State Champ Radio health care
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For touring professionals in the live music industry, healthcare has long been an elusive benefit. While local stagehands working in venues across the country have enjoyed employer-provided health insurance for decades through International Alliance of Theatrical Stage Employees (IATSE) contracts, their counterparts on the road — the audio engineers, lighting technicians, production coordinators, and other crew members who travel with touring shows — have been left to navigate the healthcare system on their own.
Now, IATSE is working to change that through an ambitious grassroots campaign to extend its National Benefit Fund to touring professionals, offering them access to the same healthcare and retirement benefits enjoyed by their venue-based colleagues.
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The disparity — what some stagehands call the tale of two crews — becomes starkly apparent when touring and local union members work side by side in the same venue.
“I’ll be in an arena for 20 plus hours working side by side with someone from the local IATSE, and we’re in the same situation, the same long hours, possibly a dangerous environment, yet they are covered,” says Ally Vatter, a production coordinator who has been touring for 21 years, currently with Nine Inch Nails. “They are insured. I pay out of pocket, but if I can’t afford that, then I won’t be insured.”
The consequences of this gap can be severe. In 2009, before the Affordable Care Act eliminated pre-existing condition exclusions, Vatter’s appendix burst while on tour. As an uninsurable 27-year-old, she was left with a $50,000 hospital bill and discharged from the hospital just a day and a half after surgery because she had no insurance. The artist she was working for organized an early crowdfunding effort that eventually paid off the debt, but the experience highlighted a systemic problem.
“We work so hard, and we work for millionaires, and we’re over here begging each other for help,” Vatter says, noting that crowdfunding campaigns for touring crew members facing medical crises remain common today.
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Nathan Honor, a sound engineer and member of IATSE Local 4 in Brooklyn and Local 100 on the East Coast, recalls his own pre-union touring days: “I broke my foot at one point and had to do an entire tour with a limp, with a bad foot, and never really dealt with it, and it had lasting repercussions.”
The irony, as Joseph Juntunen points out, is that a solution already exists. Juntunen, a special representative for IATSE who spent years touring with acts like Black 47 and Graham Parker before helping organize unions at Webster Hall and Brooklyn Steel, explains that the National Benefit Fund has been providing healthcare and retirement benefits to IATSE members across various entertainment sectors for decades.
“When an employer makes a contribution to that fund, that money belongs to the recipient. It belongs to the person that earns that money through their labor, and it goes with them wherever they go,” Juntunen says.
The fund currently serves the vast majority of IATSE’s more than 180,000 members who work in TV, film, Broadway, trade shows and venues. The touring initiative, which would extend access to an estimated 33,000 professionals working in the touring industry globally, is designed around the realities of touring work, which involves professionals potentially working for multiple employers throughout the year.
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Here’s how it would function: When an artist or management company agrees to participate, they make contributions to the National Benefit Fund on behalf of their touring crew members. These contributions then go into individual “cap accounts” that belong to the workers and accumulate across different tours and employers.
“If you do one tour for two months at the beginning of the year, that money goes into your cap account. If you do another tour three months later on the same plan, that money would go into that cap account,” Honor explains. “Every quarter, there is a qualifying period where you choose your level of coverage, and then money is deducted from that cap account to buy your health insurance.”
Critically, the money stays in the worker’s account even during gaps between tours. “Even if no employer makes a contribution for two years, that money stays in your cap account, and you can use it to buy health insurance,” Honor says.
The system offers flexible tiered coverage options, ranging from catastrophic coverage for younger, healthier workers to premium “Cadillac” plans for those with families or greater healthcare needs. Workers can also pay out of pocket to upgrade their coverage if their cap account contributions aren’t sufficient for their desired plan level.
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Healthcare is provided through Anthem Blue Cross Blue Shield, and the plan’s large membership base allows for competitive rates that individual touring professionals could never achieve on their own.
Unlike traditional union initiatives, the health plan is entirely voluntary — no employer or worker is mandated to participate. Instead, IATSE is building support through a grassroots campaign, encouraging touring professionals to have conversations with their employers about joining the program.
“The touring industry is very big and broad, but it’s also small in the way that there’s a big word-of-mouth system that happens,” Vatter says. “Word travels quickly.”
The campaign is targeting artists, managers and tour managers — the key decision makers who control touring budgets. A town hall for interested parties is planned, and committee members have been working to spread awareness across the industry.
“We’re not looking to start fights with the employers. We’re not looking to have adversarial relationships,” Juntunen emphasizes. “We’re looking to work together to build a more sustainable, healthy touring industry.”
