Unavailable or expensive health insurance may hinder the transition of individuals from paid employment to entrepreneurship, a phenomenon called entrepreneurship lock. The literature argues that the guaranteed availability of health insurance introduced by the Affordable Care Act (ACA) in the USA in 2010 could reduce this barrier to entrepreneurship and thereby increase entrepreneurial activity. In this paper, we investigate to what extent entrepreneurship lock exists due to health insurance costs even when the availability of health insurance is given. We use individual-level data from the Current Population Survey (CPS-ASEC) combined with county-level panel data on health insurance costs in local health insurance exchanges (HIX) introduced by the ACA to estimate county-treatment fixed effects regressions. The results indicate that a hike in the premium of the benchmark HIX plan by 1% decreases the entry rate into self-employment by 0.76%. Men react more strongly to local HIX premiums than women. There is a stronger effect on starting incorporated businesses than on starting unincorporated businesses, which suggests that the additional businesses triggered by lower HIX premiums are of relatively high quality.

无法获得或昂贵的健康保险可能会阻碍个人从有偿就业向创业的转变，这种现象称为创业锁定。文献认为，美国 2010 年平价医疗法案 (ACA) 引入的健康保险保证可以减少创业障碍，从而增加创业活动。在本文中，我们研究了即使在提供健康保险的情况下，由于健康保险成本而存在创业锁定的程度。我们使用来自当前人口调查 (CPS-ASEC) 的个人数据，结合 ACA 引入的当地健康保险交易所 (HIX) 中关于健康保险费用的县级面板数据来估计县治疗固定效应回归。结果表明，基准 HIX 计划的保费上涨 1% 会使自营职业的进入率降低 0.76%。男性对当地 HIX 保费的反应比女性更强烈。对开办法人企业的影响比对开办非法人企业的影响更大，这表明较低的 HIX 溢价引发的额外业务质量相对较高。