AUSTIN, Texas — A nonprofit health program has helped thousands of Austin musicians maintain health insurance as rising Affordable Care Act premiums and the expiration of enhanced federal subsidies increase coverage costs in 2026.
The Health Alliance for Austin Musicians, or HAAM, subsidizes monthly premiums for eligible musicians who enroll in ACA marketplace plans. The organization works with Central Health, Travis County’s public hospital district, to fund the roughly $4 million program.
Many participating musicians pay nothing toward their monthly premiums.
Zack Morgan, an Austin musician who lost his corporate job in 2015, turned to HAAM after deciding to pursue music full time. Morgan plays keyboard with several bands and said health insurance was one of his first concerns after leaving his corporate job.
HAAM began offering premium assistance after the ACA marketplace launched in 2014. Before that, the organization spent about a decade connecting uninsured musicians with free and low-cost medical care.
About 85% of HAAM members remained uninsured before the organization began helping with marketplace premiums, according to HAAM Chief Strategy Officer Rachel Blair.
The organization’s membership has since grown 77% to more than 3,300 people, while more than 90% of its members now have insurance.
Under the program, eligible members enroll in silver-level plans offered through Sendero Health Plans, a nonprofit health insurer operated by Central Health. Central Health covers the remaining monthly premium after federal tax credits for members whose income falls between one and two times the federal poverty level. HAAM provides a 50% subsidy for members with higher incomes who qualify for the program.
The assistance has become more important in 2026 as marketplace premiums increased and enhanced federal premium tax credits expired.
Marketplace premiums increased an average of 58% for the 2026 plan year, according to the Kaiser Family Foundation. Sendero raised premiums for its enrollees by an average of 16%.
Blair said premiums for HAAM members increased 60% from the previous year.
HAAM increased its fundraising efforts but could not provide assistance to hundreds of qualified applicants in 2026. The organization continued to cover monthly premiums for existing members, according to Kit Abney Spelce, Central Health’s vice president of operations.
Other cities have developed programs to help musicians access health care. Organizations in Seattle, New Orleans and Nashville connect musicians with medical services and insurance assistance.
HAAM also helped establish a similar program in Denton in 2017. The Denton Music and Arts Collaborative connects musicians with insurance agents and provides eligible members with a $100 monthly subsidy.
Central Health has expanded the partnership model to other groups in Austin. In 2025, nonprofit Good Work Austin launched a pilot program with Central Health to help restaurant workers enroll in Sendero plans and pay their premiums.
Spelce said community organizations can help public agencies reach workers who may not otherwise enroll in available health programs.
HAAM’s assistance does not cover Austin’s poorest residents who fall below 100% of the federal poverty level and generally cannot qualify for ACA marketplace subsidies. Texas has not expanded Medicaid under the ACA, leaving many low-income residents without coverage.
Central Health provides uninsured residents with access to local health care through its Medical Access Program. HAAM also connects uninsured musicians with primary care providers.
Blair said those services do not provide the same level of coverage as Medicaid expansion.
