This Wednesday, December 4th, is the deadline to sign up for health insurance under the new Affordable Care Act. It's intended to offer options for people who've been left out of the traditional insurance market.
But the state is making an outreach effort to convince musicians and other creatives to sign up and use the new online marketplace.
Jeremy Wilson became one of Oregon's best known rock musicians during the 90s. He's undergone four surgical procedures to correct a heart defect.
He was born with this congenital heart condition, and spent his teens, twenties, and thirties playing in breakout acts like Pilot, and the Dharma Bums. But all those years, he wasn't really OK. "When I would pass out," Wilson recalls, "I would go, 'Oh, that's got to be from exhaustion, dehydration and these things,' rather than, as a doctor finally told me, 'No, my son, there's something seriously wrong with you.' "
Eventually the blackouts were coming about every two weeks. Wilson was sort of settled down at this point - he'd started a recording studio and was eight years into the business. That's when he was diagnosed with something called Wolfe-Parkinson-White Syndrome. It makes his heart beat in a weird, irregular way.
"A whole bunch of emotion came up when I was sick," he recalls. "I didn't have health insurance, because I was an independent contractor. And to have a $500 or $600 a month bill - a third of my own income every month was totally out of reach. The minute I was diagnosed with the heart condition, I was no longer eligible for health insurance in the first place."
Wilson started the non-profit foundation that bears his name. It began as a way to avoid selling his recording studio. But it became a relief organization for sick musicians, delivering several thousand of dollars in financial aid ever year.
Jeremy Wilson is really lucky. He had a lot of friends - musician friends - who did benefit shows for him. He's not in debt. But here's the thing: despite the fact that his heart defect has been corrected, despite his years of advocacy for others, he still can't get insurance himself.
Wilson says, "I do think it's weird that I've had to dedicate seven solid years of my life to get the health care I've needed. It's like so many musicians who work so hard, and are such important cultural aspects for our communities. I haven't put a record out in that period of time. It's kind of intense."
That's why Wilson helped organize an info session in October at the Doug Fir Lounge in Portland.
Musicians were invited to ask questions, and get ready to sign up. At the info session, the communications chief for Cover Oregon, Amy Fauver said going forward, working musicians will be able to buy at cheaper rates through the new health care exchange. And she said there would be more options for those who are barely getting by to join the Oregon Health Plan. "The wait lists will go away, and it's really terrific insurance," she told the audience.
Lots of people at the forum expressed interest in signing up - and not all of them presented as rock & rollers in the Jeremy Wilson vein.
Jamie Vandenberg is a piano teacher who also plays around town: accordion in an Irish band, organ in several churches, and any random piano gig she can find. She owns her own home. She makes about $22,000 a year. "I don't have a lot of debt," she says, "I don't have a lot of overhead. I don't have expensive habits, and I have a thirty-year old car."
It's been five and a half years since she had health insurance. "At first it didn't feel like anything because I was younger, but I'm 38 now, and I feel it sometimes in the morning. I don't rebound from illnesses as quickly."
One of the challenges with the new health care system is very much present in Oregon's creative community.
Marshall and Jessica Serna aren't playing music professionally now, but they have in the past. She's a bartender, he's a free-lance photographer's assistant. They've paid thousands of dollars out of pocket for various medical problems.
Marshall Serna says they're ready to try Cover Oregon. They're in their late 30s. But he knows there are a lot of other musicians who might not be prepared to shell out even two- or three-hundred dollars per month.
"One of the hard sells for this whole thing," Serna observes, "is there are a lot of healthy young people that it's going to be difficult for them to see the value of buying into this program."
Right now, the state and federal governments can't guarantee that anyone who does want to sign up will be able to do so online - although the state is encouraging people to submit applications on paper, to meet the December 4th deadline for 2014 coverage.
TJ Sullivan is an insurance agent in Salem. He has a number of musicians among his customers and says, to the extent musicians can prioritize health care, they should. "I see a lot of them are used to doing things by themselves. But I think the best thing they can do is find someone who's licensed, a broker," Sullivan says. "But they've got to make a love connection with them. You gotta find somebody that gets you."
Sullivan says, beyond the plans created in response to the ACA, there are health savings accounts.
There's a family health insurance assistance plan that subsidizes coverage for the working poor.
Some options, like the Oregon Medical Insurance Pool, are going away. But Sullivan says it's incredibly important to try to navigate the new market wisely.
The needs are immediate. Even as Cover Oregon was explaining the new system to musicians at one club on the night of the town hall meeting, another venue was trying to help a musician with a health care crisis in progress. A standing-room only crowd bought tickets for a benefit show at Jimmy Mak's to help out LaRhonda Steele, who's sung blues and funk around town for years. She's undergoing treatment for Stage Three breast cancer.
Steele's two teenaged daughters, both serenaded their her mother at the benefit.
Tracy Pain and Susan Mills organized this show. They're both married to musicians and started putting together benefits as a for-profit company, Soul Sister Productions.
"It's kind of like a domino effect," Pain says. "Some can't drive. Some have children. When they are sick, they can no longer book gigs, their bands fall apart.
Mills chimes in, "They can't pay their mortgage."
"Right," says Tracy. "We try to also find resources to help them."
Sometimes Pain and Mills get people connected with MusiCares, a charity run by the Recording Academy. There are a few other charities, many geared to help specific genres of musicians, like older jazz or blues musicians. But overall, Mills says the need dwarfs the available resources.
Susan "There's not a lot of options for people who are uninsured and underinsured."
Hence the benefit shows. Tracy Pain says they're interested to see how the Affordable Care Act might change things. She gestures toward the honoree of their benefit, LaRhonda Steele. "LaRhonda is Portland's sweetheart," she says. "She has done so much to contribute to the music community."
When blues singer Linda Hornbuckle* was diagnosed last year with kidney cancer, it was LaRhonda who stepped in to front Linda's band.
"Mark Young, her husband, called me in tears," Steele remembers. "He asked me to keep it to myself. He said 'We just don't' know what we're going to do. Can you help the band cover these gigs?' And I cried with him and I said, 'Of course'.
And for her to come and sing for me, it's all so surreal, It's almost too much to take in."
The reality is that health care is only one part of the safety net that many musicians and creatives do without.
LaRhonda Steele's breast cancer diagnosis immediately qualified her to get on the Oregon Health Plan. But that's not automatic. While breast cancer - is covered. Other diseases, like like Linda Hornbuckle's kidney cancer - are not.
Steele's chemotherapy often leaves her unable to get out of bed. That means gigs lost, with mortgage bills waiting, two daughters to be fed, a car to insure, and a host of other bills.
"Throughout the course of my career, I have been frightened", she says. "I've sought straight jobs, because of the security of it. Getting that paycheck and knowing that this is where you show up, this is how much you're going to get, rather than looking at a calendar as a musician, and looking at four weekends when you don't have gigs."
But Steele always came back to singing.
"Music is my life. I know what it's done for me, it's what I want to continue to do for others. What we do is necessary, it's healing, it's powerful. I would hope for a society that would support us during the times we need it."
Whatever happens after January 1st, when the Affordable Care Act takes effect, it won't be for lack of interest among the creative communities the state says it wants to enroll in the new market.
(April's note - interesting article here with tips on what to look for during exchange shopping.)
* (editor's note - This story originally mis-identified one of the singers at the benefit. It was Arietta Ward. OPB regrets the error.)