Zack Morgan performs keyboard for a quantity of bands in Austin, Texas. He’s been a full-time musician since 2015.

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Musician Zack Morgan jokes that when he lost his company job in 2015, it was like being pushed off a cliff. For years, he said, he’d been enjoying both sides of the Austin coin: tech employee by day, funk keyboardist by night time.

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

Austin, Texas payments itself as “the Live Music Capital of the World,” but it can be unaffordable for the artists who present the metropolis with its cultural cachet — and assist drive its tourism income.

Morgan has supported himself by patching collectively gigs with a quantity of bands. To assist pay for medical insurance, he turned to a native 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 month-to-month insurance coverage premiums of native musicians who buy plans through the Affordable Care Act market.

To fund the roughly $4 million program, it works with Central Health, a public company that gives healthcare sources for low-income residents of Austin and surrounding Travis County.

Many of the performing artists pay $0 toward month-to-month premiums.

After more than a decade, including through the coronavirus pandemic, the help program has become an established and dependable monetary support for Austin’s musician group.

Zack Morgan performs keyboard with pop singer Ruthie Craft at the Saxon Pub in Austin, Texas, on July 27.

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This 12 months, after Congress failed to lengthen pandemic-era subsidies, premiums skyrocketed for many ACA plans. A latest report discovered that 5 million folks nationwide had dropped the protection.

HAAM helped blunt the influence for its members. It has emerged as a potential mannequin for other cities hoping to make healthcare more reasonably priced for key populations and industries.

A rising thought

Texas had the highest uninsured price among states, with 19% of folks age 64 and under uninsured as of 2024.

Even before the launch of the ACA market 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 uncovered when touring 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 technique officer.

Similar nonprofits in other U.S. cities with robust reside music cultures, such as Seattle, New Orleans and Nashville, assist musicians get medical care.

With the creation of the ACA, some of these organizations started serving to musicians navigate the sometimes advanced enrollment course of for the on-line marketplaces, though they stopped quick of pitching in on premiums.

But the workforce at HAAM acknowledged that with out direct support to assist pay premiums, many of their members would still wrestle to retain protection.

“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 performs 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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The group’s membership has grown by 77% to more than 3,300 folks since HAAM started providing premium help, and more than 90% of members are now insured.

To assist subsidize prices for members, HAAM partnered with Central Health, which is Travis County’s public hospital district — a sort of well being company in Texas charged with utilizing tax {dollars} to fund safety-net healthcare for poor residents.

Central Health also operates the nonprofit Sendero Health Plans, which provides market insurance coverage to Travis County residents.

To qualify, HAAM members must enroll in one of Sendero’s silver-level, or benchmark, plans. If their revenue is between one and two instances the federal poverty degree, Central Health pays the steadiness of their month-to-month premium after federal tax credit have been utilized.

For members who fall above that revenue vary, HAAM provides a more restricted subsidy, protecting 50% of their premium balances.

In 2017, HAAM helped set up a comparable program in Denton, a faculty city north of Dallas that has served as a testing floor for profitable musicians, from Meat Loaf to Norah Jones.

The Denton Music and Arts Collaborative works in another way: It connects members with an impartial insurance coverage agent who helps them discover the finest well being plan for their wants. The nonprofit then provides members a month-to-month subsidy of $100.

The subsidies are a manner of holding Denton’s tradition 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 12 months, the Health Alliance for Austin Musicians hosts the HAAM Day Music Festival, its annual occasion to elevate cash to assist native musicians afford insurance coverage premiums and other healthcare companies. Bands play in frequent areas across the metropolis, from grocery shops to the Texas Capitol steps. (Shunya Carroll/KUT News)

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In Austin, other sectors have been watching HAAM’s work. In 2025, Good Work Austin, a nonprofit that advocates for restaurant staff, launched a small pilot program with Central Health to assist native meals staff enroll in Sendero plans and cowl their premiums.

Kit Abney Spelce, vice chairman of operations for Central Health, said partnering with an advocacy group targeted on a explicit workforce is key because merely saying “free insurance for you” does not imply folks will signal 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 coverage premium funds usually improve 12 months over 12 months, the 2026 plan 12 months was significantly costly, growing by 58% on common.

Citing medical and pharmacy prices, Sendero raised charges by an common of 16% for its enrollees.

At the same time, Congress allowed the pandemic-era enhanced premium tax credit to expire, decreasing the federal subsidies that many market prospects 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 cowl everyone who requested help.

They had to flip away a whole lot of certified folks. Still, they were ready to buffer present members, said Spelce with Central Health.

“We’re going to make sure their monthly premium is paid every month,” she said.

A viable, if restricted, help mannequin

Beyond the eligible musicians they turned away in 2026, another inhabitants stays out of HAAM’s protection attain for premium help: Austin’s poorest residents.

Under the ACA, the market plans that HAAM helps subsidize are for low- and middle-income earners, but the folks with the very lowest incomes — under 100% of the federal poverty degree, set at about $15,000 in Texas — are supposed to be lined by expanded Medicaid.

But Texas is one of 10 states that selected not to increase Medicaid after the ACA grew to become legislation, so many of the poorest Texans stay uncovered.

With no federal subsidies accessible for that group, HAAM and Central Health have tried to develop separate options for this subpopulation.

Central Health has its Medical Access Program, an different to medical insurance that gives low-income, uninsured folks entry to a community of native care suppliers.

HAAM has also established relationships with main care suppliers to serve its uninsured musician members — but Blair acknowledges that it’s not an equal profit to what Medicaid growth would provide.

“It’s not a very sustainable solution, especially when there’s a really good alternative,” Blair said.

This story comes from NPR’s well being reporting partnership with KUT and KFF Health News.