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The ultimate vision is for healthcare contributions to become a standard line item in touring budgets, much like they already are for venue work. If major promoters like Live Nation or AEG were to adopt the program across their tours, it could rapidly become an industry standard.
“We think this is really an opportunity for artists and management to put their money where their mouth is and help the people who are making the show,” Honor says.
According to Juntunen, the response so far has been encouraging. “The conversation is expanding rapidly, and we are in active discussions with several teams right now for next year’s touring cycle,” he says.
For touring professionals who have spent their careers without the basic security that their venue-based counterparts take for granted, the initiative represents more than just healthcare — it’s recognition of their essential role in the industry.
“This is the first time that someone extended an olive branch to the touring industry and said, ‘Hey, we see you. We understand we’re working right there with you, and we really want to make sure that you guys are safe and covered and taking care of yourselves as well,’” Vatter says. “Because in the end, we have the same goal, right? It’s to get that show up and make it work.”
As Honor notes, touring is “a very high impact business” where veteran crew members often reach their 40s, 50s, and 60s with health problems they can’t afford to treat and no retirement savings. “Not a day goes by at work that you don’t meet somebody who’s been touring for 20, 30, 40 years, and they don’t have anything saved,” he says.
Jon Dee Graham, the Austin guitarist and songwriter who played in the beloved local punk band True Believers, slipped and fell in 2021, and doctors apparently did not notice a crack in his spine. In early 2024, he had spinal surgery, and a six-month recovery period meant he could not make money from playing gigs. But the procedure didn’t take, and in April, he had another surgery, then developed an infection. Today, Graham, 66, lies in bed for hours every day, taking antibiotics every 12 hours that cause nausea and chills.
“We got a call from the IV company: ‘We need up-front payment in the thousands before we’re able to deliver the medication,’ ” says William Harries Graham, Jon Dee’s son, an architect and singer-songwriter who is overseeing his care.
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Jon Dee has Medicare, but there are crucial coverage gaps — because the hospital discharged him, according to William, insurance won’t reimburse medication and other portions of his home care. So the family turned to the most reliable backup plan available to veteran, well-known musicians: fans. Jon Dee is also a painter, and William has been offering his artwork, comics and music through a zine-like Bear Cave Dispatch in exchange for online donations. It’s working — for now. “We were able to cover those initial medical expenses,” he says.
The guitarist’s story remains bleak — sepsis recently set in — but it speaks to the blessing-and-curse health-care reality that working musicians must endure as they age. As gig-economy workers whose incomes fluctuate across decades, independent artists often find themselves with few resources for medical costs beyond those covered by the Affordable Care Act (ACA), Medicare or spouses’ employer plans. And if medical issues prevent touring, artists often have zero income. But musicians such as Jon Dee and rockers Matthew Sweet and Jesse Malin, as well as the late David Johansen and Gang of Four bassist Dave Allen, have recently tapped into loyal, generous fan bases through crowd-sourcing sites like GoFundMe and other grassroots fundraising.
At recent concerts, Gang of Four founding drummer Hugo Burnham has returned to the stage post-encore to request that fans buy merchandise to offset costs for Allen’s family. (Allen died at his home in Portland, Ore., in April at 69 after a long struggle with dementia.) “It’s no secret the cost of medical care in the U.S. is an obscenity,” says Burnham, 69, who fractured a bone in his leg during the tour but is covered through his job as a college professor. “Had he lived anywhere else, there might not have been this terrible burden on the family. We all know the stories of people who have had to rely on raising money based on the kindness of strangers — and it’s not just musicians.”
Outside of the U.S. health-care system, musicians struggling with health care costs can tap into multiple resources — but they rarely come close to providing all the costs needed for severe, long-term health issues. After Chappell Roan demanded “a livable wage and health care” for artists during her acceptance speech at the 2025 Grammy Awards, music-business experts pointed out that musicians signed to major labels could access health-insurance plans provided by the SAG-AFTRA union for premiums comparable to the ACA.
In addition, Sweet Relief provides grants for artists and others in the music industry through fundraising concerts, donations and other resources. The 31-year-old nonprofit is a “stopgap,” according to executive director Aric Steinberg. In 2023, Sweet Relief helped Malin set up an online fundraiser when the veteran punk frontman suffered a paralyzing stroke in his back. “It’s unfortunate we have to exist,” Steinberg says. “Sadly, we’re busier than ever.”
