How Medicaid Helps Artists Stay in Good Health and Remain in the Limelight

By night, Lisa Lynn Kotnik was living her dream, using her voice to entertain others on the New Orleans club circuit. By day, she was living a nightmare.

Kotnik, who couldn’t afford health insurance, was fighting fibroids, ovarian cysts, and a brain aneurysm. After five surgeries, her medical woes had transformed into financial ones.

But no longer. On July 1, Healthy Louisiana, the state’s expanded Medicaid program, began offering low-cost, comprehensive coverage. After a visit soon after to the New Orleans Musicians Clinic, Kotnik finally signed up for health insurance.

Beyond helping Kotnik and millions of other working-class artists, expanding Medicaid will boost the nation’s economy via the arts. The arts contribute nearly $700 billion annually to the United States’ gross domestic product. Artists also catalyze job creation, with each job opening in the arts creating an estimated 1.6 jobs elsewhere.

A creative class that lacks health insurance is not a creative class that can contribute to the economy. Medicaid expansion can help keep the arts — which are essential to the health of any city, state, or nation’s economy — alive.

America’s Artists Are Struggling

Being a working-class musician can mean living paycheck to no paycheck. That day-to-day, week-to-week, touring lifestyle can sometimes lead to long-term health problems. Then, when funds run dry, the associated medical bills can become crippling.

But it’s not just artists and musicians feeling the pinch. According to a recent survey of the Authors Guild, 56 percent of respondents would live below the poverty line if the were to rely solely on writing income. In recent years, it has only gotten worse: From 2009 to 2014, the Guild reports authors have experienced an income drop of 24 percent. It should, therefore, be unsurprising that artist unemployment was over two times the rate for all professionals.

Even the successful, however, aren’t spared from high healthcare costs. Despite a successful career, Dick Dale isn’t retired. Rather, the 79-year-old rocker who inspired Jimi Hendrix and Eddie Van Halen is forced to tour. Dale’s daily insulin shots and ongoing medical expenses cost the musician a whopping $3,000 per month.

Nonprofits Sweet Relief and MusiCares provide help to ailing artists, but philanthropy simply can’t fill all the gaps. To care for America’s culture builders, it’s time to expand Medicaid nationwide.

Where Is Medicaid Needed Most?

Nationwide, Medicaid expansion would provide much-needed support to America’s artists. Public funding for the arts has decreased drastically in the past 20 years. In 2014, just 4 percent of arts funding came from public sources. With inflation factored in, arts funding has decreased about 26 percent since 1995.

Without Medicaid expansion to help keep them afloat, America’s arts (and artists) are particularly struggling in these states:


In Alabama, both Medicaid and the arts are hurting. As of Aug. 1, Alabama will no longer provide “enhanced payments” to doctors for primary care doctors and services.

Funding for cultural groups has also been cut year after year, and all signs point to even less funding next year. How does that affect Alabama’s arts? Take the Mobile Opera. The opera received a subsidy from the city of Mobile, Alabama, for the past 50 years — until late 2015. “The city has always been proud of and quick to point out to the international industries and visitors that Mobile has a professional opera and symphony and ballet as well as quality theater,” opera manager Scott Wright said. “Yet, when it comes time to put money where your mouth is, (the city) no longer values it.”


Florida Gov. Rick Scott recently approved $33 million for arts and culture. This sounds great — until you take a closer look. Last year, the Sunshine State allocated $34.8 million to the arts. And that figure represented a 47 percent cut from the previous year.

Rapidly declining public funding means venues host fewer performances, galleries close down, and tourists leave for more cultured destinations. Without Medicaid or sufficient work, Florida’s artists are struggling.


The arts in Kansas, it would seem, are on their last breath. Gov. Sam Brownback signed an executive order back in 2012 abolishing the Kansas Arts Commission. The commission has since been restored, but funding has fallen from $1.7 million in 2008 to just $188,000 this year. To shore up its budget, the Arts Commission has struggled to secure some $800,000 in external grants.

Brownback has also been one of the nation’s staunchest opponents of Medicaid expansion. By denying Medicaid expansion in Kansas, Brownback lost the state about $72 million in federal funding this year.

States and artists have much to gain by expanding Medicaid. To revive the arts, boost their economies, and care for their culture creators, non-expansion states must embrace Medicaid expansion.

Image via Utah Public Radio / Skip Bolen

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