Zack Morgan, a keyboardist for various bands in Austin, Texas, turned to full-time music in 2015 after losing his corporate job. A longtime tech worker by day and musician by night, he decided it was time to pursue music full-time. Getting health insurance was a priority.
Austin labels itself as ‘the Live Music Capital of the World,’ yet many artists struggle with the high cost of living. Morgan made ends meet by playing with several bands and looked to the nonprofit Health Alliance for Austin Musicians (HAAM) for health insurance support.
“That’s part of being able to make this whole thing work,” Morgan mentioned, referring to HAAM, which subsidizes insurance premiums for musicians through the Affordable Care Act (ACA) marketplace.
The program, which costs around $4 million annually, is funded in part by Central Health, an agency helping low-income Austin residents. Many musicians pay nothing toward their premiums. This assistance has been vital for the music community, especially amid rising premiums following the expiration of pandemic-era subsidies. HAAM helped stabilize its members amidst national coverage drops.
Expanding Healthcare Access for Musicians
Texas holds the highest uninsured rate among U.S. states. Before the ACA, HAAM already connected musicians with affordable healthcare. Despite this, 85% of members remained uninsured, leaving them vulnerable when traveling for gigs. With the ACA, HAAM aimed to insure its musicians fully.
Similar efforts exist in cities like Seattle and Nashville, where nonprofits help musicians with medical care. However, direct support for premiums remains uncommon. In Austin, the average HAAM member earns about $30,000 annually, making hefty healthcare costs unaffordable without subsidies.
Growing Membership and Support
Membership has grown by 77% since HAAM began funding insurance premiums, with over 90% now insured. Central Health, which runs Travis County’s public hospital district, works with HAAM to offset costs. Qualified HAAM members join Sendero Health’s silver-level plans. Federal tax credits lessen costs for lower-income members, while HAAM covers up to half of remaining balances for others.
In 2017, HAAM inspired a similar program in Denton, Texas. The Denton Music and Arts Collaborative provides a $100 monthly subsidy to members, supporting the local music culture.
Challenges and Future Outlook
While HAAM’s partnership has been effective, premium costs increased 58% for 2026 plans. Sendero Health also raised rates due to rising medical costs, and federal tax credits diminished, tightening budgets for many members. Despite increased fundraising efforts, HAAM couldn’t cover all requests for help.
For Austin’s poorest residents, HAAM and Central Health created alternatives since many fall below the federal poverty level without Medicaid access. Central Health’s Medical Access Program provides a solution, though not as beneficial as expanded Medicaid.
“It’s not a very sustainable solution, especially when there’s a really good alternative,” said Rachel Blair, HAAM’s chief strategy officer.