This study examines the prospective implications of a national public policy allowing individuals, families, and smaller groups to purchase an “entrepreneurs” coverage policy free of the benefit mandates imposed by state laws.

The study finds that if such plans were offered to the public, enrollment would be about 8 percent or 16.8 million individuals—approximately 13.6 now covered by private policies and, conservatively, about 3.2 million now uninsured who are ineligible for government programs. At the state level, the projected entrepreneurs’ policy enrollment would range from a low of 1.6 percent of those insured privately or uninsured in Idaho, to a high of 11.9 percent in Rhode Island.

“Entrepreneurs’ coverage represents a sharp departure from the policy proposals dominating the current public discussion,” said Dr. Zycher. “The economic and political debate over health care reform as it has evolved in Washington has one clear characteristic: the absence of serious measures to make health care coverage less expensive for the country. If a federally chartered entrepreneurs’ health insurance policy is made available to the public, free of mandated requirements, there would be real cost savings for the nation.”

Entrepreneurs’ coverage could also improve health care by engendering competition in the market for health insurance, thus decentralizing decision making and offering patients greater choice. “This form of coverage could represent an important step toward restoring health insurance as protection against catastrophic events, rather than as prepayment for medical services, and improve incentives to economize on the consumption of medical services,” Dr. Zycher said.

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