The Health Alliance for Austin Musicians (HAAM), a nonprofit organization, is subsidizing health insurance premiums for thousands of performing artists in Austin, Texas. Working alongside Central Health, a public health agency for Travis County, the program helps musicians purchase coverage through the Affordable Care Act (ACA) marketplace. The initiative aims to provide financial support to workers in the city’s music industry who often lack employer-based benefits.
The program was established as a response to high uninsured rates among local artists, who frequently earn modest incomes while supporting the city’s tourism and culture. Before the ACA marketplace launched in 2014, HAAM primarily connected musicians with free or low-cost care at local clinics. Since introducing premium assistance, HAAM reports its membership has grown by 77%, and more than 90% of its members are now insured.
Under the current arrangement, HAAM members must enroll in specific silver-level plans offered by Sendero Health Plans, a nonprofit operated by Central Health. For those earning between 100% and 200% of the federal poverty level, Central Health pays the remaining monthly premium after federal tax credits are applied, often resulting in $0 monthly costs for the artist. For members with higher incomes, HAAM provides a more limited subsidy that covers 50% of the premium balance.
For the individual musician, these subsidies mean the difference between paying a significant portion of their income toward health insurance or receiving coverage for $0 per month. Without this assistance, an average HAAM member earning $30,000 annually might be required to spend up to one-third of their income on healthcare costs. The program also influences local policy and labor markets, serving as a pilot model for other industries; for instance, the nonprofit Good Work Austin launched a similar program in 2025 to help local restaurant and food service workers obtain coverage.
The long-term sustainability of this model remains tied to state and federal policy decisions. Texas currently has the highest uninsured rate in the U.S. at 19% and is one of 10 states that has not expanded Medicaid. This leaves residents earning less than 100% of the federal poverty level—approximately $15,000—without access to federal marketplace subsidies or Medicaid. While HAAM and Central Health offer alternative primary care programs for these individuals, they lack the comprehensive coverage provided by marketplace plans. The next critical period for these workers will be the upcoming enrollment cycles, where premium rates and the availability of local subsidy funds will determine how many artists can maintain their coverage.