MusiCares, a 35-year-old affiliate of the Recording Academy, raises funds through high-profile events like its Grammy Week Person of the Year benefit, which has recently honored the Grateful Dead, Motown Records’ Berry Gordy Jr. and Smokey Robinson, Joni Mitchell and Aerosmith. It has provided nearly $120 million in health-care assistance to musicians and music-business workers over time, including roughly $10 million overall to 9,000 people during the past year. “It is not unlimited support,” says Theresa Wolters, MusiCares’ interim executive director/vp for health and human services. “However, it is very, very substantial.”
These limits were evident to William, who says he has reached out to MusiCares on Jon Dee’s behalf for health-care funding with “no result.” Russell Carter, Sweet’s longtime manager, adds that MusiCares contributed funds for some early medical costs, but the charity has been “just one piece in the puzzle of solving his financial woes.” (A MusiCares representative says the charity can’t comment on artists it works with. Wolters adds: “We work within the realities of our nonprofit model and our commitment to equitable support across the community. In these instances, MusiCares is one part of the solution.”)
Sweet, 60, suffered a stroke last October while touring in Toronto. After leaving an intensive-care stroke unit in a Canadian hospital, he returned to his hometown of Omaha, Neb., and has received treatment in a rehabilitation program. Although he’s improving, particularly his speech, Sweet’s main issue remains “coordination,” Carter says, and he can’t walk or play guitar or keyboard. He also has vision problems and is “generally wheelchair-bound in his home.” In addition, Sweet’s wife recently broke her leg, forcing the family to hire a full-time nurse — which is not covered through the singer’s ACA insurance or early Medicare.
Since Sweet’s stroke, his GoFundMe has raised nearly $640,000, which, Carter says, “paid for what can only be described as exorbitant medical expenses.”
Sweet and his team view the crowdfunding not as an indictment of the U.S. health-care system but a mass validation of fan loyalty and colleagues’ affection. Sweet may not currently be able to tour, but his decades of touring are paying off. “Don’t dismiss the GoFundMe,” Carter says. “It’s a vehicle for fans to contribute. These are people that would spend $35 to see Matthew if he came through town in a second, and if they can spend $35 to help Matthew — clearly, they did it, instantly. They’re willing to give back. That’s a very positive thing.”
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Jadakiss and Jim Jones joined forces to march with healthcare workers to the New York governor’s office to demand action on Medicaid.
On Saturday (March 23), members of the 1199SEIU healthcare workers union marched in New York City to the office of New York Governor Kathy Hochul to protest the new restrictions that she has placed concerning Medicaid. Joining them on the march were two top-notch rappers – Jadakiss and Jim Jones. The Dipset MC shared footage of himself and the Lox artist marching with the healthcare workers in the rain in a post on Instagram.
“What we doin?” Jadakiss asks as Jim Jones holds up the camera to capture the moment. “We gettin’ our steps on like Malcolm and Martin, out here for a good cause,” Jones replies. In the caption of the post, he wrote: “Special shout out to all the #1199Healthcare workers who show up for the cause today and march to fight for [what’s] right,” also adding:
“The government is only covering 70 percent of Medicaid cost at our new York hospitals [and] clinics. This 30 percent gap is causing underfunding [which] cause the hospitals to b[e] understaffed then eventually havin’ to close [their] doors. To prevent this from happening we [need] everyone to let the governor know we need the 30 percent to [be] implemented immediately. Shouts to @hot97 [and] @funkflex for keeping the city united when we need it the most @jadakiss.”
In January, 1199SEIU called on Governor Hochul to stop underpaying the state’s hospitals on Medicaid claims. Currently, only 70% of all bills under Medicaid are paid fully. “Over seven million New Yorkers rely on Medicaid services, the majority of whom come from Black and Latino communities. Despite the fact that Medicaid provides vital coverage to these New Yorkers, the state pays hospitals 30% less than the actual cost of needed care,” their statement reads. The practice has led to the closure of two major hospitals in New York City and 15 maternity centers in the state.
The march is the second time Jadakiss has been spotted outside in service of the people. He was recently seen offering support to those incarcerated in the Rikers Island prison system, bringing them pizza from the viral eatery, Cuts N’ Slices.
“Didn’t break my fast but I did let the brothers enjoy the meal and festivities,” he wrote in the caption.
When the American Association of Independent Music (A2IM) unveiled its new healthcare plans for working artists in August, the trade association, which represents indie labels, presented it as “a welcome ray of light for the music industry.” The monthly premiums range from $80 to $1,240 and feature benefits such as $15 co-pays for doctor visits and regular screenings for breast cancer, diabetes and depression. Affordable dental, vision and even pet insurance plans are also available.
