Nonprofits are helping musicians pay for insurance in Austin, Texas, and beyond
August 23, 202612:15 PM ET
By
Olivia Aldridge
A nonprofit helps thousands of musicians in Austin pay for insurance
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Zack Morgan plays keyboard for a number of bands in Austin, Texas. He’s been a full-time musician since 2015.
Ysa Mendoza/KUT Newshide caption
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Ysa Mendoza/KUT News
Musician Zack Morgan jokes that when he lost his corporate job in 2015, it was like being pushed off a cliff. For years, he said, he’d been playing both sides of the Austin coin: tech worker by day, funk keyboardist by night
This story was produced in partnership with KFF Health News
“Maybe this is my sign to try the full-time music thing,” Morgan recalled thinking. “Step one in that was: Get health insurance again.”
Austin, Texas bills itself as “the Live Music Capital of the World,” but it can be unaffordable for the artists who provide the city with its cultural cachet — and help drive its tourism revenue
Morgan has supported himself by patching together gigs with a number of bands. To help pay for health insurance, he turned to a local nonprofit, the Health Alliance for Austin Musicians, or HAAM
“That’s part of being able to make this whole thing work,” Morgan said
HAAM subsidizes the monthly insurance premiums of local musicians who purchase plans through the Affordable Care Act marketplace
To fund the roughly $4 million program, it works with Central Health, a public agency that provides healthcare reCounty
Many of the performing artists pay $0 toward monthly premiums
After more than a decade, including through the coronavirus pandemic, the assistance program has become an established and reliable financial support for Austin’s musician community
Zack Morgan plays keyboard with pop singer Ruthie Craft at the Saxon Pub in Austin, Texas, on July 27.
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Ysa Mendoza/KUT News
This year, after Congress failed to extend pandemic-era subsidies, premiums skyrocketed for many ACA plans. A recent report found that 5 million people nationwide had dropped the coverage
HAAM helped blunt the impact for its members. It has emerged as a potential model for other cities hoping to make healthcare more affordable for key populations and industries
A growing idea
Texas had the highest uninsured rate among states, with 19% of people age 64 and under uninsured as of 2024
Even before the launch of the ACA marketplace in 2014, HAAM had spent a decade connecting musicians with free and low-cost care at clinics and hospitals in and around Austin
But roughly 85% of HAAM members remained uninsured, leaving them exposed when traveling to gigs in other cities and states
“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,” said Rachel Blair, HAAM’s chief strategy officer
Similar nonprofits in other U.S. cities with strong live music cultures, such as Seattle, New Orleans and Nashville, help musicians get medical care
With the advent of the ACA, some of these organizations began helping musicians navigate the sometimes complex enrollment process for the online marketplaces, though they stopped short of pitching in on premiums
But the team at HAAM recognized that without direct support to help pay premiums, many of their members would still struggle to retain coverage
“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
Austin-based Latin-folk singer Gina Chavez plays on the steps of the Texas Capitol in 2025 for the HAAM Day Music Festival, an annual fundraiser for the Health Alliance for Austin Musicians.
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Shunya Carroll/KUT News
The organization’s membership has grown by 77% to more than 3,300 people since HAAM began offering premium assistance, and more than 90% of members are now insured
To help subsidize costs for members, HAAM partnered with Central Health, which is Travis County’s public hospital district — a type of health agency in Texas charged with using tax dollars to fund safety-net healthcare for poor residents
Central Health also operates the nonprofit Sendero Health Plans, which offers marketplace insurance to Travis County residents
To qualify, HAAM members must enroll in one of Sendero’s silver-level, or benchmark, plans. If their income is between one and two times the federal poverty level, Central Health pays the balance of their monthly premium after federal tax credits have been applied
For members who fall above that income range, HAAM offers a more limited subsidy, covering 50% of their premium balances
In 2017, HAAM helped set up a similar program in Denton, a college town north of Dallas that has served as a testing ground for successful musicians, from Meat Loaf to Norah Jones
The Denton Music and Arts Collaborative works differently: It connects members with an independent insurance agent who helps them find the best health plan for their needs. The nonprofit then offers members a monthly subsidy of $100
The subsidies are a way of keeping Denton’s culture of jazz and “weird art rock” alive, said the collaborative’s president, Jennifer Kapinos
“More and more people were maybe graduating college and leaving and going to find better opportunities in other places,” Kapinos said
“People who had lived here a long time suddenly were finding it harder and harder to afford to be here.”
Each year, the Health Alliance for Austin Musicians hosts the HAAM Day Music Festival, its annual event to raise money to help local musicians afford insurance premiums and other healthcare services. Bands play in common spaces across the city, from grocery stores to the Texas Capitol steps. (Shunya Carroll/KUT News)
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Shunya Carroll/KUT News
In Austin, other sectors have been watching HAAM’s work. In 2025, Good Work Austin, a nonprofit that advocates for restaurant workers, launched a small pilot program with Central Health to help local food workers enroll in Sendero plans and cover their premiums
Kit Abney Spelce, vice president of operations for Central Health, said partnering with an advocacy group focused on a particular workforce is key because simply announcing “free insurance for you” doesn’t mean people will sign up
“We are very much dependent on our partner entity to go out and connect with the community, to have that relationship and that trust,” she said
Navigating federal headwinds
Though insurance premium payments often increase year over year, the 2026 plan year was particularly expensive, increasing by 58% on average
Citing medical and pharmacy costs, Sendero raised rates by an average of 16% for its enrollees
At the same time, Congress allowed the pandemic-era enhanced premium tax credits to expire, reducing the federal subsidies that many marketplace customers relied on
“Our premiums for our members went up 60% from one year to the next,” Blair said
HAAM stepped up its fundraising into 2026, but it wasn’t enough to cover everyone who requested assistance
They had to turn away hundreds of qualified people. Still, they were able to buffer existing members, said Spelce with Central Health
“We’re going to make sure their monthly premium is paid every month,” she said
A viable, if limited, assistance model
Beyond the eligible musicians they turned away in 2026, another population remains out of HAAM’s coverage reach for premium assistance: Austin’s poorest residents
Under the ACA, the marketplace plans that HAAM helps subsidize are for low- and middle-income earners, but the people with the very lowest incomes — below 100% of the federal poverty level, set at about $15,000 in Texas — are supposed to be covered by expanded Medicaid
But Texas is one of 10 states that chose not to expand Medicaid after the ACA became law, so many of the poorest Texans remain uncovered
With no federal subsidies available for that group, HAAM and Central Health have tried to develop separate solutions for this subpopulation
Central Health has its Medical Access Program, an alternative to health insurance that gives low-income, uninsured people access to a network of local care providers
HAAM has also established relationships with primary care providers to serve its uninsured musician members — but Blair acknowledges that it’s not an equivalent benefit to what Medicaid expansion would offer
“It’s not a very sustainable solution, especially when there’s a really good alternative,” Blair said
This story comes from NPR’s health reporting partnership withKUTandKFF Health News
- Health Alliance for Austin Musicians
- Affordable Care Act marketplace
- affordability crisis
