It looks like is living the life as a musician. He鈥檚 standing under a neon sign, ready to play guitar at Austin鈥檚 famous . And when he鈥檚 not here, he鈥檚 hustling to pay his bills.
鈥淏eing a full-time musician means you have three other side jobs, you know?鈥� he says.
James moved to Austin about eight years ago and got health insurance for the first time this year. He pays $22 a month, after the $200 subsidy he gets through the Affordable Care Act. Even that is a lot, because he earns only $15,000 a year. He gets help paying his monthly premium through a local nonprofit.
鈥淲e still have to worry about counting the quarters and the pennies when we leave these venues,鈥� he says. Health insurance doesn鈥檛 come easily.
Austin thrives on its as the live music capital of the world and is making far more than quarters and pennies from music. The city the commercial music industry pumps $1.6 billion into the local economy every year.
But Austin has a lot of people like James struggling to afford life here.
鈥淎 lot of people didn鈥檛 understand just how dire that situation is,鈥� says Nikki Rowling, the founder and CEO of the . 鈥淲e have hard data that shows it.鈥�
The Titan Music Group recently conducted a large survey and several focus groups of musicians in Austin; it produced the for the city. The census found that 20 percent of Austin musicians live below the . More than 50 percent qualify for federal housing subsidies, and nearly 19 percent lack health insurance.
A lot of Austin musicians rely on the for help.
鈥淐lose to 60 percent of our membership doesn鈥檛 even qualify for the subsidies that are given through the Affordable Care Act,鈥� says Reenie Collins, the alliance鈥檚 executive director. And Texas didn鈥檛 expand Medicaid, which would have helped those musicians below the poverty line.
Her organization helps in two ways. This year, HAAM gave Kalu James and about 300 others money to afford their premiums for plans bought on the exchange. It also coordinates low-cost health care for about 2,000 members every year. It partners with doctors and hospitals to give these musicians medical, dental, vision, hearing and mental health care.
Backstage at the Moody Theater, dobro player is getting ready to go onstage.
鈥淭ravel anywhere in the United States,鈥� Caven says, 鈥測ou tell them you鈥檙e from Austin, [and] they almost always say, 鈥楢ustin City Limits,鈥� you know? This is very much the identity. And if we lost that, we鈥檇 just be another up-and-coming city with no personality.鈥�
Caven is an executive at the Seton hospital network, an organization that partners with HAAM. He is also a physician and treated musicians in Austin for almost 20 years. Caven鈥檚 band, , is performing at a local 鈥渂attle of the bands鈥� to raise money for HAAM.
鈥淪ome people feel like you just ought to work hard enough to have health insurance,鈥� he says. 鈥淏ut working in a safety-net hospital, like I do, you see people that come in. They鈥檙e working really hard 鈥� working sometimes two and three jobs to support their family.鈥�
Thanks to fundraisers and other private donations, HAAM鈥檚 Collins plans to triple the number of musicians who will get help with their premiums next year. She鈥檚 also a passionate advocate of Medicaid expansion, which would help many musicians in Austin.
鈥淢any, many people think, 鈥極h, HAAM鈥檚 not needed anymore.鈥� Well, that鈥檚 not really true,鈥� she says, 鈥渂ecause Texas did not expand Medicaid.鈥�
While more people since the rollout of the exchanges, Texas still has the highest uninsured rate in the country 鈥� about 17 percent.
This story is part of a partnership that includes , and Kaiser Health News.