The Office of the Mayor of Saint Paul engaged four students at the Humphrey School of
Public Affairs at the University of Minnesota to research the viability of a small business health
insurance pool. It was believed that creation of a citywide insurance pool for small businesses
could reduce costs.
Based on our research, our findings suggest that it is not viable for the City of Saint Paul
to pursue the creation of a small business health insurance pool due to current legal, political,
and economic conditions and realities. However, we understand that the larger goal of this
research was not just to evaluate the viability of insurance pools but to examine the landscape
for opportunities to lessen the burden of health care costs for small businesses while
maintaining consumer protections and quality of the plans offered.
We have identified two opportunities for the Mayor and his office to provide leadership
to address the problem. We found in our interviews with small business owners that there is a
need for more clarity and quality in the information available to business owners when they
choose their plans. The creation of an Information Hub, or supporting the establishment of one
by a third party, is a way that the City can directly address this specific issue. Additionally, there
is an opportunity to create positive change by leading a coalition of cities and business
association leaders in an effort to change laws at the state level to provide more flexibility for
small businesses to access cheaper, high‐quality health insurance plans.
Professional paper for the fulfillment of the Master degree.
Coulter, Nathan; Dickinson, Jack; Miles, Benjamin; Richardson, Elizabeth.
Forging a New Path: Opportunities to Lead on Small Business Health Insurance.
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