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, fighting fibroids, ovarian cysts and a brain aneurysm. Five surgeries later, and her medical pains transformed into financial ones. As an artist, money ebbs and flows with the seasons, and she says health insurance is too expensive to maintain.

No longer. As of July 1 of this year, Louisiana’s rolled out its expanded Medicaid programavailable under the Affordable Care Act. She could be seen at the New Orleans Musicians Clinic, finally signing up for the insurance she so desperately needs.

Beyond helping Lisa—and hundreds of thousands of Louisiana’s working poor—providing health insurance to artists working below the poverty line will help the American economy as a whole. Sound like a stretch? Well, in 2012, the arts contributed approximately $700 billion to our economy, according to the Miami Herald. Arts also vitalize job creation, with each art-focused job creating an estimated 1.6 additional jobs elsewhere. Book signings, concerts and gallery openings drive profits for surrounding restaurants and businesses.

And, a creative class that lacks health insurance is not a creative class that can contribute to the economy. Medicaid expansion can keep America’s arts—which is essential to the health of any city’s economy—alive.

America’s independent artists, musicians, and writers struggle to afford healthcare coverage

With royalties evaporating before artists’ weary eyes, living as an artist has become synonymous with living paycheck to no paycheck. That day-to-day, week-to-week lifestyle can cause long-term health problems. And, the associated medical bills can become crippling when your funds run dry.

A recent survey of the Authors Guild drives the severity of this issue home. 56 percent of respondents are drowning below the poverty line if they solely relied on their income from writing. What’s more from 2009 to 2014, authors have experienced an income drop of 24 percent. It should, therefore, be unsurprising that the primary artist unemployment rate was over two times the rate for all professionals. Side performers are hit the hardest because of the tendency of the entertainment industry to protect only the stars. Still, sometimes even the successful aren’t spared.

Dick Dale, the revered guitarist hailed for inventing surf music and serving as inspiration for such artists as Jimi Hendrix and Eddie Van Halen. Despite a successful career, however, Dale isn’t retired. Rather, the 79-year-old is forced to travel coast to coast in order to make the $3,000 per month he needs to pay his medical bills.

Sweet Relief and MusiCares are fighting to bridge the gap, but Medicaid expansion on a grand scale is needed to secure benefits and aid for the working musicians affected.

How Medicaid Can Help Revive American Arts

Funding for the arts seems to be cut left and right. In fact, only 4 percent of all arts funding came from public sources in 2014. Funding hasn’t kept up with inflation, and has decreased drastically in the last 20 years. Unfortunately, these cuts aren’t isolated. Cuts to the arts affect the vitality of a city’s economy as a whole. Here are three non-expansion states where the arts (and artists) are struggling.

1. Alabama
Take Mobile, Alabama, for instance. Funding for cultural groups, including the symphony and opera, has continued to fall year after year, and all signs point to an even lower figure next year. Mobile Symphony Orchestra president asserts that governments should continue to support the arts, because when they don’t, businesses will follow.

2. Florida
Florida governor recently approved $33 million for arts and culture. This sounds great, until you take a closer look. Last year, $34.8 million was approved. And that figure represented a 47 percent cut from the previous year. This downward trend will affect artists such as Kotnik. With no public funding, artist will struggle to make it day to day, much less pay for health insurance.

3. Kansas
Arts in Kansas, it would seem, are dead. The Kansas Arts Commission’s budget is down 73 percent. Without the money to run culturally important arts programs, the Commission will almost definitely have to cut programs.

Artists have much to gain through Medicaid. In addition to reducing medical costs and rates of chronic diseases, Medicaid expansion could promise economic turnaround. In Louisiana, for example, it is reported that there have been 2.5 million cases of chronic illnesses such ascender and heart disease. This led to $17.4 billion in economic losses. Medicaid expansion can aid in turning this crisis around. More than saving money, though, Medicaid expansion could change—and save—lives.

I wrote this piece as a freelance writer for Influence & Co. for Benjamin Geyerhahn of Benestream.