Guide for Massachusetts Health Care Organizations and Providers Enrolling
Artists Working in all Disciplines into Health Care Reform Options
thank you for caring for Massachusetts artists and helping them navigate
the health care system and the new options under the Massachusetts Health
Care Reform Law. Your organization is a resource gate way for our population
for health care and other community based resources. If possible, please
refer artists to this web site designed for them: www.healthcareforartists.org
are using a broad and inclusive definition of artists working in all
disciplines. It encompasses: visual artists, film makers, musicians,
composers, writers, poets, playwrights, new media artists, crafts people,
actors, singers, performance artists, graphic designers, lighting designers,
dancers, choreographers, and the like. We have encouraged artists to
self-indentify that they are artists when they interact with you and
your organization. If possible, could you please keep count of how many
artists contact you and how many you can enroll into your programs.
This would be very helpful. We are trying to track the numbers for our
in-state purposes and for a national artists health care research project
we are collaborating on.
agencies and organizations have even designated a staff person to work
specifically with the artists population and we hope you will consider
doing this at your organization. For example, South
Boston Community Health Center has designated, Pat O'Keefe to be
the artists specialist and we urge artists who are in the SBCHC area
to request to meet with her.
artists are not eligible for Commonwealth Care or any of the other subsidized
health coverage programs. One key improvement of the ACA was that Modified Adjusted Gross Income (MAGI) is now the measure used to see if individuals are eligible for subsidies/tax credits to pay for their insurance. This is very helpful for those who are self-employed or have 1099 income. To learn what MAGI is: http://laborcenter.berkeley.edu/pdf/2013/MAGI_summary13.pdf
hopefully make it a little easier for you and the artists trying to
assess their income level and to see what programs they might be eligible
for, we have asked artists to think about their income in the following
Income only: A Full time job and/or multiple part time jobs and your
employer(s) takes out withholdings (i.e., social security, federal,
Medicare, etc.). They are paid on a regular basis by their employer(s),
these jobs may or may not be temporary, semester based or seasonal.
Their employer(s) issues them a W-2 form for your taxes. They are
not reporting any non W-2 income (freelance work, sales/commissions
from their artwork, grants, etc.) on their taxes. They may, however,
be reporting their art making expenses on their taxes. IMPORTANT to
know is that many artists do not have regular pay stubs, but may be
paid regularly by checks that do not have paystubs (i.e. the artist
may not know what their gross pay is before taxes via a pay stub).
Income: Their income is a combination of W-2 income (could be a full
time job and/or multiple part-time jobs that are yearly, semester
based and/or seasonal or any combination), grants, commissions, money
earned from selling work/performing, 1099 income/freelance work, visiting
artists engagements, and/or some self employment income. They may,
however, be reporting their art making expenses on their taxes, and/or
they are reporting their businesses expenses of being self-employed
(which may or may not be their art making expenses). If they are not
counting their businesses and/or art making expenses on their taxes
you may want to urge them to speak to an accountant to have them prepare
their income taxes. AGAIN it is important to know that many artists
do not have regular pay stubs, but may be paid regularly by checks
that do not have pay stubs (i.e. the artist may not know what their
gross pay is before taxes via a pay stub).
W-2 Income/Self-Employed Income only: All moneys earned are non W-2
income. They may, however, be reporting their art making expenses
on their taxes, and/or they are reporting their businesses expenses
of being self-employed (which may or may not be their art making expenses).
If they are not counting their businesses and/or art making expenses
on their taxes you may want to urge them to speak to an accountant
to have them prepare their income taxes. These artists will not usually
have regular pay stubs to determine their income by.
KEY Information on artists
artists do not hold one 9-5 job, but rather have combination sources
for their income (multiple part-time jobs that are semester based
and not yearly based, freelance income, contract jobs, self employed
income, grants, etc. They usually don't have regular pay stubs to
determine their income.
artists have very fluid employment patterns. For example, they may
have a job that offers them insurance for part of the year (a contract
teaching job) and then the second part of the year they have a different
job that does not offer them insurance. So many artists will be in
and out of employer based health insurance plans.
majority of artists are self-employed, have multiple part-time jobs,
and/or have combination income and thus do not have access to health
insurance from an employer or for that matter any of their employers.
And those who are offered insurance from their employers, usually
can't afford it.
income not only fluctuates from year to year, but from month to month.
This has proved problematic for this population to be processed to
see if they are indeed eligible for the existing free care system
and sliding scale fee-based system used by health care providers in
will be important to keep the above issues in mind when creating a system
to enroll artists into your system. We urge you to create a process
those that can not only enroll people who hold one job, but a system
that can also process artists and those who do not have regular pay
stubs. You may need to consider creating a specific
form or process to be used by artists who have multiple sources
of fluctuating income and/or do not have regular pays stubs to assess
their income. Contact the South Boston Community Health Center/ Pat
O'Keefe for more information on their process (617-269-7500).
general, insurance presently available to artists is usually economically
out of reach for them. Many cannot afford the premiums for Commonwealth
Care/subsidized plans-those who are eligible for it and those who are not.
population also has very very limited discretionary income, so the very
notion of affordable needs to be actively discussed (i.e., they often
can't afford the prescriptions or even the co-pays).
population has been bartering for health care and health services for
years (for example during early years of the HIV/AIDS crisis in this
country, many visual artists were trading art work as a payment for
their health care).
Background on artists:
Please read the Fall 2009 report on Massachusetts Artists, Stand Up and Be Counted. It contains very important information on health care issues impacting artists. Artists have their own health care issues directly related to their
the vast majority of artists working in all disciplines in the state
are weighing whether it makes sense to stay in the state due to the
high costs of living here. As highlighted in the 10/29/06 Boston Globe
Sunday Magazine's cover story, RI is successfully courting our artists,
arts organizations, and other businesses that make up our creative economy.
The Artists community is already at a tipping point and they are ready
to and have started to relocate to other states.
vast majorities of living/contemporary artists of all disciplines -with
the exception of the few who have become "stars" - cannot
and do not earn a living from their work as artists and must have supplementary
jobs to supply their income whether those jobs are teaching positions
and/or jobs in fields not related to their artistic discipline.
pay out a significant amount of their gross income to their art making.
The largest subsidy to the arts in this country does not come from the
government or private sector but from artists from their unpaid labor,
underpaid labor, and from them subsidizing their art making with their
own income. Also due to the costs artists incur from making their work,
gross income is not a fair way to assess an artist's income. After business
tax income is a fairer way to assess an artist's income (line 22 on
the federal income tax form if they are even able to do this-some only
have W-2 income that is not related to their art making and can't do
deductions). Again we urge that perhaps a special form could be made
for artists and those who are self-employed.
are the working poor of the art world, yet they are foundation of creative
economy that everyone benefits from. In general, artists live on the
edge economically and any major shift or new unforeseen cost could severely
and negatively impact an artist. The foundation of the creative economy,
our artists community, is a very fragile and fluid one.