JUANA SUMMERS, HOST:
Since the '90s, Austin, Texas, has proudly billed itself as the live music capital of the world, but Austin is no longer the affordable college town that it was back then. Many musicians now struggle to make ends meet. As Olivia Aldridge at KUT in Austin explains, an advocacy group helps them get and pay for insurance, even as healthcare costs keep rising.
ZACK MORGAN: Yeah. What's up, everybody? How are we doing?
(CHEERING)
OLIVIA ALDRIDGE, BYLINE: Zack Morgan is a funk keyboardist in Austin. These days, he's pretty established. He plays with a bunch of bands around town. He's 38 and married and thinking about having a kid. But to get started on this path, he needed a big push. That came in 2015 when he lost his job in tech.
MORGAN: I was like, OK, well, maybe this is my sign to try the full-time music thing. Step one, and that was, like, get health insurance again.
ALDRIDGE: Coming from the corporate world, it was intimidating to think about figuring out health benefits on his own. He found help from the nonprofit Health Alliance for Austin Musicians, or HAAM.
MORGAN: That's part of being able to make this whole thing work, I think.
ALDRIDGE: HAAM subsidizes the monthly insurance premiums for thousands of musicians who buy plans through the Affordable Care Act marketplace. They partner with Central Health, a public agency that provides healthcare resources for low-income residents of Austin and surrounding Travis County. Together, they plan to spend about $4 million on the program this year. Rachel Blair is chief strategy officer for HAAM.
RACHEL BLAIR: 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.
ALDRIDGE: Here's how it's worked for the past decade. HAAM members enroll in one of the plans that Central Health offers on the marketplace, and if they fall within a certain income range, they'll get a federal subsidy for part of the monthly premium. Central Health covers the rest. Musicians who don't quite fit in the income criteria, maybe because they make a little more, can still get about half their premium costs covered directly by HAAM. Blair says musicians who are insured are healthier and they don't have to worry as much about falling ill or getting in an accident while on the road.
BLAIR: That chronic stress erodes our health. It impacts creativity. I impacts a willingness to take a risk, to go out and be a creative entrepreneur, to be a musician, to put yourself out there in a very physical way.
ALDRIDGE: HAAM's work has become a model for other cities that have live music scenes. Some of them, like New Orleans and Nashville, also have programs for getting musicians healthcare. In Texas, HAAM helped launch a similar program in Denton. That's where the University of North Texas has its top-rated music and art schools. Roy Orbison, Norah Jones, Meat Loaf and others got their start in Denton.
JENNIFER KAPINOS: There's a very long history of jazz, weird art rock. The visual arts community here is very strong.
ALDRIDGE: That's Jennifer Kapinos, president of the Denton Music and Arts Collaborative. They want local musicians and artists to stick around.
KAPINOS: More and more people were maybe graduating college and leaving and going to find better opportunities other places.
ALDRIDGE: The Denton group offers a subsidy of a hundred dollars a month to help local musicians and artists buy insurance. Back in Austin, the restaurant industry is another important part of the local economy. Central Health just started another partnership like HAAM's to help ensure waiters, cooks and other food workers. Kit Abney-Spelce with Central Health says they like to work with specific industries that already have networks they can tap.
KIT ABNEY-SPELCE: I think some people believe that, oh, if you just say it - like, hey, you know, free insurance for you - that people will just come, and that's not always the case.
ALDRIDGE: The model does have gaps. In most states, the very lowest-income people are covered by Medicaid, not the marketplace plans. But Texas is 1 of 10 states that did not expand Medicaid, so those people can't get coverage through either option. HAAM tries to help musicians in that situation get low-cost doctors appointments when they can.
And for people who do qualify, it's gotten more expensive. Insurance rates are rising everywhere, and Congress decided to cut back on subsidies for marketplace plans in 2026. Rachel Blair says HAAM has had to turn people away. The percentage of HAAM members who are insured dropped from 95 to 91% this year.
BLAIR: While it is a decrease, we feel really proud of being able to stay as high as we are, and we're working to get back as best we can.
ALDRIDGE: In September, HAAM will hold its yearly festival and fundraiser. Bands will play at grocery stores, parking lots, even on the steps of the Texas Capital, doing their part to raise enough money to help pay for their healthcare in 2027.
For NPR News, I'm Olivia Aldridge in Austin.
SUMMERS: This story comes from NPR's partnership with KUT and KFF Health News. Transcript provided by NPR, Copyright NPR.
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