Musician Zack Morgan humorously describes his transition to full-time music in 2015 as being “pushed off a cliff.” Juggling a corporate job during the day and performing as a funk keyboardist at night, he quickly realized that securing health insurance was his first step toward embracing his new career path.
Austin, known as “the Live Music Capital of the World,” poses significant financial challenges for the artists who contribute to its vibrant cultural scene and tourism industry. Morgan has navigated this landscape by piecing together various gigs, and to afford health insurance, he turned to the Health Alliance for Austin Musicians (HAAM), a local nonprofit dedicated to supporting musicians.
“That’s part of being able to make this whole thing work,” Morgan stated, highlighting the importance of HAAM’s assistance. The organization subsidizes the monthly premiums for local musicians who purchase plans through the Affordable Care Act (ACA) marketplace, making healthcare more accessible.
To sustain its approximately $4 million program, HAAM collaborates with Central Health, a public agency that aims to provide healthcare resources for low-income residents in Austin and surrounding Travis County. Many musicians benefit from the program, with some paying nothing for their monthly premiums.
After more than ten years, even through the challenges posed by the coronavirus pandemic, HAAM’s assistance program has solidified its role as a vital support system for Austin’s music community.
Despite the city’s lively music scene, Texas has one of the highest uninsured rates in the country, with 19% of individuals aged 64 and under lacking coverage as of 2024. Before the ACA marketplace was established in 2014, HAAM had already dedicated a decade to connecting musicians with low-cost or free medical care.
However, around 85% of HAAM’s members found themselves uninsured, especially when traveling for performances outside of Austin. Rachel Blair, HAAM’s chief strategy officer, noted the organization’s strategic shift following the ACA’s stability, focusing on fully insuring local musicians.
Similar nonprofits in cities renowned for their live music, such as Seattle, New Orleans, and Nashville, provide medical care assistance to musicians. With the arrival of the ACA, many organizations began to help artists navigate the enrollment process, but few offered financial support for premiums.
Recognizing the need for direct premium assistance, HAAM stepped in to ensure its members could maintain health coverage. “With the average HAAM member earning around $30,000 a year, it is impractical for them to allocate a third of their income to healthcare,” Blair explained.
Since HAAM initiated its premium assistance program, membership has surged by 77%, reaching over 3,300 individuals, with more than 90% now insured. To help cover costs, HAAM works closely with Central Health, which operates Sendero Health Plans, providing marketplace insurance to residents of Travis County.
Eligibility for HAAM’s assistance requires members to enroll in one of Sendero’s silver-level plans. Those with incomes between one and two times the federal poverty level receive full premium coverage after tax credits. For those earning above this range, HAAM offers a limited subsidy, covering half of their premium costs.
In 2017, HAAM established a similar program in Denton, Texas, a college town known for its music scene. The Denton Music and Arts Collaborative connects musicians with independent insurance agents to find suitable health plans while offering a $100 monthly subsidy.
This initiative aims to preserve Denton’s unique cultural landscape amidst concerns of residents leaving for better opportunities elsewhere. “People who had lived here for a long time were suddenly finding it harder to afford to stay,” said Jennifer Kapinos, president of the collaborative.
HAAM’s efforts have caught the attention of other sectors, such as the restaurant industry. In 2025, Good Work Austin launched a pilot program in collaboration with Central Health to assist local food workers with enrollment in Sendero plans and premium payments.
Kit Abney Spelce, vice president of operations at Central Health, emphasized the importance of partnerships with advocacy groups to foster community trust and participation. “Simply announcing ‘free insurance for you’ isn’t enough to ensure sign-ups,” she noted.
However, the 2026 insurance landscape presented significant challenges, with premiums rising by an average of 58%. Sendero attributed its rate hikes to increased medical and pharmacy costs, compounding the impact of Congress allowing pandemic-era premium tax credits to expire.
“Our members experienced a 60% increase in premiums from one year to the next,” Blair remarked. In response, HAAM ramped up fundraising efforts but still had to deny assistance to hundreds of qualified individuals. Nevertheless, they managed to protect existing members from steep increases, according to Spelce at Central Health.
Despite HAAM’s significant contributions, there remains a gap in coverage for the poorest residents of Austin. Individuals earning below 100% of the federal poverty level, estimated at about $15,000 in Texas, fall outside the ACA’s assistance umbrella and are meant to be served by expanded Medicaid.
However, Texas has opted not to expand Medicaid, leaving many low-income individuals without coverage. HAAM and Central Health continue to explore alternative solutions for this underserved population, including Central Health’s Medical Access Program, which offers access to local care providers for low-income, uninsured residents.
While HAAM has developed relationships with primary care providers for its uninsured members, Blair acknowledges that these measures do not equate to the comprehensive benefits that Medicaid expansion would deliver. “It’s not a sustainable solution, especially when a viable alternative exists,” she concluded.
