"The creative economy" is a polite way of saying you have no job and no money to pay your bills, much like Democrat Underground refers to itself as the reality-based community.
While that's not really a fair shot, Pelosi had to have been on drugs (Even more powerful ones than usual) when she said that nonsense. There is no connection whatsoever between having an unpredictable income due to your work being in performing or visual arts, or any other long-delays-between-variable-paydays kind of work and the ability to obtain insurance...and to the extent any connection could be made, it would all be to the disadvantage of ACA since these are the folks who would intentionally buy only the kind of insurance they were most likely to need, rather than one with a minimum premium based on every chronic or genetic disease and every possible condition known to either sex at any stage in their lives in a single unified price point.