Nonprofits are helping musicians pay for insurance in Austin, Texas, and beyond

Austin’s Musicians Found a Way to Stay Insured When the Market Failed Them

Ecorescuezone.com – Texas carries the highest uninsured rate of any state in the country. As of 2024, roughly 19 percent of residents under age 64 had no health coverage at all — a figure that makes the state a national outlier and a persistent headache for anyone trying to build a safety net for working people. For the city that brands itself “the Live Music Capital of the World,” the gap hits a particular demographic hard: the performers whose nightly sets generate tourism dollars and cultural identity for Austin but who often earn too little to absorb the cost of a marketplace plan.

The answer, at least locally, has been a nonprofit called the Health Alliance for Austin Musicians, or HAAM. Operating for more than a decade — through the coronavirus pandemic and beyond — the organization now subsidizes monthly insurance premiums for local musicians who buy plans through the Affordable Care Act marketplace. The program, which costs approximately $4 million to run, has become a dependable financial pillar for the city’s performing-arts community.

From Gig Economy to Coverage

Zack Morgan, a funk keyboardist who once split his days between a tech office and a stage, described losing his corporate position in 2015 as feeling “like being pushed off a cliff.” For years he had played both sides of what he called the Austin coin — tech worker by day, musician by night. When the corporate paycheck vanished, the question became immediate and practical.

“Maybe this is my sign to try the full-time music thing,” Morgan recalled thinking. “Step one in that was: Get health insurance again.”

Morgan had been surviving on a patchwork of band gigs. To keep himself covered, he turned to HAAM. The organization’s intervention meant he could maintain a marketplace plan without the premium consuming his entire income.

“That’s part of being able to make this whole thing work,” Morgan said.

How the Subsidy Mechanism Works

HAAM does not operate its own insurance product. Instead, it partners with Central Health, the public hospital district for Travis County — the Texas agency charged with using tax dollars to fund safety-net healthcare for low-income residents. Central Health also runs the nonprofit Sendero Health Plans, which sells marketplace insurance to Travis County residents.

Under the arrangement, HAAM members must enroll in one of Sendero’s silver-level, or benchmark, plans. If a member’s income falls between one and two times the federal poverty level, Central Health covers the remaining monthly premium after federal tax credits have been applied. In practice, many performing artists end up paying zero dollars toward their monthly bill. For members whose income sits above that band, HAAM steps in with a more limited subsidy, absorbing 50 percent of the premium balance.

The financial logic is straightforward. Rachel Blair, HAAM’s chief strategy officer, noted that the average member earns around $30,000 a year.

“When you think about the average HAAM member making about $30,000 a year, there’s no way that they would be able to spend a third of their income on healthcare,” Blair said.

Growth and Impact

Since HAAM began offering premium assistance, its membership has swelled by 77 percent to more than 3,300 people. Over 90 percent of those members are now insured — a dramatic reversal from the pre-ACA era, when roughly 85 percent of HAAM’s roster remained without coverage, leaving artists exposed whenever they traveled to gigs in other cities or states.

Before the ACA marketplace opened in 2014, HAAM had already spent a decade connecting musicians with free and low-cost care at clinics and hospitals around Austin. But that patchwork could not follow an artist across state lines or cover the full spectrum of medical needs.

“When the Affordable Care Act came out and we knew it was here to stay, it really made sense for us to start getting our musicians fully insured,” Blair said.

A National Backdrop of Shrinking Coverage

The program’s relevance has sharpened in recent months. After Congress failed to extend the pandemic-era premium subsidies that had temporarily lowered marketplace costs, premiums spiked across many ACA plans. A recent report found that approximately 5 million people nationwide dropped their coverage in the wake of that policy lapse. HAAM’s direct premium support helped blunt the blow for its members, insulating them from the full force of the price jump.

The organization has since emerged as a potential model for other cities that want to make healthcare more affordable for key populations and industries — particularly those whose economic contributions are culturally vital but financially precarious.

Denton and the Wider Pattern

In 2017, HAAM helped launch a parallel program in Denton, a college town north of Dallas that has produced successful musicians ranging from Meat Loaf to Norah Jones. The Denton Music and Arts Collaborative operates differently: it connects members with an independent insurance agent who helps them identify the best plan for their individual needs, then provides a flat monthly subsidy of $100.

Similar nonprofits in Seattle, New Orleans, and Nashville have long helped musicians navigate the sometimes labyrinthine enrollment process for online marketplaces. Most of those groups, however, stopped short of directly subsidizing premiums. HAAM’s team recognized that without direct financial support toward the premium itself, many members earning modest gig incomes would still struggle to retain coverage month to month.

The distinction matters. Enrollment assistance solves the paperwork problem; premium subsidies solve the affordability problem. For a community of working artists whose annual income hovers near $30,000, the latter is the difference between staying insured and sliding back into the uninsured majority that defines Texas’s national record.