maynard of the Benson Area Medical Center said providing care to farmworkers is a challenge. Many procedures can be done at his office, where prices are based on a sliding fee scale. But some problems require specialists, whose steep prices are out of the reach of most workers.

Often, Maynard said, he places workers on waiting lists for charity care, but they are so long that workers return to Mexico before seeing a specialist. “Insurance makes that process a lot easier,” Maynard said.

Alice Pollard of the North Carolina Community Health Center Association said access to health insurance also opens the door to preventive care for, say, diabetes and high blood pressure, chronic conditions prevalent among farmworkers.

Some are skeptical, though, that improved access to health insurance would translate into better health care.

Thomas Arcury, director of the Center for Worker Health at Wake Forest Baptist Medical Center, said farmworkers work long hours, don't have access to transportation or accumulate paid sick days, which is why many ignore their illnesses.

What's more, if they purchase insurance in one state and then move to another, the insurance may not work in the new state.

Employers with large farms are required to offer insurance to their workers. They have raised the issue of cost, arguing that they already provide workers' compensation, which covers work-related injuries.

Rep. Renee Ellmers, R-N.C., has twice introduced a bill to exclude farmworkers under the H-2A visa program from the employer mandate. In a statement, she said the cost would put many farmers out of business.

Steve Davis of Greene County Health Care, a community health center that enrolled nearly 800 workers last year, said most farmworkers know of employees who were injured in a soccer game or got violently ill while in the U.S. and landed in the emergency room.

Last October, Feliciano Gonzalez was picking sweet potatoes when he felt an unbearable pain in his arm and chest. In his 17 years picking and planting food in the U.S., Gonzalez, 50, said he never felt so sick.

He underwent a number of tests in the emergency room. Doctors kept him overnight, he said.

The hospital billed him $14,900. It wasn't a work injury, so his workers' compensation insurance didn't cover the expense. Luckily, Gonzalez had health insurance. His portion of the bill was $750.

“We need to be protected,” Gonzalez said.