What Does All Of This Action On Healthcare Mean For Musicians?


image from futureofmusic.orgMusicians, by the nature of their craft are often self-employed and under capitalized making them particularly vulnerable to changes in health care and insurance. But there is so much noise coming out of Washington that it’s impossible to keep track. So Kevin Ericson of The Future Of Music Coalition did the research and shares an important update.

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Future of MusicGuest post by Kevin Ericson of The Future of Music Coalition

It’s often challenging for musicians to try and keep track of all the policy issues that can potentially impact their lives and livelihoods. In the unprecedented day-to-day chaos and unpredictability of our current unconventional political environment, it can be even harder.

So here’s a quick update on one of the most important issues facing musicians, some questions answered, and some thoughts about what may lie ahead.

What’s happened so far?

In 2016, Donald Trump made promises to repeal the Affordable Care Act a central feature of his campaign. After inauguration day, however, lawmakers were confronted with a massive mobilization of grassroots activism, including calls, emails, rallies, marches, op-eds, angry town halls, and direct action. This mobilization, coupled with the fact that would-be-repealers were deeply divided on the details of replacement plans, stalled the repeal attempts. In a dramatic late-night vote in July 2017, the Senate’s “skinny repeal” bill to repeal Obamacare failed.

All through 2017, FMC has been working to help represent how musicians are impacted by these potential legislative moves, both on Capitol Hill and in media coverage on the issue. We’ve drawn on our original research (in partnership with AHIRC) that shows that before the Affordable Care Act, musicians reported that they were nearly 3 times as likely as the general population to be uninsured—we can’t go back. We’ve described the structural reasons that musicians have specific coverage needs, and emphasized the importance of provisions guaranteeing coverage of essential benefits like mental health care and substance abuse treatment. And we’ve encouraged musicians and their fans to tell their health care stories: often personal accounts are particularly powerful in helping policymakers and fans alike understand our concerns.

And as we work to defend the Affordable Care Act, we’ve also pointed out that there is much more to be done to improve the current system and make health care truly comprehensive and affordable for musicians, both at home and on the road.

Collectively, citizen activist efforts have transformed the debate about health care in the United States, and musicians and fans have played an important role in that progress (so give yourselves a pat on the back!).

What’s happening this week? Should we be sounding the alarm?

Although previous attempts to pass repeal legislation have failed, a last-ditch effort has been mounted by Sen. Lindsay Graham and Sen. Bill Cassidy to pass an updated bill before the reconcilation period ends Sept 30 (after this date, a health bill would need 60 votes to pass the Senate). While three Republican senators now are have announced their opposition to the Graham-Cassidy bill—enough to doom it—it’s possible that yet another version might be introduced. Reports do indicate that Republican leadership and the White House are pulling out all the stops to try and acquire the necessary votes.

So, yes, it’s very much worth contacting your Senators at (202) 224-3121 and making your voice heard, as a vote could come any day before Sept 30. And remember, it’s just as important to thank elected officials when they do the right thing for musicians as it is to express disapproval when they let us down.

What would the impact of this legislation be on musicians?

The nonpartisan Congressional Budget Office hasn’t even assessed the bill, but some have estimated as many as 30 million more people would be uninsured, and this would include countless musicians. For those with insurance, the quality of plans could go down dramatically—states could waive essential benefits like mental health coverage, maternity, etc. And pre-existing conditions could lead to astronomically higher premiums. Here’s a full rundown from Vox.

What’s all this new talk about single payer?

The more people learn about our health care system, the better single-payer approaches start to look. As debate over the fate of ACA has progressed, and advocates have described ways the ACA could be improved, we’ve seen a groundswell of support for #medicareforall, and accompanying legislative proposals: Rep. John Conyers’ bill in the house of representatives and Sen. Bernie Sanders’ bill in the Senate. Rep. Conyers is perhaps best known to the music community as a longtime advocate for artist compensation on issues like the AM/FM radio performance right; he’s actually been introducing versions of the single payer idea in every Congress for some time.  Notably, this year’s bill has 119 cosponsors in the House compared to 49 in 2015’s version—clearly, the idea is becoming more and more a part of mainstream policy discussion.

A single-payer system would be infinitely simpler and more humane, and is a goal worth working for. That said, #medicareforall is likely to be a long-game kind of policy victory—acheived after years of work rather than months. The good news is that musicians are good at the long game! As we’ve argued before:

There’s a basic structural similarity between the kind of slow and steady work it takes to hone your craft as a composer or performer over many years, keeping your eyes on what opportunities and challenges lie around the corner while working to address your present needs, and the slow and steady process of building movements for justice. Making an impact in either policy or music often requires the same kind of passion and perspective.

So it’s important to talk seriously about single payer and the ways it could address shortcomings of the current system. At the same time, we have some immediate tasks ahead of us. Those include:

  • Fight to preserve the progress made by the Affordable Care Act.
  • Work to stabilize and improve the existing system.
  • Make sure as many musicians as possible get the information, support, and assistance they need to get enrolled during the forthcoming open enrollment period.

On that last item: I read that advertising budgets for open enrollment have been cut. Is that true?

Yes, and budgets for navigators to help with enrollment are down too. That means it’s even more important for musicians and their allies to help spread the word. This year, the enrollment period starts November 1, and there will be less time to shop for a plan. In the coming weeks and months, FMC will be working to give you some tools and resources to help get the word out.

What’s the takeaway?

Even if the worst case scenario happens and the Graham/Cassidy bill passes, it will take some time before it takes effect. ACA marketplace subsidies will still be available for 2018, as well as Medicaid expansion in the states where it currently exists. If you’re currently uninsured, you should definitely endeavor to get covered. And if you currently get coverage through the marketplace, you should plan to update your coverage details. The details of what plans are available and in what markets may be in flux, so mark your calendar now and plan to spend some time in November researching your options.

So don’t panic, don’t lose hope, don’t hesitate to take action, and don’t underestimate what musicians and our fellow citizens can accomplish together.