AUDIE CORNISH, HOST:
In Austin, Texas, the music industry generates almost $2 billion a year for the local economy, but some musicians say they're lucky if they leave a gig with $5 in their pocket. From member station KUT in Austin, Veronica Zaragovia reports on how many of them have trouble affording the basics including health insurance.
VERONICA ZARAGOVIA, BYLINE: It looks like Kalu James is living the life as a musician. He's standing under a neon sign ready to play guitar at Austin's famous Continental club. But when he's not here, he's hustling to pay his bills.
KALU JAMES: Being a full-time musician means you have three other side jobs, you know?
ZARAGOVIA: 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 tax subsidy he got through the Affordable Care Act. Even those $22 are a lot when you only earn roughly $15,000 a year. He gets help paying his premium through a local nonprofit.
JAMES: We still have to worry about counting the quarters and then the pennies when we leave these venues. And, yeah, health insurance and all these things to take care of yourself is certainly something that doesn't come by quite easily for us.
ZARAGOVIA: The live music capital of the world is making far more than quarters and pennies from music. In 2012, the city estimated 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. Nikki Rowling is the founder and CEO of the Titan Music Group.
NIKKI ROWLING: A lot of people did not understand just how dire that situation is. And so we have hard data that shows it.
ZARAGOVIA: Her group recently conducted the Austin Music Census. It found that 20 percent of Austin musicians live below the federal poverty level. And almost 19 percent have no health insurance. Reenie Collins is executive director of the Health Alliance for Austin Musicians, or HAAM. A lot of Austin musicians rely on her group for help.
REENIE COLLINS: Close to 60 percent of our membership doesn't even qualify for the subsidies that are given through the Affordable Healthcare Act.
ZARAGOVIA: And Texas didn't expand Medicaid, so HAAM helps in two ways. This year, it gave Kalu James and about 300 others money to afford their premiums. And it coordinates low-cost healthcare for more than 2,000 members every year. Backstage at the Moody Theater, dobro player Dr. Tom Caven is getting ready to go on stage.
TOM CAVEN: Travel anywhere in the United States and you tell them you're from Austin, they almost always say Austin City Limits, you know? So this is very much the identity, and if we lost that, we'd just be another up-and-coming city with no personality.
ZARAGOVIA: Caven is an executive at the Seton hospital network that partners with HAAM to provide healthcare. He was also a doctor who treated musicians in Austin for about 20 years. Caven's band, The Stray Bullets, is performing at a battle of the bands to raise money for HAAM.
CAVEN: Working in a safety-net hospital like I do, you see people that come in, they're working sometimes two and three jobs to support their family.
ZARAGOVIA: Thanks to fundraisers like these and other private donations, HAAM director Reenie Collins plans to triple the number of musicians who'll get help with their premiums next year. She's also a passionate advocate of Medicaid expansion, which would help many more musicians.
COLLINS: People think, oh, HAAM's not needed anymore. That's not really true because Texas did not expand its Medicaid product.
ZARAGOVIA: While more people have gotten insured in the state since the rollout of the exchanges, Texas still has the highest uninsured rate in the country. For NPR News, I'm Veronica Zaragovia in Austin.
CORNISH: And this story is part of a reporting partnership with NPR, local member stations and Kaiser Health News.
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.