But buried in the descriptions of several plans, which are accessible for those with a $100 annual A2IM membership, are restrictions and costs that could drain indie musicians’ finances. Three of the five plans offered, which cost $80 to $210 per month for individuals and $160 to $510 for families, do not cover emergency room care, hospital room fees, childbirth/delivery costs in hospitals or any type of care from a physician or surgeon. The two more expensive plans — $560 to $690 for individuals and $1,060 to $1,240 for families — don’t cover ambulance charges, radiation, chemotherapy, dialysis or transplants.
“What A2IM is doing is fantastic. I am applauding them hugely for this,” says Tatum Allsep, founder and CEO of Music Health Alliance, a Nashville group that advises artists on healthcare. “But read the fine print.”
A2IM bills the plans as “compliant” with the Affordable Care Act (ACA, also known as Obamacare), but Allsep disagrees. “Nothing about this is aligned with the coverage on state exchanges. Not one bit,” she says. “Somebody’s going to think, for 80 bucks, they’re going to have health insurance because it says in black and white, ‘ACA-compliant.’ And that is absolutely false.”
Dr. Elisabeth Rosenthal, author of A Terrible Sickness: How Healthcare Became Big Business and How You Can Take It Back, adds, “It’s a terrible burden to place on patients to have to read the fine print in this way. I’ve spent my life thinking about these things, and I’m trained as a physician, and it gives me a headache to look at these policies.”
A2IM first offered health insurance to its 600 members, mostly indie labels, in September 2022, then expanded this past August to artists who are sole business proprietors.
A2IM president/CEO Richard James Burgess says the plans are “compliant” with the ACA and that “several dozen families” have enrolled in them so far.
“It was incredibly challenging to find affordable healthcare insurance for A2IM members outside of the state exchanges. For years, there appeared to be no viable options,” he says. “A2IM has never diminished the great work the state exchanges have done. We are not in competition with them. Rather, we wanted to offer more options to our members.”
According to a representative with the U.S. Centers for Medicare and Medicaid Services, ACA-compliant plans must have three key characteristics: They have to cover preventive services (like vaccines and screening tests), prohibit insurers from denying clients based on preexisting conditions and ban limits for total healthcare costs. “On the exchanges, those plans basically have consumer protection built into them,” says Liz McCuskey, a Boston University professor of health law policy. Consumers can buy “off-exchange” plans outside of the ACA, but she says they “are subject to much lighter rules.”
Michael Desnoyers, director of sales for Chicago insurance broker Independent Health Agents, says of A2IM’s plans, “If it’s the first time they’re being offered to musicians, they probably don’t have the option to get their proper group plan through Blue Cross/Blue Shield or United Healthcare.”
Desnoyers adds that the A2IM options might work for musicians who are younger, with no serious health risks or preexisting conditions, even if they “don’t come through with the benefits the major medical plans do.” Tim Hebert — a Fort Collins, Colo., health insurance broker who is also a managing partner for Sage Benefit Advisors and the state legislative chair for the National Association of Benefits and Insurance Professionals — adds: “In certain situations, it can absolutely make sense. If [musicians] have moderate income but they just don’t have any assets, the A2IM plan works. It gives them basic coverage. You just don’t have to pay the higher premiums.”
Until 2010, self-employed musicians had few ways to obtain low-cost insurance, especially if they had preexisting conditions such as asthma or cancer. The ACA changed all that, and today, individual states are obligated to provide plans that cover catastrophic medical events and not to discriminate based on preexisting conditions. Still, several music industry organizations, including the Recording Academy, the American Federation of Musicians — and now A2IM — offer additional plans to members as cheaper alternatives.
For example, the academy provides plans for its more than 15,000 members through Stride Health that cost as little as $25 per month, with options to add dental, vision and life insurance coverage. The American Federation of Musicians (AFM), which represents 80,000 members of bands and orchestras, as part of Broadway productions and touring shows, provides group health insurance for freelance musicians. “The Affordable Care Act provided considerable relief to workers by requiring that health insurance be made available to them on a non-cancellable basis,” an AFM rep said in a statement, “but the ACA provided no meaningful relief for premium costs.” The plans offered through the academy and the AFM are similar to those on Obamacare state exchanges, according to Allsep.
Some major labels offer certain health-related benefits, if not actual insurance, to artists on their rosters. Sony and Universal Music Group (UMG) provide access to the Music Health Alliance, which offers expertise and suggestions on finding services elsewhere. Although reps for UMG and Warner Music Group did not respond to inquiries about health benefits, Sony artists can sign up for Artist Forward, which provides what the label calls “wellness solutions” like free counseling services.
