Health Care Law Displaces Health Service for Austin Musicians

By Andrea Kurth
For Reporting Texas

Antonio Vanalli was living on a musician’s salary in the 1990s when he dropped his health insurance because he could no longer afford the premiums.

When he was diagnosed with rheumatoid arthritis and pre-diabetes, Vanalli turned to the Health Alliance for Austin Musicians, or HAAM. The nonprofit organization provides a network of health services to qualifying Austin-area musicians.

“If it was not for HAAM, I don’t even want to think about what would be of my life today,” Vanalli, 59, said.

Musicians in Austin often exist from show to show and work part-time jobs to make ends meet, making health insurance an expense they cannot afford. Since 2005, HAAM has offered free health care to Austin-area musicians. But requirements in the federal Affordable Care Act mean many musicians will soon be ineligible for HAAM assistance.

To qualify for HAAM, members must be working musicians, live within 50 miles of Austin and make less than 250 percent of the federal poverty level, or $29,175 a year for an individual. They must also be uninsured.

The ACA requires individuals making more than 133 percent of the federal poverty level, or $15,521, to buy coverage, with subsidies available for people who make less than 400 percent of the poverty level. But musicians who make more than the law’s benchmark must buy insurance and would not be able to receive health care through HAAM. They still would be eligible for the nonprofit’s free dental, vision and hearing services.

HAAM has not changed its eligibility requirements in response to the ACA, said Jennifer Stowe, the nonprofit’s director of services. About half of HAAM’s 2,000 members fall beneath the poverty line and will continue receiving medical care through HAAM, Stowe said. The average annual income of a HAAM musician is about $15,000 a year for an individual.

HAAM provides a network of doctors, dental hygienists, ophthalmologists and other health professionals for musicians.

The nonprofit is providing information on how to apply for insurance under ACA for the remaining 1,000 members who now qualify for government-subsidized insurance. People who did not get insurance by March 31 must pay a fine, which this year is $95 for each adult or up to one percent of taxable income, whichever is greater. The amount will increase each year.

“We’re not forcing people to get health insurance or kicking them off of HAAM, but they have to pay the penalty at the end of the year,” Stowe said. Musicians can apply now for insurance that would start in January.

Stowe hopes the conversation about health insurance will encourage more musicians to seek health care, through HAAM or private insurance. In the past, people have joined HAAM only when they had a health emergency, and not for preventative care, she said.

“Very often we see people sign up for HAAM because they are needing something or they are in pain,” Stowe said.

Joe Kraft, 29, a drummer from Round Rock, has not had insurance since he stopped being covered under his parent’s insurance seven years ago.

“Because I’ve been a musician all over the place, I haven’t found a very steady opportunity to be health insured,” Kraft said.

Kraft makes up to $300 a month playing shows with local band The Staylyns and works two part-time jobs to pay the rest of the bills. Although he is eligible for HAAM, he says he never signed up because he didn’t see the need.

“Because I’ve lived a relatively healthy lifestyle, my insurance plan has been to try and eat right, try and work out and stay physically active and don’t do anything stupid and get myself hurt,” Kraft said.

After the ACA passed, he looked into his health insurance options through the government’s website but could not make any progress because the site was too slow, Kraft said. He will pay the penalty this year but try to sign up again for next year. He says he is skeptical he’ll be able to afford it.

“My current income pretty much breaks even,” he said. “Right now, it doesn’t seem affordable” unless he finds a way to make more money.

For other musicians such as Vanalli, even affordable insurance may not solve all their health problems.

Vanalli applied for insurance before the March 31 deadline, yet is skeptical about the new insurance mandates.

He is from Brazil but has lived in Austin for 27 years. In many of those years, he toured the world playing in Latin and jazz bands. Vanali originally played drums but no longer can because of his rheumatoid arthritis. He requires weekly shots that ease his symptoms.

Vanalli is a member of HAAM, but since the alliance does not cover prescription medications, Vanalli received them through a medical trial that a doctor recommended to him. But the trial has ended, and he is worried about obtaining the shots, which cost over $1,000 weekly and have no generic substitutes. They are not covered by Humana, the insurer he applied to through the insurance exchange.

“I am not too hopeful,” Vanalli said. “I am very in the air right now, and it’s not a nice feeling.”

Despite questions about the impact of the health care law on Austin musicians, Stowe is hopeful that it will solve the problem HAAM was founded to address.

“Whether it’s because they want to avoid a penalty or whether the view around health insurance changes, it’s a good thing,” Stowe said.

However, Stowe doesn’t see the need for HAAM going away soon because it provides services that are not covered by health insurance, she said, including hearing tests, eye exams and glasses.

“Any nonprofit would like to be put out of business because the problem is solved,” Stowe said. “But even if people are required to get health insurance, HAAM will still be needed for the other services.”