April 03, 2010

By Alex Maiolo

There's already been a lot of talk about what the passage of health-care-reform legislation will mean for "real Americans," a demographic whose mythical stature is matched only by their ability to inspire talking points.

But what does it mean for "real musicians"—namely, those artists and songwriters trying to make a living in a time of unprecedented economic challenge?

Before we consider the potential impact of the health-care-reform bill, we should look at the facts. A 2002 Future of Music Coalition survey found that 44% of the 2,700 musicians surveyed didn't have health insurance—almost three times the national average. With the economy in a protracted downturn, there's good reason to believe that these figures haven't improved.

There's much to commend in the historic bill that President Barack Obama signed March 23. That doesn't mean it's perfect. It's not a single-payer system that would cover the medical expenses of every American. And there isn't a "government option" that would provide security outside of the private-insurance nexus.

Still, the legislation could improve conditions for musicians, who, as part-time or contract employees, often have difficulty securing consistent coverage. Aspects worth applauding include a clause that lets individuals stay on their parents' plans until the age of 26. Many insurance plans cease coverage for dependents when they turn 19 or finish college. This is good news for artists at prime touring age, whose van-driven vocation poses very real hazards.

Additionally, there's a catastrophic-coverage option for the young, which kicks in in 2014. That makes sense for musicians who may only require this kind of plan. And the small-business tax benefit currently under discussion could conceivably benefit incorporated bands.

With the passage of reform, insurance companies can only deny fraudulent claims. They will also be prevented from dropping people when they get sick.

Most important, insurance companies will not be able to deny coverage based on pre-existing conditions. This policy will be a part of the state-run "insurance exchanges"—set to be implemented in 2014—that will let individuals and small businesses select from a range of supposedly affordable coverage options. Until then, qualifying individuals who have trouble getting insurance could obtain coverage through a temporary plan that would eventually be replaced by a plan they find through an exchange.

These stipulations could benefit musicians who may have otherwise been prevented from vigorously pursuing their careers due to insurance restrictions.

By 2014, most Americans will be required to carry insurance or risk paying fines. Some would argue that this represents an intrusion of government into people's individual decision-making. This is a valid point, but one that doesn't take into consideration the need to balance risk with nonexclusionary coverage.

What's more debatable is whether an insurance exchange (with tax credits for incomes up to 400% of the poverty line) will be as effective as a government option in terms of providing access to coverage for low-wage earners. Musicians may not be able to obtain employer-based insurance, and their incomes tend to fluctuate. This is the part of the bill where our community should be paying close attention to outcomes.

It would be naïve to think that the passage of health care reform will have an impact on the situation for musicians overnight. Still, this legislation should help ameliorate some of the most persistent problems with the for-profit insurance system: denial of coverage for those with pre-existing conditions and the risk of being dropped from coverage after getting sick.

I'm an active musician myself. And, as a partner at an independent insurance agency, I am familiar with the overall landscape and have been a longtime critic of the health insurance industry. For the better part of the last decade, I've counseled musicians on their health insurance options on behalf of the Future of Music Coalition, while personally advocating for reform that would make insurance more affordable and accessible to my peers.

I know firsthand that many working artists agree on the need for reform. But the endless back-and-forth about "death panels" and deficits doesn't exactly make for cheery post-show conversation. The protracted debate about health care reform has been highly contentious, and you can hardly blame musicians for tuning out.

But artists and creators must recognize how much they, like other Americans, have at stake. Even as we recognize the historic accomplishment of sweeping health care reform, we must keep a close eye on what's working and where there's room for improvement.

The health of the entire music ecosystem depends on the well-being of its musicians. We should all be ready to take its pulse. ••••

Alex Maiolo is project coordinator for the Future of Music Coalition's Health Insurance Navigation Tool, which provides free consultations to musicians about their health insurance options. In addition to playing with the bands Violet Vector & the Lovely Lovelies and Hi-Fi Sky, Maiolo is a partner with an insurance agency in the Carrboro/Chapel Hill area of North Carolina.

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