Prior to its current offering, A2IM adopted a health plan from Zion Health Share, a Utah company that describes its membership as an “innovative and affordable medical cost-sharing community.” Its plan description stated, “This program is not insurance,” required participants to acknowledge that Zion “affiliates itself, and considers itself, accountable to a higher power” and limited care for people with preexisting conditions other than high blood pressure, high cholesterol or diabetes.
Several healthcare experts criticized the plan, including Allsep, Rosenthal and Valarie Blake, a West Virginia University law professor who specializes in healthcare policy. “I would not enroll unless I was a gambling man,” Blake says. When Billboard asked A2IM to comment on the Zion plan, Burgess said it was no longer available through A2IM. Representatives for Zion Health did not respond to email inquiries. “I am glad they changed course,” Blake says.
Academy CEO Harvey Mason jr. says he’s sympathetic to the A2IM’s healthcare efforts: “We’re all trying to figure this stuff out together,” he says. “It doesn’t matter who provides coverage. It’s the fact that people are signing up for coverage. That’s the win.”
But after reviewing A2IM’s current plans, Allsep cautions: “Buyer beware.”
The American Association of Independent Music, or A2IM, announced on Tuesday that artists who pay a $99 yearly fee will have access to healthcare benefits, including high-and-low-deductible plans, vision and dental, life insurance, renters’ insurance and even pet insurance. The program will expand from indie labels and other member companies to sole proprietors — “specifically designed for individual artists,” said Lisa Hresko, A2IM’s general manager.
“It’s a lot harder for artists to find available programs. What’s available to you is just more limiting in the U.S. if you do not have an employee-sponsored healthcare program,” Hresko added. “To have that option, whether you’re an artist or 1099 worker, should give you peace of mind.”
The healthcare plans, through the new A2IM Artist Pro program, are similar to Affordable Care Act options, but with “slightly more favorable pricing,” according to Hresko. Low-cost plans are available for $160 per month, or $260 for families, but they vary widely according to age, location and medical history. An average plan for a 40-year-old, relatively healthy individual ranges from $330 to $450 per month on the A2IM benefits website, depending on the deductible, a bit less expensive than a 2023 ACA plan.
In September, when the organization offered plans to its more than 600 indie-label member companies, about 30 signed up. The new program “definitely casts a wider net,” focusing on not just company employees but touring artists and others who have more complicated schedules than 9-to-5 employees.
“It’s exhausting on your physical and mental health to be on the road or keeping off-hours,” Hresko said. “Hopefully something like this gives people confidence and safety.”
After the Obama Administration’s signature healthcare plan became law in 2010, musicians were among the gig workers who suddenly no longer had to worry about insurance companies raising healthcare rates due to preexisting conditions. For most artists, the new A2IM plan will supplement the ACA as an option to achieve prescription drugs and emergency care, among other things. But Republicans have sharply attacked the ACA over the years, and programs like A2IM Artist Pro could be crucially important should the political winds change.
A2IM does not take a cut of the health-insurance payments, according to Hresko: “It’s a service for our members.”
She declined to name the organization’s health-insurance partner, to discourage members and potential members from “working their way around us.” Hresko adds: “We spent years searching for a correct partner. It was not a matter of a lack of trying, but what was available and who was willing to work with us. It took a while.”
Fat Joe is using his platform for a good cause.
The 52-year-old rapper flew down to Washington D.C. on Wednesday (April 26) as a spokesperson for Power to the Patients, which advocates for health care billing transparency. He spoke to a crowd at Capitol Hill, sharing how his hometown of NYC’s The Bronx has “protected” him throughout his life, and that he’s ready to help out the “voiceless” people in his community in return.
“They know they got somebody here who’s willing to step up and fight for their rights and fight for their families, fight for their health,” Fat Joe is heard saying in a clip shared by TMZ. “This is not a rocket scientist thing. Just show us the prices so we can know whether we want to go to this hospital or if we want to go to the other hospital.”
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Fat Joe, a longtime Power to the Patients supporter, is also set to perform at an event sponsored by the organization ahead of the White House Correspondents’ Association on Thursday (April 27), taking the stage alongside fellow rappers Busta Rhymes, French Montana and Rick Ross.
“It’s your right to know HOSPITAL PRICES,” the “Lean Back” rapper captioned a post on Instagram, in which he shared a number of snaps from his trip to the nation’s capital so far. See the post below.
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