The imminent repeal of the Affordable Care Act will no doubt have repercussions for persons working within the arts. Historically artists in the United States have always dealt with a lack of health care: The health care system is structured in such a way that access is determined by one’s ability to pay for it. By and large most artists, musicians, writers, etc, live on an extremely tight budget if they are living off their work at all, or else they supplement their income with a “day job” that may or may not come with employer-provided health insurance.
I asked a range of persons from within northeastern Oregon how their access to health care, through its many forms — be it employer-provided insurance, private insurance with a federal subsidy, socialized medicine through the Indian Health Service, or otherwise — have impacted the ability to produce art.
Pendleton Center for the Arts executive director and book maker Roberta Lavadour recently started receiving health coverage through the PCA but is worried that removing the ability to deny coverage due to preexisting conditions could jeopardize that. “Even though I have employer provided health insurance right now I could lose it due to rheumatoid arthritis,” she said.
Prior to having health insurance Lavadour says, “My wellness program was to go donate blood so I knew I wasn’t anemic and my blood pressure was good.” When she eventually paid for a private health insurance plan, its premium was $300, which doubled after her diagnosis of rheumatoid arthritis. When the ACA went into effect her premium was reduced.
“To be able to make art, you have your life grounded and feel secure in the world so you can feel confidence in expressing your point of view and not going bankrupt or being homeless because of a medical emergency,” says Lavadour. “To know my entire safety net could be wiped out by one operation is terrifying.”
Enterprise recording engineer and country singer-songwriter Bart Budwig embodies this statement. He found that the coverage offered to him through the ACA was a contributing factor in allowing him to pursue the entrepreneurial task of being a self-sustaining musician, as well as prevented him from sidetracking his career.
“I’ve been covered since January of 2015,” says Budwig. “I’ve pretty much — to my knowledge — had full coverage. Last year I had to go to the ER for a kidney stone. With my kidney stone I would’ve had to have a job to help pay it off, which would’ve made it so I couldn’t be a full-time artist.”
Prior to transitioning into working full-time as a musician, Budwig had a full-time job as a certified nursing assistant in Moscow, Idaho, which did provide him with insurance though it still required him to pay a $100 monthly premium.
“I’m super thankful to have it,” Budwig says of his current coverage. “I’ve been way more productive being able to focus on art. I’ve recorded between ten and twelve albums this past year and there’s no way I could’ve done anything close to that if I had a full-time job on top of making music. Most artists are happy doing something they love, so if they have their basic needs met it makes a really big difference.”
Northeastern Oregon’s most well-known artist, James Lavadour, expresses ambivalence about the impending repeal of the ACA since he is an enrolled member of the Confederated Tribes resceives care through the Indian Health System and is also on Medicaid.
Lavadour acknowledges there are inherent risks in being a working artist, lack of health care access being one of them, but that shouldn’t be an impediment to pursuing vocation. “I worked a long time without health insurance. It’s a risky, no-guarantee kinda business — you do it whether you have health insurance or not. You find a way to get by though.”
However, a repeal of the ACA may affect the services that Lavadour receives. The ACA includes a permanent reauthorization of the Indian Healthcare Improvement Act, which authorizes the federally-administered Indian Health Service. His Medicare coverage may be affected as well since the proposal transforming Medicaid into a block grant program has been one of the few replacement options voiced.
Whatever the ACA replacement looks like, it is hoped that it won’t unintentionally lessen the flourishing cultural scene in northeastern Oregon by dissuading artists from pursuing their craft in order to focus on more pressing issues of how to pay medical bills.
Roberta Lavadour remains cautiously optimistic about her prospects for the continuation of her health coverage, though other may not be as fortunate. “I may be okay now that I have insurance through [the Pendleton Center for the Arts] — since I’m already in there they may not kick me off because it’s not a private plan. It’s such human nature when something isn’t affecting you personally to put it in the back of your mind. It’s human nature to say, ‘I’ve got mine, you’re not working hard enough.’”
James Dean Kindle is a Pendleton musician and executive director of the Oregon East Symphony. Contact him at email@example.com.